Abstract: Background　Anxiety is a common psychological problem that hinders the healthy aging process of the elderly. At present，most studies on the mental health of the elderly are focused on the urban or rural elderly in local areas，and there are limited comparative studies on the anxiety level of the nationwide elderly and the difference between urban and rural areas. Objective　To investigate the incidence of anxiety among the elderly nationwide，analyze and compare the detection rate and influencing factors of anxiety symptoms between rural and urban elderly，in order to provide a basis for mental health intervention for the elderly. Methods　In February 2021，data from the 2018 Chinese Longitudinal Healthy Longevity Survey conducted by the Peking University Center for Healthy Aging and Development was adopted. A total of 14 417 survey subjects who were aged≥60 years，received an anxiety survey and had complete values of related variables were selected as the research subjects. Anxiety was evaluated by 7-item Generalized Anxiety Disorder Scale（GAD-7），which is stratified by place of residence（urban/rural），and different characteristics（demographic characteristics，socioeconomic status，health status，life satisfaction，lifestyle and medical services accessibility）were compared. Unconditional Logistic regression was used to analyze related factors. Results　Among 14 417 elderly people，1 751 people had anxiety symptoms，and the overall detection rate was 12.15%，including 1 400 people with mild anxiety（79.95%），256 people with moderate anxiety（14.62%），and 95 people with severe anxiety（5.43%）. The incidence of anxiety symptoms in rural elderly〔13.05%（1 459/11 183）〕was higher than that in urban elderly〔9.03%（292/3 234）〕（χ2=37.946，P<0.001），and the severity of anxiety was higher in rural compared with urban elderly people（Z=-2.312，P=0.021）. The results of multivariate analysis showed that western region，bad self-reported financial conditions，with ordinary or bad self-reported health status，with bad self-reported life satisfaction，no smoking were independent risk factors affecting the occurrence of anxiety in urban elderly（P<0.05），and having sleep time of 7~8 hours was a protective factor（P<0.001）for the occurrence of anxiety in urban elderly. Female，central region，with ordinary or bad self-reported financial conditions，with ordinary or bad self-reported health status，with ordinary or bad self-reported life satisfaction，serious illness cannot be treated in time，salty diet were risk factors affecting the occurrence of anxiety in rural elderly（P<0.05），and having sleeping time of 7~8 hours or more than 8 hours was protective factor（P<0.001）for the occurrence of anxiety in rural elderly. Conclusion　The detection rate of anxiety symptoms in the Chinese elderly is relatively high and the detection rate of anxiety symptoms in rural elderly is higher than that in urban elderly. The factors associated with anxiety symptoms in urban and rural elderly people were partially different. So urban-rural differences should be considered when delivering preventive interventions or improving management interventions for such people.

Key words: Anxiety, Aged, Rural, Urban, Differences, Root cause analysis

摘要： 背景　焦虑是影响老年人健康老化过程的常见心理问题。我国老年人心理健康研究对象多为局部地区的城市或农村老年人，针对全国老年人焦虑发生状况展开的调查较少，且较少研究行城、乡老年人焦虑发生现状及影响因素的比较分析。目的　调查全国老年人焦虑发生状况，比较并分析城市和农村老年人焦虑症状检出率及影响因素，旨在为老年人心理健康干预提供依据。方法　于2021年2月采用北京大学健康老龄与发展研究中心开展的中国老年人健康影响因素跟踪调查（CLHLS）2018年数据，选取年龄≥60岁、接受了焦虑状态调查且关键变量值完整的老年人14 417例作为研究对象。焦虑状态的测量采用广泛性焦虑量表（GAD-7）。以居住地分层（城市/农村），比较不同特征（人口学特征、社会经济地位、健康状况、生活满意度、生活方式和医疗服务可及性）老年人焦虑发生情况的差异性，采用非条件Logistic回归分析影响城、乡老年人焦虑发生的因素。结果　14 417例老年人中，1 751例出现焦虑症状，焦虑症状检出率为12.15%。其中轻度焦虑者1 400例（79.95%），中度焦虑者256例（14.62%），重度焦虑者95例（5.43%）。农村老年人焦虑症状检出率高于城市老年人〔13.05%（1 459/11 183）比9.03%（292/3 234），χ2=37.946，P<0.001〕，且农村焦虑老年人焦虑严重程度高于城市焦虑老年人，差异有统计学意义（Z=-2.312，P=0.021）。非条件Logistic回归分析结果显示，居住地为西部地区、自评经济状况为困难、自评健康状况为一般和不好、自评生活满意度为不满意及不吸烟是城市老年人焦虑发生的危险因素（P<0.05）；睡眠时间7~8 h是城市老年人焦虑发生的保护性因素（P<0.001）。女性、居住地为中部地区、自评经济状况为一般和困难、自评健康状况为一般和不好、自评生活满意度为一般和不满意、患重病不能及时就医及饮食口味偏咸是农村老年人焦虑发生的危险因素（P<0.05）；睡眠时间7~8 h和>8 h是农村老年人焦虑发生的保护性因素（P<0.001）。结论　我国老年人焦虑症状检出率较高，农村老年人焦虑症状检出率高于城市老年人，且城、乡老年人焦虑状况的影响因素不尽相同。在对老年人焦虑状况进行干预时应考虑城、乡差异，并有针对性地采取预防和管理措施。

关键词: 焦虑, 老年人, 农村, 城市, 差异性, 影响因素分析