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Article(id=1241035812264014473, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407504, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1722182400000, receivedDateStr=2024-07-29, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815594973, onlineDateStr=2026-03-18, pubDate=1733760000000, pubDateStr=2024-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815594973, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815594973, creator=13701087609, updateTime=1773815594973, updator=13701087609, issue=Issue{id=1241035810628235909, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='23', pageStart='4225', pageEnd='4416', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815594584, creator=13701087609, updateTime=1773815743629, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241036435843764756, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241036435843764757, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035810628235909, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=4338, endPage=4342, ext={EN=ArticleExt(id=1241035812758942348, articleId=1241035812264014473, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of depression status and its influencing factors in elderly patients with dyslipidemia comorbidity in China, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the depression status and its influencing factors among elderly patients with dyslipidemia comorbidity in China.

Methods

Utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), we selected individuals aged 60 and above suffering from two or more chronic diseases, including dyslipidemia, to calculate the prevalence of depressive symptoms. A multivariate logistic regression analysis was conducted to explore the influencing factors of depressive symptoms.

Results

A total of 1 120 elderly patients with dyslipidemia comorbidity were included in this study, with a prevalence of depressive symptoms at 46.79%. The multivariate logistic regression analysis revealed that living in rural areas (OR=2.121, 95%CI: 1.475-3.050) and having physical functional impairments (OR=1.053, 95%CI: 1.035-1.072) were risk factors for depression. Conversely, self-rated health (OR=0.782, 95%CI: 0.641-0.955), daily sleep duration (OR=0.835, 95%CI: 0.776-0.899), life satisfaction (OR=0.653, 95%CI: 0.522-0.816), health satisfaction (OR=0.676, 95%CI: 0.554-0.826), and spousal relationship satisfaction (OR=0.691, 95%CI: 0.572-0.835) were identified as protective factors against depression.

Conclusion

The prevalence of depression among elderly patients with dyslipidemia comorbidity in China is notably high. There is a need to enhance the assessment of depressive symptoms in these patients, particularly focusing on those in rural areas and those with physical functional impairments, to safeguard their mental health.

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目的

分析我国老年血脂异常共病患者的抑郁状况及其影响因素。

方法

利用2018年中国健康与养老追踪调查项目(CHARLS)数据，选取年龄≥60岁、罹患包括血脂异常在内的2种以上慢性疾病人群，计算抑郁症状检出率，采用多因素logistic回归分析探究抑郁症状的影响因素。

结果

本研究共纳入1 120名老年血脂异常共病患者，抑郁症状检出率为46.79%。多因素logistic回归分析显示，居住在农村(OR=2.121，95%CI：1.475～3.050)和身体功能障碍(OR= 1.053，95%CI：1.035～1.072)是抑郁的危险因素，健康自评(OR=0.782，95%CI：0.641～0.955)、每天睡眠时间(OR= 0.835，95%CI：0.776～0.899)、生活满意度(OR=0.653，95%CI：0.522～0.816)、健康满意度(OR=0.676，95%CI：0.554～0.826)、配偶关系满意度(OR=0.691，95%CI：0.572～0.835)是抑郁的保护因素。

结论

我国老年血脂异常共病患者的抑郁检出率较高，应加强老年血脂异常共病患者的抑郁症状评估，加大对农村地区、存在身体功能障碍的老年血脂异常共病患者的关注，保障其心理健康。

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蓝韶清，E-mail:
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鲁丹凤（1984—），女，博士在读，副教授，研究方向：中医药文化、中医心理学、青少年心理健康教育

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鲁丹凤（1984—），女，博士在读，副教授，研究方向：中医药文化、中医心理学、青少年心理健康教育

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鲁丹凤（1984—），女，博士在读，副教授，研究方向：中医药文化、中医心理学、青少年心理健康教育

