健康与遗传心理学研究室知识库

研究目的

通过对蚌埠城市和农村老年人抑郁情绪进行流行病学的横断研究，了解当地老年人抑郁情绪的发生情况，分析城乡老年人抑郁情绪检出率及其在各个特征群体(社会人口学特征、经济状况、躯体健康情况、生活方式)中分布的特点，探讨城市和农村老年人抑郁情绪的影响因素及其异同。为减少蚌埠地区老年人抑郁情绪的发生及恶化，做好城乡老年人抑郁情绪的预防及早期干预，调配城市和农村资源，促进城乡老年人生活质量及健康水平全面提高，提供科学的决策依据及理论参考。

研究方法

现场调查:采用方便取样的方法，选取蚌埠城市及农村>60岁常住老年人599人(城市388人，农村211人)。使用简版的流调中心抑郁量表(CESD 10 )进行抑郁情绪筛检(得分>10为有抑郁情绪);使用自编的基本情况调查问卷了解城乡老年人的社会人口学特征、经济状况、躯体健康情况、生活方式等情况。

统计分析:采用SPSS22.0统计软件对调查数据进行统计分析及相关处理。以描述性分析的频数及比率表示抑郁情绪的检出情况。使用x2检验((P<0.05)比较样本基本情况及抑郁情绪检出率的城乡差异，比较抑郁情绪检出率在各子群体上分布的城乡差异。采用x2检验(P<0.05)、二项logisti。回归模型分析抑郁情绪的影响因素。

研究结果

Cl)x2检验((P<0.05)显示:城乡老年人的性别、年龄、居住状况、慢性病数、日常活动能力及饮食习惯差异不显著;与城市老年人相比，农村老年人在受教育程度低、体力劳动、居住满意度低、钱不够用、贫穷、身体健康自评不好、既往病史少、生活自理能力差、不参加劳动、极少身体锻炼及社会活动少的比例较高。

C2)描述性分析显示:蚌埠老年人抑郁情绪检出率为24.5%，城市老年人抑郁情绪检出率为17.5%，农村老年老年人抑郁情绪检出率为37.4% 。

C 3 ) x2检验显示:农村老年人抑郁情绪检出率显著高于城市老年人抑郁情绪检出率(P<0.001)。男性、低龄、体力劳动、与配偶同住、富裕程度自评一般、慢性病数少、既往病史少、生活自理能力好、日常活动能力好、参加劳动、社会活动少、荤素平衡的农村老年人抑郁情绪检出率相对于相应群体的城市老年人较高(P<0.001)。对于城市老年人来说，女性、没受过教育、无配偶同住、居住满意度一般、钱不够用、贫穷、身体健康自评不好、慢性病多、既往病史多、生活自理能力差、日常活动能力差、不参加劳动、极少身体锻炼、社会活动少的老年人的抑郁情绪检出率相对更高(P<0.05 );对于农村老年人来说，居住不满意、钱不够用、贫穷、身体健康自评不好、生活自理能力差、日常活动能力一般、不参加劳动的老年人的抑郁情绪检出率相对更高(P<0.05 ) 。

(4)二项logisti。回归分析(全体样本)显示:以性别、年龄、受教育程度、职业性质、居住状况、钱是否够用、富裕程度自评、身体健康自评、慢性病数、既往病史、生活自理能力、日常活动能力、劳动情况、身体锻炼、社会活动及饮食习惯为自变量，老年人抑郁情绪是否发生为因变量，并加入户籍变量为自变量，控制其它变量的混杂效应后，农村老年人抑郁情绪问题的危险性是城市老年人的1.73倍。

(5)二项logistic回归多因素分析(城市组和农村组)显示:城市老年人抑郁情绪的危险因素包括女性、居住满意度一般、身体健康自评不好、贫穷、既往病史多、日常活动能力差、社会活动少;农村老年人抑郁情绪的危险因素包括居住满意度一般、身体健康自评不好、贫穷、生活自理能力差。

研究结论

蚌埠老年人的抑郁情绪存在着显著的城乡差异，农村老年人抑郁情绪的发生更为普遍，而影响城市老年人抑郁情绪发生的因素更为复杂多样。老年人抑郁的预防应注重城乡间的差异，采取多元多渠道的干预措施，加大农村基础设施建设、资源配置的力度。

Objactive

Through the mental disorder epidemiological survey of the urban and rural elderly in Bengbu, finding out the prevalence of depressive emotion in elderly; comparing the prevalence of depressive emotion in urban and rural elderly, and their distribution characteristics (sociodemographic characteristics, economic status,physical condition, life style)9 discussing the influencing factors of depressive emotion in urban and rural elderly, and analyzing the similarities and differences between them; these provides scientific basis of decision making and theoretic reference for the early intervention of depressive .emotion and resources allocation, promoting the life quality and health level in urban and rural elderly Bengbu, to reduce the prevalence and danger of depressive emotion in urban and rural elderly Bengbu.

