关键词: 老年人, 慢性病, 抑郁, 影响因素分析, 城乡

Abstract: Background　Depression is a common mental health problem among the elderly，which is even more prevalent in the elderly with chronic diseases. Currently，studies about depression prevalence in elderly people mostly focus on those living in the urban community，but seldom concern about those living in rural areas or comparatively analyze urban and rural differences in this population. Objective　To explore the differences of depressive symptoms prevalence and influencing factors between urban and rural elderly people with chronic diseases，to provide a reference for improving the mental health of elderly people with chronic conditions. Methods　A multi-stage random cluster sampling was used to enroll 2 504 urban and rural elderly patients with chronic diseases from Taiyuan，Shanxi Province，China in October 2018. They were surveyed with a questionnaire including general demographic information，behavioral factors，number of chronic diseases and depressive symptoms（screened using the 15-item Geriatric Depression Scale）. Binary Logistic regression model was used to analyze the influencing factors of depressive symptoms. Results　Urban and rural elderly patients with chronic diseases accounted for 55.39%（1 387/2 504） and 44.61%（1 117/2 504） of the total cases，respectively. The sex ratio，distributions of age，education level，marital status，major source of income，relationships with offspring，relationship with spouse，physical activity level，and number of chronic diseases，and smoking prevalence showed statistically significant differences between urban and rural respondents（P<0.05）. Depressive symptoms prevalence was 37.02%（927/2 504）in all the respondents. Rural respondents showed a higher prevalence than their counterparts〔45.66%（510/1 117） vs 30.06%（417/1 387）〕. The results of binary Logistic regression analysis showed that the relationship with offspring，the relationship with spouse and the level of physical activity were associated with depressive symptoms in both urban and rural respondents（P<0.05）. In addition，age and the number of chronic diseases were also associated with depressive symptoms in urban respondents（P<0.05），smoking prevalence，drinking prevalence and major source of income were also associated with depressive symptoms in rural respondents（P<0.05）. Conclusion　The factors associated with depressive symptoms in urban and rural elderly people with chronic diseases were partially different. So urban-rural differences should be considered when delivering preventive interventions or improving treatment interventions for such people.

Key words: Aged, Chronic diseases, Depressive state, Root cause analysis, Urban and rural areas