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Sleep Medicine,2022, 98: 1-8., articleTitle=Association between sleep and multimorbidity in Chinese elderly: Results from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), refAbstract=null), Reference(id=1241069126530167621, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, doi=null, pmid=null, pmcid=null, year=2023, volume=47, issue=1, pageStart=72, pageEnd=86, url=null, language=null, rfNumber=[22], rfOrder=33, authorNames=王学义, 彭敬, journalName=人口研究, refType=null, unstructuredReference=王学义，彭敬.老年夫妻婚姻满意度对抑郁症状的影响[J].人口研究，2023，47（1）：72-86., articleTitle=老年夫妻婚姻满意度对抑郁症状的影响, refAbstract=null), Reference(id=1241069126668579656, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, doi=null, pmid=null, pmcid=null, year=2023, volume=47, issue=1, pageStart=72, pageEnd=86, url=null, language=null, rfNumber=[22], rfOrder=34, authorNames=Wang XY, Peng J, journalName=Population Research, refType=null, unstructuredReference=Wang XY, Peng J. The influence of marital satisfaction on depressive symptoms of elderly couples in China[J]. Population Research, 2023, 47(1):72-86.(In Chinese), articleTitle=The influence of marital satisfaction on depressive symptoms of elderly couples in China, refAbstract=null), Reference(id=1241069126777631565, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, doi=null, pmid=null, pmcid=null, year=2023, volume=26, issue=25, pageStart=3091, pageEnd=3095, 3111, url=null, language=null, rfNumber=[23], rfOrder=35, authorNames=杨璐, 宗占红, 易莹莹, journalName=中国全科医学, refType=null, unstructuredReference=杨璐，宗占红，易莹莹.中国农村中老年女性抑郁状况及影响因素研究[J].中国全科医学，2023，26（25）：3091-3095, 3111., articleTitle=中国农村中老年女性抑郁状况及影响因素研究, refAbstract=null), Reference(id=1241069126903460691, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, doi=null, pmid=null, pmcid=null, year=2023, volume=26, issue=25, pageStart=3091, pageEnd=3095, 3111, url=null, language=null, rfNumber=[23], rfOrder=36, authorNames=Yang L, Zong ZH, Yi YY, journalName=Chinese General Practice, refType=null, unstructuredReference=Yang L, Zong ZH, Yi YY. Current status and influencing factors of depression among rural middle-aged and elderly women in China[J].Chinese General Practice, 2023, 26(25): 3091-3095, 3111.(In Chinese), articleTitle=Current status and influencing factors of depression among rural middle-aged and elderly women in China, refAbstract=null)], funds=[Fund(id=1241069121064989247, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, awardId=20&ZD122, language=CN, fundingSource=国家社会科学基金重大项目(20&ZD122), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241069115142631590, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, xref=1., ext=[AuthorCompanyExt(id=1241069115151020199, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, companyId=1241069115142631590, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China), AuthorCompanyExt(id=1241069115155214504, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, companyId=1241069115142631590, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.广州中医药大学公共卫生与管理学院，广东 广州 510006)]), AuthorCompany(id=1241069115260072109, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, xref=2., ext=[AuthorCompanyExt(id=1241069115268460719, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, companyId=1241069115260072109, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.广州城市理工学院心理健康教研室，广东 广州 510800)]), AuthorCompany(id=1241069115419455675, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, xref=3., ext=[AuthorCompanyExt(id=1241069115427844285, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, companyId=1241069115419455675, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.广东中医药博物馆，广东 广州 510006)])], figs=[ArticleFig(id=1241069119857029603, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, language=EN, label=Table 1, caption=

