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[老年人的抑郁症状。患病率及相关因素]

[Depressive symptoms in the elderly. Prevalence and associated factors].

作者信息

Urbina Torija Juan Román, Flores Mayor José Miguel, García Salazar María Pilar, Torres Buisán Luis, Torrubias Fernández Rosa María

机构信息

Centro de Salud de Atención Primaria de Azuqueca de Hena, Guadalajara, España.

出版信息

Gac Sanit. 2007 Jan-Feb;21(1):37-42. doi: 10.1157/13099119.

Abstract

OBJECTIVES

To estimate the prevalence of depressive symptoms in people older than 64 and to analyze their association with sociodemographic factors, frailty markers, and disabling diseases.

METHODS

A survey-based, cross-sectional descriptive study was carried out. The sample was composed of 417 elderly people living in Guadalajara (Spain), selected on the basis of health cards. Depressive symptoms were assessed using Yesavage's test (cut-off: 6 or more items). The questionnaire contained sociodemographic and clinical items and evaluation scales for cognitive impairment, disability, and social risk. The frailty markers studied were age over 80 years old, female sex, cognitive impairment, disability, polypharmacy, comorbidity, and social risk.

RESULTS

The prevalence of depressive symptoms was 19.7% (95% CI, 15.9-23.4) and clinical depression was diagnosed in 5% (95% CI, 2.3-7.7). Depressive symptoms were more frequent in elderly individuals living in rural environments than in those living in urban areas (p < 0.05). These symptoms increased with age (p linear trend < 0.001) and were associated with social risk (p < 0.001), comorbidity (p < 0.001), cognitive impairment (p < 0.01), and disability (p < 0.05). When a multivariate statistical analysis was applied using logistic regression models, only comorbidity (odds ratio [OR] = 2.38; 95% CI, 1.35-4.20) and social risk (OR = 2.69; 95% CI, 1.50-4.83) were significantly associated.

CONCLUSIONS

The prevalence of depressive symptoms is very high in the elderly, four times higher than a diagnosis of clinical depression. Social risk and comorbidity are strongly associated with depressive symptoms.

摘要

目的

评估64岁以上人群抑郁症状的患病率,并分析其与社会人口学因素、衰弱标志物及致残性疾病之间的关联。

方法

开展了一项基于调查的横断面描述性研究。样本由417名居住在西班牙瓜达拉哈拉的老年人组成,基于健康卡进行选取。使用耶萨维奇测试评估抑郁症状(临界值:6项及以上)。问卷包含社会人口学和临床项目以及认知障碍、残疾和社会风险的评估量表。所研究的衰弱标志物包括80岁以上、女性、认知障碍、残疾、多种药物治疗、合并症和社会风险。

结果

抑郁症状的患病率为19.7%(95%置信区间,15.9 - 23.4),临床抑郁症的诊断率为5%(95%置信区间,2.3 - 7.7)。生活在农村环境中的老年人比生活在城市地区的老年人抑郁症状更常见(p < 0.05)。这些症状随年龄增加而增多(p线性趋势< 0.001),并与社会风险(p < 0.001)、合并症(p < 0.001)、认知障碍(p < 0.01)和残疾(p < 0.05)相关。当使用逻辑回归模型进行多变量统计分析时,仅合并症(比值比[OR] = 2.38;95%置信区间,1.35 - 4.20)和社会风险(OR = 2.69;95%置信区间,1.50 - 4.83)有显著关联。

结论

老年人抑郁症状的患病率非常高,是临床抑郁症诊断率的四倍。社会风险和合并症与抑郁症状密切相关。

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