Methods

Field Survey: The convenient sampling procedure was used to collect 599 samples (388 from urban and 211 from rural) aged 60 years and older in Bengbu. Depressive emotion were evaluated by the 10-item short form of the Center for Epidemiologic Studies Depression Scale (with a cutoff score≥10). Basis situation about sociodemographic characteristics, economic status, physical condition, and life

style were examined by self made questionnaires. Statistical Analysis: Statistical software SPSS22.0 was used to analyze data and correlative processing. The descriptive analysis was used to describe the frequency and ratio of depression emotion in elderly. The x² test (P<0.05) was used to compare the basis situation and prevalence of geriatric depressive emotion in the urban and rural elderly, to compare the distribution characteristics of the populations with depressive emotion in urban and rural. The x² test and binary logistic regression model were used to analyze the risk factors of the depressive emotion in the urban and rural elderly.

Results

(1) x² Test (P<0.05) show: There were no significant differences in the gender, age, 1iv ing status, chronic diseases, daily activities and dietary habit between rural and urban cldcrly9 compare to the urban elderly, the lower educational level, manual labor before retirement, low residential satisfaction, not enough money, poor, bad self i0atcd physical health9 less past illnesses9 self-care inability, not participate labor, less physical exercise and social activities limitation of rural elderly have a higher proportion

(2) Descriptive Analysis show: The prevalence of depressive emotion in Bengbu elderly was 24.5%, and the prevalence of depressive emotion in rural elderly was 37.4% while urban elderly was 17.5%.

(3) x² Test show: The prevalence of depressive emotion in rural elderly was significantly higher than their urban counterparts (P<0.001).The prevalence of depressive emotion in male, younger, manual labor before retirement, living with spouse, acceptable prosperity condition, less chronic diseases, less past illnesses, strong self care ability, strong daily activity ability, participate labor, less social activities, balance meat and vegetable in rural elderly were significantly higher than their urban counterparts ( P<0.001).1~ or urban areas, the elderly with female, no education, living without spouse, residential satisfaction acceptable, not enough money, poor, bad self-rated physical health, more chronic diseases, more past illnesses, poor self-care ability, poor daily activity ability, not participate labor, hardly ever physical exercise, less social activities had significantly higher prevalence of depressive emotion (P<0.05)，while for rural areas, the elderly with residential dissatisfaction, not enough money, poor, bad self-rated physical health, poor self-care ability, poor daily activity ability, not participate labor had significantly higher prevalence of depressive emotion (P<0.05).

(4) Binary Logistic 1Zegression Analysis (to all samples) show: The risk of depressive emotion in rural elderly is 1.73 times of urban elderly, after controlling the mixed effects from each other (variables) by taking gender, age, education level, job,living status, residential satisfaction, do you have money enough, wealth status,self-rated physical health, chronic diseases, past illnesses, self-care abilities, daily activities, labor participation, physical exercise, social activities and dietary habit as independent variables, and whether depressive emotion will happen as a dependent variable, and household register as independent variable was adding.

(5) binary Logistic Regression Analysis (samples were divided to urban group and rural group) show: female, acceptable for residential satisfaction, bad self-rated physical health, poor, more past illnesses, daily activity limitation, seldom participate social activities are the risk factors to urban elderly, while acceptable for residential satisfaction, bad self-rated physical health, poor, poor self-care ability are the risk factors to rural elderly.

Conclusion

The depressive emotion in urban and rural elderly of Bengbu had significant differences. Rural elderly had higher prevalence of depressive emotion, while more factors affecting the depressive emotion happen to urban elderly. The different prevalence/risk factors of depressive emotion between urban and rural elderly should be paid more attention and diversity measures should be adopted during depressive emotion intervention, and, the infrastructure construction and resource allocation in rural must speed up.