Sociodemographic characteristics and depression in elderly patients with dyslipidemia comorbidities in China ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量例数无抑郁有抑郁χ2值P值
性别男503 (44.91)296 (49.66)207 (39.50)11.635<0.001
女617 (55.09)300 (50.34)317 (60.50)
居住区域城或镇中心区273 (24.38)182 (30.54)91 (17.37)35.835<0.001
城乡或镇乡结合区112 (10.00)70 (11.74)42 (8.02)
农村735 (65.63)344 (57.72)391 (74.62)
民族汉族1 022（91.25)545 (91.44)477 (91.03)0.0590.807
少数民族98 (8.75)51 (8.56)47 (8.97)
个人收入有215 (19.20)135 (22.65)80 (15.27)9.8010.002
无905 (80.80)461 (77.35)444 (84.73)
有无保险有1 093 (97.59)588 (98.66)505 (96.37)6.1810.013
无27 (2.41)8 (1.34)19 (3.63)
体力活动无101 (9.02)39 (6.54)62 (11.83)14.2720.003
轻度345 (30.80)188 (31.54)157 (29.96)
中度367 (32.77)215 (36.07)152 (29.01)
重度307 (27.41)154 (25.84)153 (29.20)
饮酒史是327 (29.20)203 (34.06)124 (23.66)14.579<0.001
否793 (70.80)393 (65.94)400 (76.34)
社会交往有676 (60.36)394 (66.11)282 (53.82)17.604<0.001
无444 (39.64)202 (33.89)242 (46.18)
工作或劳动能力无法工作162 (14.46)52 (8.72)110 (20.99)90.922<0.001
不能长时间工作347 (30.98)141 (23.66)206 (39.31)
没有问题611 (54.55)403 (67.62)208 (39.69)
), ArticleFig(id=1241069119966081516, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, language=CN, label=表1, caption=

中国老年血脂异常共病患者的社会人口学特征与抑郁情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量例数无抑郁有抑郁χ2值P值
性别男503 (44.91)296 (49.66)207 (39.50)11.635<0.001
女617 (55.09)300 (50.34)317 (60.50)
居住区域城或镇中心区273 (24.38)182 (30.54)91 (17.37)35.835<0.001
城乡或镇乡结合区112 (10.00)70 (11.74)42 (8.02)
农村735 (65.63)344 (57.72)391 (74.62)
民族汉族1 022（91.25)545 (91.44)477 (91.03)0.0590.807
少数民族98 (8.75)51 (8.56)47 (8.97)
个人收入有215 (19.20)135 (22.65)80 (15.27)9.8010.002
无905 (80.80)461 (77.35)444 (84.73)
有无保险有1 093 (97.59)588 (98.66)505 (96.37)6.1810.013
无27 (2.41)8 (1.34)19 (3.63)
体力活动无101 (9.02)39 (6.54)62 (11.83)14.2720.003
轻度345 (30.80)188 (31.54)157 (29.96)
中度367 (32.77)215 (36.07)152 (29.01)
重度307 (27.41)154 (25.84)153 (29.20)
饮酒史是327 (29.20)203 (34.06)124 (23.66)14.579<0.001
否793 (70.80)393 (65.94)400 (76.34)
社会交往有676 (60.36)394 (66.11)282 (53.82)17.604<0.001
无444 (39.64)202 (33.89)242 (46.18)
工作或劳动能力无法工作162 (14.46)52 (8.72)110 (20.99)90.922<0.001
不能长时间工作347 (30.98)141 (23.66)206 (39.31)
没有问题611 (54.55)403 (67.62)208 (39.69)
), ArticleFig(id=1241069120066744823, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, language=EN, label=Table 2, caption=

Health, sleep, satisfaction and depression in elderly patients with dyslipidemia comorbidities in China

, figureFileSmall=null, figureFileBig=null, tableContent=
项目总数无抑郁有抑郁t值P值
健康自评2.59±0.932.87±0.892.27±0.8811.288<0.001
身体功能障碍26.79 ±10.5423.44±8.7530.60±11.10-11.871<0.001
每天睡眠时间6.00±2.086.41±1.955.53±2.147.127<0.001
生活满意度3.12±0.853.38±0.682.83±0.9311.122<0.001
健康满意度2.61±0.952.93±0.842.25±0.9512.489<0.001
配偶关系满意度3.30±0.853.52±0.733.06±0.919.170<0.001
子女关系满意度3.60±0.783.74±0.703.43±0.846.688<0.001
空气满意度3.08±0.883.15±0.842.99±0.923.0230.003
), ArticleFig(id=1241069120192573954, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, language=CN, label=表2, caption=

