Article(id=1321169498468635120, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169495406785472, articleNumber=null, orderNo=null, doi=10.11847/zgggws1147665, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1744560000000, receivedDateStr=2025-04-14, revisedDate=1753113600000, revisedDateStr=2025-07-22, acceptedDate=1754928000000, acceptedDateStr=2025-08-12, onlineDate=1792920954577, onlineDateStr=2026-10-25, pubDate=1762704000000, pubDateStr=2025-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792920954577, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792920954577, creator=13701087609, updateTime=1792920954577, updator=13701087609, issue=Issue{id=1321169495406785472, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='11', pageStart='1281', pageEnd='1408', issueExtLink='null', onlineDate='null', pubDate='1762704000000', pubDateStr='2025-11-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792920953847, creator='13701087609', updateTime=1793011176900, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1321547918390178721, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169495406785472, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1321547918390178722, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321169495406785472, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1301, endPage=1308, ext={EN=ArticleExt(id=1321169498703516145, articleId=1321169498468635120, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Factors associated with depressive symptoms, anxiety symptoms, and comorbidities in the elderly population of Jiangsu province: an analysis based on data from the Elderly Psychological Care Action Project, columnId=1321169498275689409, journalTitle=Chinese Journal of Public Health, columnName=Special Report—Advancing Mental Health and Building Mental Health Care Systems, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the depressive symptoms, anxiety symptoms, and comorbidities among the elderly in Jiangsu province and their influencing factors, thus providing data support for the prevention and control of depression and anxiety in the elderly.

Methods

The data from the Elderly Psychological Care Action Project that was carried out in Jiangsu province from 2022 to 2024 were used, a total of 67 817 elderly people aged 65 and above were included in the analysis. Binary logistic regression and unordered multinomial logistic regression models were used to analyze the influencing factors of depressive symptoms, anxiety symptoms, and comorbidities.

Results

The detection rates of depressive symptoms, anxiety symptoms, and comorbid depressive and anxiety symptoms among elderly people aged 65 and above in Jiangsu province were 5.1%, 2.7%, and 2.1%, respectively. Binary logistic regression and unordered multinomial logistic regression analyses showed that the risks of depression, anxiety, and comorbidities in female elderly people were 1.206, 1.211, and 1.189 times that in male elderly people, respectively. The risks of depression, anxiety, and comorbidities in elderly people aged 85 and above were 1.313, 1.389, and 1.508 times that of those aged 65–69, respectively. The risks of depression, anxiety, and comorbidities in elderly people with chronic diseases were 2.217, 2.079, and 2.242 times that of those without chronic diseases, respectively. The risks of depression, anxiety, and comorbidities in elderly people with 1–5 years of education were 0.689, 0.594, and 0.528 times that of those with no education, respectively. The risks of depression, anxiety, and comorbidities in elderly people with 6–10 years of education were 0.856, 0.619, and 0.587 times that of those with no education, respectively. The risks of depression, anxiety, and comorbidities in elderly people satisfied with their relationship with their children were 0.742, 0.500, and 0.573 times that of those without children, respectively. The risks of depression and comorbidities in elderly people dissatisfied with their relationship with their children were 1.797 and 1.707 times that of those without children, respectively. The risks of anxiety and comorbidities in unmarried elderly people were 2.013 and 1.915 times that of married elderly people, respectively. The risks of anxiety and comorbidities in elderly people dissatisfied with their relationship with their spouse were 2.931 and 2.874 times that of those without a spouse, respectively. The risks of anxiety and comorbidities in elderly people with poor relationships with friends were 1.891 and 1.851 times that of those without friends, respectively. The risks of depression, anxiety, and comorbidities in elderly people who regularly participated in elderly activities were 0.649, 0.630, and 0.633 times that of those who did not participate, respectively. The risks of depression, anxiety, and comorbidities in elderly people with negative attitudes towards aging were 1.363, 1.277, and 1.365 times that of those who did not have a clear attitude, respectively. The risks of depression, anxiety, and comorbidities in elderly people with positive attitudes towards aging were 0.470, 0.408, and 0.349 times that of those who did not have a clear attitude, respectively. The risks of depression, anxiety, and comorbidities in elderly people with poor psychological resilience were 2.345, 2.138, and 2.482 times that of those with good psychological resilience, respectively. The risks of depression, anxiety, and comorbidities in elderly people satisfied with their overall life were 0.186, 0.154, and 0.119 times that of those dissatisfied, respectively. The risks of depression, anxiety, and comorbidities in elderly people engaged in various non-paid work in daily life were higher than those engaged in paid work (all P<0.05).

