West C G, Reed D M, Gildengorin G L
Buck Center for Research in Aging, Novato, California 94945, USA.
J Am Geriatr Soc. 1998 Jan;46(1):49-57. doi: 10.1111/j.1532-5415.1998.tb01012.x.
To determine if the inverse association between depressive symptoms and income reported in predominantly low- and middle-income older populations is present in a more affluent population of older adults and to determine if this pattern is independent of other known correlates of depressive symptoms such as medical problems, physical disability, and social support.
Cross-sectional analysis within a prospective cohort study.
An ongoing, community-based cohort study conducted by an independent research institution in an affluent Northern California county.
A total of 1948 randomly selected, noninstitutionalized county residents 55 years of age and older who completed the baseline questionnaire and physical performance tests.
The outcome measure was high level of depressive symptoms (score > or = 16) using the Center for Epidemiologic Studies-Depression scale (CES-D).
The prevalence of high levels of depressive symptoms (CES-D score > or = 16) was lower than in most other population-based samples using an identical CES-D scale. In age-adjusted, sex-specific analyses, increasing income level was associated significantly with lower levels of depressive symptoms, but the nature of the relationship appeared quadratic rather than linear (Men: odds ratio (OR) income .80, 95% confidence interval (CI) .68-.94; income2 OR 1.006, 95% CI 1.001-1.011. Women: OR income .80, 95% CI .69-.91; income2 OR 1.007, 95% CI 1.002-1.011). In multivariate regression analyses including potential confounding risk factors, the magnitude of the association between depressive symptoms and income decreased and was not statistically significant when measures of health conditions, physical disability, and social support were included in the model (Men: OR income .90, 95% CI .75-1.06; income2 OR 1.003, 95% CI .998-1.009. Women: OR income .90, 95% CI .78-1.05; income2 OR 1.003, 95% CI .998-1.008).
These findings suggest that poor health, physical disability, and social isolation are the major factors responsible for the observed inverse relationship between income and symptoms of depression in affluent, as well as economically disadvantaged, older populations.
确定在以低收入和中等收入为主的老年人群体中报告的抑郁症状与收入之间的反向关联在更富裕的老年人群体中是否存在，并确定这种模式是否独立于抑郁症状的其他已知相关因素，如医疗问题、身体残疾和社会支持。
前瞻性队列研究中的横断面分析。
由一家独立研究机构在加利福尼亚州北部一个富裕县进行的一项正在进行的基于社区的队列研究。
总共1948名年龄在55岁及以上的随机选择的非机构化县居民，他们完成了基线问卷和身体性能测试。
使用流行病学研究中心抑郁量表（CES-D），结果测量指标为高水平抑郁症状（得分≥16）。
使用相同的CES-D量表，高水平抑郁症状（CES-D得分≥16）的患病率低于大多数其他基于人群的样本。在年龄调整的、按性别分层的分析中，收入水平的提高与较低水平的抑郁症状显著相关，但这种关系的性质似乎是二次曲线而非线性（男性：收入的优势比（OR）为0.80，95%置信区间（CI）为0.68 - 0.94；收入²的OR为1.006，95% CI为1.001 - 1.011。女性：收入的OR为0.80，95% CI为0.69 - 0.91；收入²的OR为1.007，95% CI为1.002 - 1.011）。在包括潜在混杂风险因素的多变量回归分析中，当模型中纳入健康状况、身体残疾和社会支持的测量指标时，抑郁症状与收入之间关联的强度降低且无统计学意义（男性：收入的OR为0.90，95% CI为0.75 - 1.06；收入²的OR为1.003，95% CI为0.998 - 1.009。女性：收入的OR为0.90，95% CI为0.78 - 1.05；收入²的OR为1.003，95% CI为0.998 - 1.008）。
这些发现表明，健康状况不佳、身体残疾和社会隔离是在富裕以及经济处于不利地位的老年人群体中观察到的收入与抑郁症状之间反向关系的主要因素。