中国老年血脂异常共病患者健康、睡眠、满意度和抑郁情况

, figureFileSmall=null, figureFileBig=null, tableContent=
项目总数无抑郁有抑郁t值P值
健康自评2.59±0.932.87±0.892.27±0.8811.288<0.001
身体功能障碍26.79 ±10.5423.44±8.7530.60±11.10-11.871<0.001
每天睡眠时间6.00±2.086.41±1.955.53±2.147.127<0.001
生活满意度3.12±0.853.38±0.682.83±0.9311.122<0.001
健康满意度2.61±0.952.93±0.842.25±0.9512.489<0.001
配偶关系满意度3.30±0.853.52±0.733.06±0.919.170<0.001
子女关系满意度3.60±0.783.74±0.703.43±0.846.688<0.001
空气满意度3.08±0.883.15±0.842.99±0.923.0230.003
), ArticleFig(id=1241069120339374606, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, language=EN, label=Table 3, caption=

Variable assignment of multivariate logistic regression analysis of depression in elderly patients with dyslipidemia comorbidities in China

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量赋值
性别男=1，女=2
居住区域城或镇中心区=1，城乡或镇乡结合区=2，农村=3
收入情况无=0，有=1
医保情况无= 0，有=1
体力活动无=0，轻度=1，中度=2，重度=3
饮酒史无=0，有=1
社会交往无=0，有=1
工作或劳动能力无法工作=1，不能长时间工作=2，没有问题=3
健康自评原值录入
身体功能障碍原值录入
每天睡眠时间原值录入
生活满意度原值录入
健康满意度原值录入
配偶关系满意度原值录入
子女关系满意度原值录入
空气满意度原值录入
), ArticleFig(id=1241069120473592343, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, language=CN, label=表3, caption=

中国老年血脂异常共病患者抑郁状态的多因素logistic回归分析变量赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量赋值
性别男=1，女=2
居住区域城或镇中心区=1，城乡或镇乡结合区=2，农村=3
收入情况无=0，有=1
医保情况无= 0，有=1
体力活动无=0，轻度=1，中度=2，重度=3
饮酒史无=0，有=1
社会交往无=0，有=1
工作或劳动能力无法工作=1，不能长时间工作=2，没有问题=3
健康自评原值录入
身体功能障碍原值录入
每天睡眠时间原值录入
生活满意度原值录入
健康满意度原值录入
配偶关系满意度原值录入
子女关系满意度原值录入
空气满意度原值录入
), ArticleFig(id=1241069120645558822, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, language=EN, label=Table 4, caption=

Multivariate Logistic regression analyses of influencing factors of depression in elderly patients with dyslipidemia comorbidities in China

, figureFileSmall=null, figureFileBig=null, tableContent=
变量B Waldχ2值P值OR值（95%CI）
居住区域=城或镇中心区参考组18.806<0.001
居住区域=城乡或镇乡结合区0.1810.2870.3990.5281.198（0.683～2.102）
居住区域=农村0.7520.18516.447<0.0012.121（1.475～3.050）
身体功能障碍0.0520.00932.134<0.0011.053（1.035～1.072）
健康自评-0.2460.1025.8210.0160.782（0.641～0.955）
每天睡眠时间-0.1800.03723.112<0.0010.835（0.776～0.899）
生活满意度-0.4270.11414.066<0.0010.653（0.522～0.816）
健康满意度-0.3910.10214.674<0.0010.676（0.554～0.826）
配偶关系满意度-0.3690.09714.599<0.0010.691（0.572～0.835）
常量3.2400.58230.954<0.00125.525
), ArticleFig(id=1241069120767193644, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035812264014473, language=CN, label=表4, caption=