Conclusions

The detection rates of depressive and anxiety symptoms among elderly people aged 65 and above in Jiangsu province are relatively low. Gender, age, marital status, educational background, chronic diseases status, the relationships with relatives and friends, the main daily work, participation in elderly activities, attitude towards aging, psychological resilience, and overall satisfaction with current life are influencing factors for depressive symptoms, anxiety symptoms, and comorbidities in the elderly.

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SU Jian, E-mail:
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目的

分析江苏省老年人抑郁、焦虑症状及共病情况及影响因素,为老年人抑郁和焦虑防控提供科学依据。

方法

采用2022—2024年在江苏省开展的老年心理关爱行动项目数据,纳入分析67 817名≥65岁老年人,采用二元logistic回归和无序多分类logistic回归模型分析抑郁、焦虑症状及共病相关影响因素。

结果

江苏省≥65岁老年人抑郁症状检出率为5.1%,焦虑症状检出率为2.7%,抑郁和焦虑症状共病检出率为2.1%。二元多分类logistic回归和无序多分类logistic回归分析显示,女性老年人抑郁、焦虑及共病风险分别为男性的1.206、1.211和1.189倍;≥85岁老年人分别为65~69岁老年人的1.313、1.389和1.508倍;患有慢性病的老年人分别为未患慢性病的2.217、2.079和2.242倍;受教育年限1~5年的老年人分别为未受教育的0.689、0.594和0.528倍;受教育年限6~10年的老年人分别为未受教育的0.856、0.619和0.587倍;对子女关系满意的老年人分别为无子女的0.742、0.500和0.573倍;而子女关系不满意的老年人抑郁和共病风险分别为无子女的1.797和1.707倍;焦虑和共病风险非在婚的老年人分别为在婚的2.013和1.915倍;对夫妻关系不满意的老年人分别为无老伴的2.931和2.874倍,与朋友关系不好的老年人为无朋友的1.891和1.851倍;经常参加老年活动的老年人抑郁、焦虑及共病风险分别为不参加的0.649、0.630和0.633倍;抑郁、焦虑及共病风险老化态度消极的老年人分别为说不好的1.363、1.277和1.365倍;而老化态度积极的老年人分别为说不好的0.470、0.408和0.349倍;心理韧性差的老年人分别为心理韧性好的2.345、2.138和2.482倍;对生活总体满意的老年人分别为不满意的0.186、0.154和0.119倍,每日最主要从事各种非有偿工作的老年人抑郁、焦虑及共病风险均高于每日最主要从事有偿工作的老年人(均P<0.05)。

结论

江苏省≥65岁老年人抑郁和焦虑症状检出率较低,性别、年龄、婚姻、受教育程度、慢性病患病情况、亲朋关系状况、每日最主要日常工作、老年活动参与度、老化态度、心理韧性和目前生活总体满意度是老年人抑郁、焦虑症状及共病的影响因素。

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吴洵(1992—),主管医师,硕士,研究方向:慢性病及伤害预防控制

