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中国老年人日常生活活动障碍与抑郁症状的性别特异性关联:来自中国健康与养老追踪调查的证据。

Gender-specific associations between activities of daily living disability and depressive symptoms among older adults in China: Evidence from the China Health and Retirement Longitudinal Study.

机构信息

School of Nursing, Jilin University, Changchun, China.

Department of Rehabilitation, China-Japan Union Hospital, Jilin University, Changchun, China; Department of Nursing, China-Japan Union Hospital, Jilin University, Changchun, China.

出版信息

Arch Psychiatr Nurs. 2019 Dec;33(6):160-166. doi: 10.1016/j.apnu.2019.08.010. Epub 2019 Aug 22.

Abstract

PURPOSE

To evaluate the associations between BADL/IADL disability and depressive symptoms from the perspective of gender among older adults in China.

METHODS

This cross-sectional study used the data from the second wave of the China Health and Retirement Longitudinal Study (CHARLS). The sample included 3463 older adults aged 60 years and older across China. Multivariable logistic regression models were conducted.

RESULTS

Among 3463 older adults, 1240 (35.8%) were classified as depressed, the prevalence of BADL and IADL disabilities were 756 (21.8%) and 1194 (34.5%), respectively. After controlling for covariates, BADL/IADL disability was significantly associated with an increased risk of depression prevalence both in men and women among older adults. Compared with IADL independent, IADL disability was about two times more likely to develop depressive symptoms in men (OR = 2.165, 95% CI = 1.661-2.822), which was much higher than that in women (OR = 1.748, 95% CI = 1.415-2.160). In contrast, the odds of being depressed for women with BADL disability (OR = 1.824, 95% CI = 1.447-2.299) were much higher than the odds for men with BADL disability (OR = 1.791, 95% CI = 1.348-2.379).

CONCLUSIONS

Older adults with BADL/IADL disability were more likely to have depressive symptoms both for men and women. However, the associations between depressive symptoms and BADL/IADL disability were different in gender. Our results suggest that differential institutional care service and appropriate strategies for improvement in mental health are required.

摘要

目的

从性别角度评估中国老年人日常生活活动/工具性日常生活活动(BADL/IADL)残疾与抑郁症状之间的关联。

方法

本横断面研究使用了中国健康与退休纵向研究(CHARLS)第二波数据。样本包括中国各地 3463 名 60 岁及以上的老年人。采用多变量逻辑回归模型进行分析。

结果

在 3463 名老年人中,1240 人(35.8%)被诊断为抑郁,BADL 和 IADL 残疾的患病率分别为 756 人(21.8%)和 1194 人(34.5%)。在控制了混杂因素后,BADL/IADL 残疾与老年人的抑郁患病率增加显著相关,无论男女。与 IADL 独立相比,IADL 残疾使男性发生抑郁症状的风险增加约两倍(OR=2.165,95%CI=1.661-2.822),高于女性(OR=1.748,95%CI=1.415-2.160)。相比之下,BADL 残疾的女性发生抑郁的几率(OR=1.824,95%CI=1.447-2.299)远高于 BADL 残疾的男性(OR=1.791,95%CI=1.348-2.379)。

结论

BADL/IADL 残疾的老年人更有可能出现抑郁症状,无论男女。然而,抑郁症状与 BADL/IADL 残疾之间的关联在性别上存在差异。我们的研究结果表明,需要针对不同性别提供差异化的机构护理服务和改善心理健康的适当策略。

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