中国老年血脂异常共病患者抑郁状态影响因素的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量B Waldχ2值P值OR值（95%CI）
居住区域=城或镇中心区参考组18.806<0.001
居住区域=城乡或镇乡结合区0.1810.2870.3990.5281.198（0.683～2.102）
居住区域=农村0.7520.18516.447<0.0012.121（1.475～3.050）
身体功能障碍0.0520.00932.134<0.0011.053（1.035～1.072）
健康自评-0.2460.1025.8210.0160.782（0.641～0.955）
每天睡眠时间-0.1800.03723.112<0.0010.835（0.776～0.899）
生活满意度-0.4270.11414.066<0.0010.653（0.522～0.816）
健康满意度-0.3910.10214.674<0.0010.676（0.554～0.826）
配偶关系满意度-0.3690.09714.599<0.0010.691（0.572～0.835）
常量3.2400.58230.954<0.00125.525
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我国老年血脂异常共病患者抑郁状况及其影响因素分析
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鲁丹凤 1, 2 , 颜宇攀 1 , Nunez A. Rafael 1 , 邹冠炀 1 , 蓝韶清 3
现代预防医学 | 健康与社会行为 2024,51(23): 4338-4342
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现代预防医学 | 健康与社会行为 2024, 51(23): 4338-4342
我国老年血脂异常共病患者抑郁状况及其影响因素分析
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鲁丹凤1, 2, 颜宇攀1, Nunez A. Rafael1, 邹冠炀1, 蓝韶清3
作者信息
  • 1.广州中医药大学公共卫生与管理学院，广东 广州 510006
  • 2.广州城市理工学院心理健康教研室，广东 广州 510800
  • 3.广东中医药博物馆，广东 广州 510006

    • 鲁丹凤（1984—），女，博士在读，副教授，研究方向：中医药文化、中医心理学、青少年心理健康教育

通讯作者:

蓝韶清，E-mail:
Analysis of depression status and its influencing factors in elderly patients with dyslipidemia comorbidity in China
Dan-feng LU1, 2, Yu-pan YAN1, Nunez A. Rafael1, Guan-yang ZOU1, Shao-qing LAN3
Affiliations
  • School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510006, China
出版时间: 2024-12-10 doi: 10.20043/j.cnki.MPM.202407504
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摘要
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目的

分析我国老年血脂异常共病患者的抑郁状况及其影响因素。

方法

利用2018年中国健康与养老追踪调查项目(CHARLS)数据，选取年龄≥60岁、罹患包括血脂异常在内的2种以上慢性疾病人群，计算抑郁症状检出率，采用多因素logistic回归分析探究抑郁症状的影响因素。

结果

本研究共纳入1 120名老年血脂异常共病患者，抑郁症状检出率为46.79%。多因素logistic回归分析显示，居住在农村(OR=2.121，95%CI：1.475～3.050)和身体功能障碍(OR= 1.053，95%CI：1.035～1.072)是抑郁的危险因素，健康自评(OR=0.782，95%CI：0.641～0.955)、每天睡眠时间(OR= 0.835，95%CI：0.776～0.899)、生活满意度(OR=0.653，95%CI：0.522～0.816)、健康满意度(OR=0.676，95%CI：0.554～0.826)、配偶关系满意度(OR=0.691，95%CI：0.572～0.835)是抑郁的保护因素。

结论

我国老年血脂异常共病患者的抑郁检出率较高，应加强老年血脂异常共病患者的抑郁症状评估，加大对农村地区、存在身体功能障碍的老年血脂异常共病患者的关注，保障其心理健康。

老年人  /  血脂异常共病  /  抑郁  /  影响因素分析  /  中国
Objective

To analyze the depression status and its influencing factors among elderly patients with dyslipidemia comorbidity in China.

Methods

Utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), we selected individuals aged 60 and above suffering from two or more chronic diseases, including dyslipidemia, to calculate the prevalence of depressive symptoms. A multivariate logistic regression analysis was conducted to explore the influencing factors of depressive symptoms.