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苏健,E-mail:
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url=null, language=null, rfNumber=43, rfOrder=42, authorNames=null, journalName=null, refType=null, unstructuredReference=龚琳, 孙秋子, 刘付东, 等. 盐城市社区高血压/糖尿病患者抑郁状况及影响因素分析[J]. 江苏预防医学, 2024, 35(5): 588-591, 599., articleTitle=null, refAbstract=null), Reference(id=1321169512079151686, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=44, rfOrder=43, authorNames=null, journalName=null, refType=null, unstructuredReference=冯志昕, 史珈铭, 蒋潮鑫, 等. 互联网使用对老年人抑郁症状的影响: 社会网络的中介作用与城乡因素的调节作用[J]. 心理科学, 2024, 47(1): 161-169., articleTitle=null, refAbstract=null), Reference(id=1321169512217563719, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=45, rfOrder=44, authorNames=null, journalName=null, refType=null, unstructuredReference=胡依, 李贝. 基于CHARLS面板数据的中国老年人抑郁症状变动情况及影响因素分析[J]. 中国全科医学, 2021, 24(26): 3281-3287., articleTitle=null, refAbstract=null), Reference(id=1321169512641188424, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=46, rfOrder=45, authorNames=null, journalName=null, refType=null, unstructuredReference=卢映君, 张维森, 朱彤, 等. 广州市中老年人社会经济状况与抑郁症状的关系[J]. 中国慢性病预防与控制, 2024, 32(4): 287-291., articleTitle=null, refAbstract=null), Reference(id=1321169513027064393, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=47, rfOrder=46, authorNames=null, journalName=null, refType=null, unstructuredReference=罗川钦, 杨宜平. 基于线性混合效应模型双惩罚变量选择研究老年人抑郁影响因素[J]. 中国卫生统计, 2024, 41(5): 725-729., articleTitle=null, refAbstract=null), Reference(id=1321169513148699210, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=48, rfOrder=47, authorNames=null, journalName=null, refType=null, unstructuredReference=李扬, 江华. 心血管代谢性共病与抑郁症的双向关联及对全科实践的意义[J]. 中华全科医师杂志, 2021, 20(11): 1187-1191., articleTitle=null, refAbstract=null), Reference(id=1321169513538769483, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=49, rfOrder=48, authorNames=null, journalName=null, refType=null, unstructuredReference=王星光, 常世宁, 葛怡然, 等. 老年人自我价值感对抑郁的影响: 老化态度与焦虑的链式中介作用[J]. 中华行为医学与脑科学杂志, 2024, 33(1): 64-68., articleTitle=null, refAbstract=null), Reference(id=1321169513882702412, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=50, rfOrder=49, authorNames=null, journalName=null, refType=null, unstructuredReference=扶蓉, 石磊, 何飞英. 中老年人糖尿病与抑郁状态共病: 睡眠和运动及社交活动的影响研究[J]. 中国全科医学, 2025, 28(20): 2491-2500., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321169500075053557, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, xref=null, ext=[AuthorCompanyExt(id=1321169500079247862, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, companyId=1321169500075053557, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China), AuthorCompanyExt(id=1321169500087636471, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, companyId=1321169500075053557, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=江苏省疾病预防控制中心慢性非传染病防制所,南京 210009)])], figs=[ArticleFig(id=1321169504005116435, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, language=EN, label=Tab.1, caption=

