中国全科医学 ›› 2023, Vol. 26 ›› Issue (34): 4329-4335.DOI: 10.12114/j.issn.1007-9572.2023.0269

• 医学循证 • 上一篇    下一篇

中国老年人抑郁检出率及影响因素的Meta分析

王越1, 陈晴1, 刘鲁蓉2,*()   

  1. 1.611137 四川省成都市,成都中医药大学管理学院
    2.611137 四川省成都市,成都中医药大学基础医学院
  • 收稿日期:2023-03-15 修回日期:2023-07-11 出版日期:2023-12-05 发布日期:2023-07-31
  • 通讯作者: 刘鲁蓉

  • 作者贡献:王越负责文章的构思与设计、研究资料的收集与整理、表格的制作、论文的撰写;陈晴负责研究资料的收集与整理、表格的制作;刘鲁蓉负责文章的质量控制及审校,对文章整体负责。
  • 基金资助:
    四川省应用心理学研究中心项目(CSXL-212A11)

Detection Rate of Depression and Its Influencing Factors in Chinese Elderly: a Meta-analysis

WANG Yue1, CHEN Qing1, LIU Lurong2,*()   

  1. 1. School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
    2. School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
  • Received:2023-03-15 Revised:2023-07-11 Published:2023-12-05 Online:2023-07-31
  • Contact: LIU Lurong

摘要: 背景 我国已处于深度老龄化社会阶段,老年人的健康问题越来越受到重视。老年人抑郁不仅影响其晚年生活质量,同时加重了社会和家庭的经济负担,及早识别其发生的影响因素具有重要意义,但现有研究结论尚存争议,且国内鲜见相关系统评价。 目的 探讨2018年以来中国老年人抑郁检出率及影响因素,为降低老年人抑郁发生率和促进健康老龄化提供参考依据。 方法 于2023年1月计算机检索2018—2022年PubMed、EmBase、Web of Science、中国知网(CNKI)、万方数据知识服务平台(Wanfang Date)、维普网(VIP)等数据库中公开发表的关于中国老年人抑郁影响因素的研究,对文献进行数据提取,并采用美国医疗保健研究与质量局(AHRQ)的横断面研究质量评价标准对纳入文献进行质量评价,运用Stata 15.0软件对纳入文献进行Meta分析。 结果 最终纳入23篇文献,累计研究对象75 599人,共检出抑郁老年人13 815人;文献的AHRQ质量评价得分为5~7分。Meta分析结果显示,中国老年人抑郁检出率为20.6%〔95%CI(16.6%,24.8%)〕,女性〔OR=1.46,95%CI(1.30,1.64)〕、高龄〔OR=1.48,95%CI(1.13,1.94)〕、教育程度较低〔OR=1.52,95%CI(1.32,1.75)〕、无配偶〔OR=1.60,95%CI(1.35,1.91)〕、居住地为农村〔OR=1.38,95%CI(1.14,1.66)〕、罹患慢性病〔OR=2.75,95%CI(2.07,3.66)〕、罹患2种慢性病〔OR=1.84,95%CI(1.07,3.14)〕、罹患3种及以上慢性病〔OR=3.86,95%CI(2.89,5.15)〕、自评健康状况差〔OR=3.47,95%CI(1.14,10.53)〕、失眠〔OR=2.62,95%CI(1.88,3.66)〕、独居〔OR=1.86,95%CI(1.56,2.21)〕、不锻炼〔OR=1.88,95%CI(1.60,2.20)〕、生活自理情况为需要或部分需要〔OR=2.96,95%CI(1.12,7.85)〕是老年人发生抑郁的危险因素(P<0.05),饮酒〔OR=0.67,95%CI(0.50,0.88)〕、有朋友〔OR=0.52,95%CI(0.38,0.71)〕是老年人发生抑郁的保护因素(P<0.05)。 结论 中国老年人抑郁检出率处于较高水平,女性、高龄、教育程度较低、无配偶、居住地为农村、罹患慢性病、罹患慢性病共病、自评健康状况差、失眠、独居、不锻炼、生活自理情况为需要或部分需要的中国老年人可能更容易出现抑郁症状。

关键词: 抑郁, 老年人, 检出率, 影响因素分析, Meta分析

Abstract:

Background

China has been already in the stage of deeply aging society, and the health problems of the elderly are getting more and more attention. Depression in the elderly not only affects the quality of life in later life, but also increases the economic burden on society and families, so early identification of the influencing factors of its development is of great significance. However, the existing research conclusions are still controversial, and there are few relevant systematic reviews in China.

Objective

To explore the depression detection rate and its influencing factors in the elderly in China since 2018, provide reference for reducing the incidence of depression in the elderly and promoting healthy aging.

Methods

In January 2023, PubMed, EmBase, Web of Science, CNKI, Wanfang Date and VIP were searched for publicly available studies on factors influencing depression in Chinese elderly from 2018 to 2022. The data were extracted and the literature quality was evaluated according to the cross-sectional study quality assessment criteria of Agency for Healthcare Research and Quality (AHRQ) and Stata 15.0 was adopted for Meta-analysis.

Results

Twenty-three papers were finally included, with a cumulative study population of 75 599, and a total of 13 815 depressed older adults were detected; the AHRQ quality assessment scores of the papers ranged from 5 to 7. Meta-analysis results showed that the detection rate of depression in the elderly in China was 20.6%〔95%CI (16.6%, 24.8%) 〕, female〔OR=1.46, 95%CI (1.30, 1.64) 〕, advanced age〔OR=1.48, 95%CI (1.13, 1.94) 〕, lower education level〔OR=1.52, 95%CI (1.32, 1.75) 〕, no spouse〔OR=1.60, 95%CI (1.35, 1.91) 〕, living in rural areas〔OR=1.38, 95%CI (1.14, 1.66) 〕, suffering from chronic diseases〔OR=2.75, 95%CI (2.07, 3.66) 〕, 2 chronic diseases〔OR=1.84, 95%CI (1.07, 3.14) 〕, 3 or more chronic diseases〔OR=3.86, 95%CI (2.89, 5.15) 〕, poor self-rated health〔OR=3.47, 95%CI (1.14, 10.53) 〕, insomnia〔OR=2.62, 95%CI (1.88, 3.66) 〕, living alone〔OR=1.86, 95%CI (1.56, 2.21) 〕, no exercise〔OR=1.88, 95%CI (1.60, 2.20) 〕, self-care needs or partial needs〔OR=2.96, 95%CI (1.12, 7.85) 〕were risk factors for depression in the elderly (P<0.05), while drinking〔OR=0.67, 95%CI (0.50, 0.88) 〕and having friends〔OR=0.52, 95%CI (0.38, 0.71) 〕were protective factors (P<0.05) .

Conclusion

Although the detection rate of depression among elderly in China has decreased, it is still at a high level, and the elderly in China who are female, elderly, less educated, without spouse, living in rural areas, suffering from chronic diseases and chronic disease comorbidity, with poor self-rated health, suffering from insomnia, living alone, without exercise, and living in need or partial need of self-care may be more likely to suffer from depression.

Key words: Depression, Aged, Relevance ratio, Root cause analysis, Meta-analysis