Results

A total of 1 120 elderly patients with dyslipidemia comorbidity were included in this study, with a prevalence of depressive symptoms at 46.79%. The multivariate logistic regression analysis revealed that living in rural areas (OR=2.121, 95%CI: 1.475-3.050) and having physical functional impairments (OR=1.053, 95%CI: 1.035-1.072) were risk factors for depression. Conversely, self-rated health (OR=0.782, 95%CI: 0.641-0.955), daily sleep duration (OR=0.835, 95%CI: 0.776-0.899), life satisfaction (OR=0.653, 95%CI: 0.522-0.816), health satisfaction (OR=0.676, 95%CI: 0.554-0.826), and spousal relationship satisfaction (OR=0.691, 95%CI: 0.572-0.835) were identified as protective factors against depression.

Conclusion

The prevalence of depression among elderly patients with dyslipidemia comorbidity in China is notably high. There is a need to enhance the assessment of depressive symptoms in these patients, particularly focusing on those in rural areas and those with physical functional impairments, to safeguard their mental health.

Elderly  /  Dyslipidemia comorbidity  /  Depression  /  Influencing factors analysis  /  China
鲁丹凤, 颜宇攀, Nunez A. Rafael, 邹冠炀, 蓝韶清. 我国老年血脂异常共病患者抑郁状况及其影响因素分析. 现代预防医学, 2024 , 51 (23) : 4338 -4342 . DOI: 10.20043/j.cnki.MPM.202407504
Dan-feng LU, Yu-pan YAN, Nunez A. Rafael, Guan-yang ZOU, Shao-qing LAN. Analysis of depression status and its influencing factors in elderly patients with dyslipidemia comorbidity in China[J]. Modern Preventive Medicine, 2024 , 51 (23) : 4338 -4342 . DOI: 10.20043/j.cnki.MPM.202407504
正文
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慢性病共病是多发于老年人的普遍问题[1]。血脂异常作为一种无明显异常症状、产生隐匿损害的慢性疾病[2]，常与高血压、糖尿病合并存在[3]，对老年人的全因死亡风险有影响[4]。一项meta分析研究[5]显示，中国老年人血脂异常率高达47.0%(95%CI：40.0%～54.0%)。中国的一项前瞻研究[6]发现，血脂异常共病与抑郁显著相关，加强老年血脂异常共病人群的心理健康管理尤为关键。因此，本研究旨在分析中国血脂异常共病老年患者抑郁症状的影响因素，为开展老年血脂异常共病患者的抑郁情绪管理提供参考。
1 对象与方法
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1.1 研究对象