Distribution of depressive and anxiety symptoms in the elderly with different characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类总人群(n=67 817)有抑郁症状(n=3476)χ2值P值有焦虑症状(n=1 808)χ2值P值
人数比例/%人数比例/%人数比例/%
性别男性32 12047.41 41840.863.411<0.00172740.238.118<0.001
女性35 69752.62 05859.21 08159.8
年龄/岁65~6922 17232.795427.4148.264<0.00151828.775.425<0.001
70~7420 40430.193426.946625.8
75~7913 38819.774721.537620.8
80~847 62711.349114.125213.9
≥854 2266.235010.119610.8
城乡城市46 28168.22 45570.69.6020.0021 30872.314.417<0.001
农村21 53631.81 02129.450027.7
受教育年限/年08 70212.866519.124.873<0.00138221.19.817<0.001
1~518 77727.785224.543324.0
6~1032 33747.71 46742.266036.5
≥118 00111.849214.233318.4
婚姻在婚54 37280.22 50972.2147.296<0.0011 33173.650.249<0.001
非在婚13 44519.896727.847726.4
慢性病患病否23 33734.463918.4417.047<0.00134719.2190.628<0.001
是44 48065.62 83781.61 46180.8
对子女关系满意度无子女9321.4772.31 490.966<0.001543.11 426.492<0.001
不满意6961.01915.61438.0
一般5 3978.068119.638621.7
满意60 14289.62 47272.31 19667.2
对夫妻关系满意度无老伴13 23219.794727.61 083.308<0.00146025.71 106.259<0.001
不满意5080.81263.71005.6
一般4 3966.550914.832318.1
满意49 18073.11 85454.090450.6
与朋友关系无朋友6 3879.444412.8855.757<0.00121611.9772.169<0.001
不好4740.7932.7734.0
一般8 12012.084324.249127.2
好52 83677.92 09660.31 02856.9
与邻居关系一般12 72418.81 06330.6372.783<0.00159532.9265.125<0.001
较好26 65939.31 32538.167437.3
好28 43441.91 08831.353929.8
每日最主要工作有偿工作5 6358.31263.6406.434<0.001693.9419.952<0.001
家务33 99650.11 51743.671639.6
帮子女带孩子3 8195.62116.11528.4
照料其他家人1 9983.02507.21749.6
公益活动/志愿者5290.8451.3271.5
没有固定事做20 46830.21 24935.963535.1
其他1 3722.0782.2351.9
老年活动参与度不参加31 68746.72 07459.7283 667<0.0011 10461.0163.837<0.001
偶尔参加28 61342.21 21434.9995.5
经常参加7 51711.11885.460533.5
老化态度说不好9 76114.491026.21 872.571<0.00151728.61 342.342<0.001
积极52 90978.11 75850.782145.5
消极5 1177.580023.146825.9
心理韧性好30 02144.372420.8947.891<0.00136520.2490.406<0.001
说不好19 32728.51 16133.462334.4
差18 46927.21 59145.882045.4
生活总体满意度不满意1 8132.747313.62 748.719<0.00135919.82 563.200<0.001
一般8 32112.399028.547526.3
满意56 91683.91 96956.695452.8
无法回答7671.1441.3201.1
), ArticleFig(id=1321169504135139860, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, language=CN, label=表1, caption=

