内科

目的了解我国农村老年人抑郁症状的流行现状，并分析其相关因素。方法基于中国健康与养老追踪调查（CHARLS）2020年的数据，选取5 208名≥60岁的农村老年人为研究对象。采用流行病学研究中心抑郁量表（CESD-10）评估抑郁症状，总分≥10分定义为存在抑郁症状。根据评估结果将研究对象分为抑郁症状组与无抑郁症状组。采用单因素logistic回归初步筛选变量，再使用LASSO回归进一步压缩变量集，最终采用多因素logistic回归模型分析抑郁症状的相关因素。结果共纳入5 208名农村老年人，其CESD-10评分为9.0（6.0，15.0）分。其中，抑郁症状组2 538人（48.7%），CESD-10评分为15.0（12.0，19.0）分；无抑郁症状组2 670人（51.3%），CESD-10评分为6.0（3.0，7.0）分。单因素分析显示，13个变量与抑郁症状相关（均P<0.05）。LASSO回归筛选出性别、半年内独居时间、慢性病数量、夜间睡眠时长、自评健康状况和生活满意度6个变量纳入多因素模型。多因素分析结果显示，女性（OR=1.65，95%CI：1.47～1.86）、半年内独居时间（1～60 d：OR=1.28；61～120 d：OR=1.43；>120 d：OR=1.25）、慢性病数量（1种：OR=1.21；2～3种：OR=1.45；≥4种：OR=1.91）、夜间睡眠时长（OR=0.90，95%CI：0.88～0.93）、自评健康状况（一般：OR=1.67；不好：OR=2.41；很不好：OR=3.55）及生活满意度（比较满意：OR=1.34；不太满意：OR=3.50；一点也不满意：OR=2.73）均与农村老年人抑郁症状呈独立相关（均P<0.05）。结论我国农村老年人抑郁症状检出率较高。性别、独居时间、慢性病数量、夜间睡眠时长、自评健康状况及生活满意度是该人群抑郁症状的独立相关因素。

Objective To understand the prevalence of depressive symptoms among rural elderly in China and analyze its associated factors. Methods Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) 2020, 5,208 rural elderly aged ≥60 years were selected as the research participants. The Center for Epidemiologic Studies Depression Scale-10 (CESD-10) was used to assess depressive symptoms, and a total score ≥10 was defined as the presence of depressive symptoms. According to the assessment results, the research subjects were divided into the depressive symptom group or the non-depressive symptom group. Univariate logistic regression was used for preliminary variable screening, followed by LASSO regression for further variable set reduction, and multivariate logistic regression model was employed to analyze the factors associated with depressive symptoms in the end. Results A total of 5,208 rural elderly were included, with a CESD-10 score of 9.0 (6.0, 15.0). Among them, 2,538 cases (48.7%) were in the depressive symptom group, with a CESD-10 score of 15.0 (12.0, 19.0); 2,670 cases (51.3%) were in the non-depressive symptom group, with a CESD-10 score of 6.0 (3.0, 7.0). Univariate analysis showed that 13 variables were associated with depressive symptoms (all P<0.05). LASSO regression screened out 6 variables, including gender, duration of living alone in half a year, number of chronic diseases, nighttime sleep duration, self-rated health, and life satisfaction, which were included in the multivariate model. The results of multivariate analysis showed that female (OR=1.65, 95% CI: 1.47-1.86), duration of living alone in half a year (1-60 days: OR=1.28; 61-120 days: OR=1.43; >120 days: OR=1.25), number of chronic diseases (1 disease: OR=1.21; 2-3 diseases: OR=1.45; ≥4 diseases: OR=1.91), nighttime sleep duration (OR=0.90, 95% CI: 0.88-0.93), self-rated health (fair: OR=1.67; poor: OR=2.41; very poor: OR=3.55), and life satisfaction (fairly satisfied: OR=1.34; not very satisfied: OR=3.50; not satisfied at all: OR=2.73) were independently associated with depressive symptoms in rural elderly (all P<0.05). Conclusion The detection rate of depressive symptoms among rural elderly in China is relatively high. Gender, duration of living alone, number of chronic diseases, nighttime sleep duration, self-rated health, and life satisfaction are independent factors associated with depressive symptoms in this population.

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