本研究对象数据来源于中国健康与养老追踪调查项目(China Health and Retirement Longitudinal Study, CHARLS)[7]。该调查由北京大学开展，基线调查中样本散布全国28个省区、150个县级单位、450个村级单位、10 257户适龄家户、共计17 708人。本研究采用2018年追踪的第四期数据，使用的数据集包括参与调查人群的基本信息、健康状况、认知和抑郁、医疗保险情况、个人收入情况，以2018年的调查时间为节点，纳入年龄≥60岁、罹患包括血脂异常在内的2种以上慢性疾病人群，排除数据缺失人群，最终纳入1 120人作为研究对象。
1.2 研究变量
1.2.1 血脂异常共病
以CHARLS问卷中“是否有医生曾告诉您有以下这些慢性病？”的答案为依据，慢性病种类含血脂异常、糖尿病等14种。患有血脂异常在内的2种以上慢性病定义为“血脂异常共病”。
1.2.2 抑郁症状
以流调中心抑郁量表10-item Center for Epidemiologic Studies Depression Scale（CESD-10）为评估标准。CESD-10量表经Andresen等人[8]对20条目量表简化而成，包含10个与感觉或行为有关的问题，正性感觉或行为发生频率少于1 d、1～2 d、3～4 d和5～7 d分别记3、2、1和0分，负性感觉或行为则刚好相反，10个问题得分之和即为CESD-10总评分，总分10分及以上者就被认为存在抑郁情况[9]。
1.2.3 协变量
（1）性别：男、女。（2）居住区域：城或镇中心区、城乡镇乡结合区、农村（本研究将特殊区域选项合并到农村选项）。（3）民族：汉族、少数民族（本研究将所有少数民族定义为少数民族）。（4）收入情况：在调查中，调查对象要求回答“您有没有领工资，包括资金、各种补贴，不包括退休工资？”，根据回答结果分为有、无。（5）本研究将所有医保类型定义为有医保，其他为无医保。（6）健康自评：选项为很好、好、一般、不好、很不好，五级评分，可作为连续变量，原值录入。（7）身体功能障碍：在问卷中与身体功能障碍相关题目的选项分数之和。（8）每天睡眠时间：调查对象要求回答“过去一个月内，您平均每天晚上真正睡着的时间大约是几小时？”，根据回答原值录入。（9）体力活动：根据选项为无、轻度、中度、中度。（10）饮酒史：调查对象要求回答“在过去的一年，您喝酒吗？喝酒频率如何？”，选择“什么也不喝”定义为无，其他选项为有。（11）社会交往：调查对象要求回答“您过去一个月是否进行了下列社交活动？”，选择“以上均没有”定义为无，其他选项为有。（12）工作或劳动能力：根据选项为无法工作、不能长时间工作、没有问题。（13）生活满意度、健康满意度、配偶关系满意度、 子女关系满意度、空气满意度：选项均为极其满意、非常满意、比较满意、不太满意、一点也不满意，五级评分，可作为连续变量，原值录入。
1.3 统计学分析
采用SPSS 27.0软件进行统计分析。采用描述统计对老年血脂异常共病患者的抑郁状况进行分析，计数资料以例数和百分数表示，组间比较采用χ2检验，连续变量符合正态分布，以表示，两组间较采用独立样本t检验；采用多因素logistic回归分析老年血脂异常共病患者抑郁的影响因素。检验水准α=0.05。
2 结果
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2.1 中国老年血脂异常共病患者抑郁情况
本研究共纳入1 120名老年血脂异常共病患者，其中存在抑郁症状524人，抑郁症状检出率为46.79%。
2.2 中国老年血脂异常共病患者的社会人口学特征和抑郁情况
性别、居住区域、收入情况、医保情况、体力活动、饮酒史、社会交往、工作或劳动能力与是否抑郁存在统计学差异（P<0.05）。见表1。
2.3 中国老年血脂异常共病患者的自评健康、睡眠、生活满意度和抑郁情况
生活满意度、健康满意度、配偶关系满意度、子女关系满意度、空气满意度、健康自评、身体功能障碍、每天睡眠时间与是否抑郁存在统计学差异（P<0.01）。见表2。
2.4 中国老年血脂异常共病患者抑郁状态影响因素分析
以抑郁状态为因变量（赋值：无抑郁状态=0，存在抑郁状态=1），以单因素分析中差异有统计学意义的变量为自变量进行抑郁状态影响因素的多因素logistic回归分析。变量赋值见表3，回归分析结果见表4。
分析结果，居住在农村和身体功能障碍是抑郁的危险因素（P<0.001），健康自评、每天睡眠时间、生活满意度、健康满意度、配偶关系满意度是抑郁的保护因素（P<0.001）。
3 讨论
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3.1 中国老年血脂异常共病患者抑郁情况
本研究发现，中国老年血脂异常共病患者中抑郁检出率为46.79%，高于老年糖尿病患者的41.26%[10]，表明相较于其他慢性病患者，血脂异常共病的老年患者可能较容易产生抑郁症状。韩国的一项队列研究[11]发现，与无抑郁的血脂异常患者相比，抑郁患者发生心血管疾病的风险更高，因此，应当加强对血脂异常共病患者抑郁症状的重视和管理，避免病情迁延发展。
3.2 中国老年血脂异常共病患者抑郁状况影响因素