不同特征老年人抑郁与焦虑症状分布情况

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类总人群(n=67 817)有抑郁症状(n=3476)χ2值P值有焦虑症状(n=1 808)χ2值P值
人数比例/%人数比例/%人数比例/%
性别男性32 12047.41 41840.863.411<0.00172740.238.118<0.001
女性35 69752.62 05859.21 08159.8
年龄/岁65~6922 17232.795427.4148.264<0.00151828.775.425<0.001
70~7420 40430.193426.946625.8
75~7913 38819.774721.537620.8
80~847 62711.349114.125213.9
≥854 2266.235010.119610.8
城乡城市46 28168.22 45570.69.6020.0021 30872.314.417<0.001
农村21 53631.81 02129.450027.7
受教育年限/年08 70212.866519.124.873<0.00138221.19.817<0.001
1~518 77727.785224.543324.0
6~1032 33747.71 46742.266036.5
≥118 00111.849214.233318.4
婚姻在婚54 37280.22 50972.2147.296<0.0011 33173.650.249<0.001
非在婚13 44519.896727.847726.4
慢性病患病否23 33734.463918.4417.047<0.00134719.2190.628<0.001
是44 48065.62 83781.61 46180.8
对子女关系满意度无子女9321.4772.31 490.966<0.001543.11 426.492<0.001
不满意6961.01915.61438.0
一般5 3978.068119.638621.7
满意60 14289.62 47272.31 19667.2
对夫妻关系满意度无老伴13 23219.794727.61 083.308<0.00146025.71 106.259<0.001
不满意5080.81263.71005.6
一般4 3966.550914.832318.1
满意49 18073.11 85454.090450.6
与朋友关系无朋友6 3879.444412.8855.757<0.00121611.9772.169<0.001
不好4740.7932.7734.0
一般8 12012.084324.249127.2
好52 83677.92 09660.31 02856.9
与邻居关系一般12 72418.81 06330.6372.783<0.00159532.9265.125<0.001
较好26 65939.31 32538.167437.3
好28 43441.91 08831.353929.8
每日最主要工作有偿工作5 6358.31263.6406.434<0.001693.9419.952<0.001
家务33 99650.11 51743.671639.6
帮子女带孩子3 8195.62116.11528.4
照料其他家人1 9983.02507.21749.6
公益活动/志愿者5290.8451.3271.5
没有固定事做20 46830.21 24935.963535.1
其他1 3722.0782.2351.9
老年活动参与度不参加31 68746.72 07459.7283 667<0.0011 10461.0163.837<0.001
偶尔参加28 61342.21 21434.9995.5
经常参加7 51711.11885.460533.5
老化态度说不好9 76114.491026.21 872.571<0.00151728.61 342.342<0.001
积极52 90978.11 75850.782145.5
消极5 1177.580023.146825.9
心理韧性好30 02144.372420.8947.891<0.00136520.2490.406<0.001
说不好19 32728.51 16133.462334.4
差18 46927.21 59145.882045.4
生活总体满意度不满意1 8132.747313.62 748.719<0.00135919.82 563.200<0.001
一般8 32112.399028.547526.3
满意56 91683.91 96956.695452.8
无法回答7671.1441.3201.1
), ArticleFig(id=1321169504244191765, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, language=EN, label=Tab.2, caption=

Binary logistic regression analysis of depression and anxiety among the elderly in Jiangsu province

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分类抑郁症状焦虑症状
OR值95%CIP值OR值95%CIP值
性别男性1.0001.000
女性1.2061.115~1.305<0.0011.2111.087~1.348<0.001
年龄/岁65~691.0001.000
70~741.0050.910~1.1100.9150.9690.845~1.1110.650
75~791.1151.001~1.2420.0481.1270.972~1.3060.114
80~841.1140.983~1.2640.0921.0940.922~1.2990.305
≥851.3131.133~1.522<0.0011.3891.142~1.690<0.001
受教育年限/年01.0001.000
1~50.6890.614~0.772<0.0010.5940.511~0.691<0.001
6~100.8560.767~0.9550.0050.6190.535~0.718<0.001
≥111.0980.954~1.2630.1941.1830.990~1.4120.064
婚姻在婚1.0001.000
非在婚1.1880.690~2.0460.5352.0131.134~3.5720.017
慢性病患病否1.0001.000
是2.2172.021~2.432<0.0012.0791.833~2.359<0.001
对子女关系满意度无子女1.0001.000
不满意1.7971.295~2.494<0.0011.2910.882~1.8910.188
一般0.9460.720~1.2430.6910.6190.445~0.8600.004
满意0.7420.573~0.9630.0250.5000.366~0.683<0.001
对夫妻关系满意度无老伴1.0001.000
不满意1.3900.772~2.5020.2732.9311.565~5.491<0.001
一般0.9550.548~1.6650.8712.1221.173~3.8380.013
满意0.9460.545~1.6420.8451.7270.960~3.1080.068
与朋友关系无朋友1.0001.000
不好1.3270.993~1.7720.0561.8911.351~2.646<0.001
一般1.2631.100~1.444<0.0011.5771.311~1.897<0.001
好0.9880.869~1.1230.8531.1330.947~1.3550.171
每日最主要工作有偿工作1.0001.000
家务1.6231.336~1.972<0.0011.3731.055~1.7870.019
帮子女带孩子2.3391.841~2.971<0.0012.9482.169~4.006<0.001
照料其他家人4.6673.668~5.938<0.0015.2243.833~7.119<0.001
公益活动/志愿者3.9712.682~5.878<0.0013.5122.112~5.842<0.001
没有固定事做1.9321.584~2.356<0.0011.6631.272~2.174<0.001
其他2.2351.639~3.047<0.0011.7981.163~2.7790.008
老年活动参与度从不参加1.0001.000
偶尔参加0.7960.734~0.863<0.0010.7280.651~0.814<0.001
经常参加0.6490.551~0.763<0.0010.6300.503~0.789<0.001
老化态度说不好1.0001.000
消极1.3631.209~1.537<0.0011.2771.093~1.4910.002
积极0.4700.426~0.518<0.0010.4080.358~0.466<0.001
心理韧性好1.0001.000
说不好1.6961.522~1.890<0.0011.6801.446~1.953<0.001
差2.3452.126~2.588<0.0012.1381.863~2.453<0.001
生活总体满意度不满意1.0001.000
一般0.2080.147~0.294<0.0010.2670.224~0.318<0.001
满意0.1860.162~0.214<0.0010.1540.130~0.182<0.001
无法回答0.3900.337~0.452<0.0010.1430.088~0.231<0.001
), ArticleFig(id=1321169504361632278, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, language=CN, label=表2, caption=