多因素logistic回归分析发现，居住区域在农村和身体功能障碍是中国老年血脂异常共病患者抑郁状况的危险因素，这与以往研究结果[12]类似。吴政宇[13]等人认为，农村地区在生活环境、经济状况、医疗条件等方面都落后于城镇地区，导致农村老人健康素养相对较差，加重了老年血脂异常共病患者的抑郁状况。此外，在身体功能方面存在障碍的老年血脂异常共病患者，由于生活自理能力下降，自主感丧失[14-15]，同时，身体功能的缺陷使得个体的日常生活活动能力下降，生命质量降低[16]，又给家人增加了照料成本，可能更容易产生心理负担和消极悲观情绪。因此，国家应提高农村地区心理健康服务的可及性，加大农村地区的医疗资源倾斜，加强农村地区的医疗保险覆盖，提高农村地区的养老保险金额和经济保障水平，重视因身体功能受损而产生的心理健康问题，为农村地区存在身体功能障碍的老年血脂异常共病患者提供便捷的医疗服务。
本研究发现，健康自评、每天睡眠时间、生活满意度、健康满意度、配偶关系满意度是中国老年血脂异常共病患者抑郁状况的保护因素。健康自评是个体对自己健康现状及变化情况的主观评价和体验[17]，本研究结果与任蒋磊等人[18]研究相同，健康自评较好的血脂异常共病老年患者倾向于保持积极心态，可能不容易产生抑郁情绪。每天睡眠时间是老年血脂异常共病患者抑郁的影响因素。睡眠是心理健康的重要指标，有研究认为，老年人的睡眠时间与抑郁症状的关系并非线性关系，睡眠不足或睡眠过长均可能增加抑郁风险[19-20]；还有一项纵向调查发现，夜间正常睡眠时间和良好睡眠质量对预防多重发病有重要影响[21]。因此，老年血脂异常共病患者应保证适当的睡眠时长，医疗机构应重视睡眠健康的宣传教育，加强对患者睡眠时长的评估和管理，减少抑郁风险，保持心理健康状态。生活满意度、健康满意度是个体对自己生活、健康的综合判断，作为认知因素，对个体的情绪体验有重要的影响。在本研究中，老年血脂异常共病患者的生活满意度、健康满意度越高，对生活质量、健康水平的评价越积极，个体抑郁风险越低。本研究结果提示，老年血脂异常共病患者的配偶关系满意度越高，个体出现抑郁症状风险越低，这与以往研究结果一致，王学义等人[22]发现，老年人的婚姻满意度不仅是自身抑郁症状的保护因素，还对配偶的抑郁症状有显著的负向影响；在中国空巢老人不断增加，配偶是老年人重要的社会支持系统，良好的支持对情绪具有积极的作用[23]，特别是对于疾病缠身的老年患者来说，配偶可能是主要的照护者，与朝夕相伴的配偶关系越融洽、越满意，患者的心理健康就越有保障。
本研究存在以下局限之处：一是，本研究是一项横断面研究，不能揭示影响因素与变量的因果关系；二是，本研究数据为自我报告式数据，特别是血脂异常等慢性病的临床诊断和具体检查数值无法获取，可能存在一定的信息偏倚。
综上所述，我国老年血脂异常共病患者的抑郁检出率较高，抑郁状况受多种因素的影响。本研究结果可为该人群的心理健康保障管理工作提供参考。
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2024年第51卷第23期
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doi: 10.20043/j.cnki.MPM.202407504
  • 接收时间：2024-07-29
  • 首发时间：2026-03-18
  • 出版时间：2024-12-10
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  • 收稿日期：2024-07-29
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国家社会科学基金重大项目(20&ZD122)
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    1.广州中医药大学公共卫生与管理学院，广东 广州 510006
    2.广州城市理工学院心理健康教研室，广东 广州 510800
    3.广东中医药博物馆，广东 广州 510006

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2种不同金属材料的力学参数
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total species (%)		 属
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species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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