江苏省老年人群抑郁症状、焦虑症状的二分类logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素分类抑郁症状焦虑症状
OR值95%CIP值OR值95%CIP值
性别男性1.0001.000
女性1.2061.115~1.305<0.0011.2111.087~1.348<0.001
年龄/岁65~691.0001.000
70~741.0050.910~1.1100.9150.9690.845~1.1110.650
75~791.1151.001~1.2420.0481.1270.972~1.3060.114
80~841.1140.983~1.2640.0921.0940.922~1.2990.305
≥851.3131.133~1.522<0.0011.3891.142~1.690<0.001
受教育年限/年01.0001.000
1~50.6890.614~0.772<0.0010.5940.511~0.691<0.001
6~100.8560.767~0.9550.0050.6190.535~0.718<0.001
≥111.0980.954~1.2630.1941.1830.990~1.4120.064
婚姻在婚1.0001.000
非在婚1.1880.690~2.0460.5352.0131.134~3.5720.017
慢性病患病否1.0001.000
是2.2172.021~2.432<0.0012.0791.833~2.359<0.001
对子女关系满意度无子女1.0001.000
不满意1.7971.295~2.494<0.0011.2910.882~1.8910.188
一般0.9460.720~1.2430.6910.6190.445~0.8600.004
满意0.7420.573~0.9630.0250.5000.366~0.683<0.001
对夫妻关系满意度无老伴1.0001.000
不满意1.3900.772~2.5020.2732.9311.565~5.491<0.001
一般0.9550.548~1.6650.8712.1221.173~3.8380.013
满意0.9460.545~1.6420.8451.7270.960~3.1080.068
与朋友关系无朋友1.0001.000
不好1.3270.993~1.7720.0561.8911.351~2.646<0.001
一般1.2631.100~1.444<0.0011.5771.311~1.897<0.001
好0.9880.869~1.1230.8531.1330.947~1.3550.171
每日最主要工作有偿工作1.0001.000
家务1.6231.336~1.972<0.0011.3731.055~1.7870.019
帮子女带孩子2.3391.841~2.971<0.0012.9482.169~4.006<0.001
照料其他家人4.6673.668~5.938<0.0015.2243.833~7.119<0.001
公益活动/志愿者3.9712.682~5.878<0.0013.5122.112~5.842<0.001
没有固定事做1.9321.584~2.356<0.0011.6631.272~2.174<0.001
其他2.2351.639~3.047<0.0011.7981.163~2.7790.008
老年活动参与度从不参加1.0001.000
偶尔参加0.7960.734~0.863<0.0010.7280.651~0.814<0.001
经常参加0.6490.551~0.763<0.0010.6300.503~0.789<0.001
老化态度说不好1.0001.000
消极1.3631.209~1.537<0.0011.2771.093~1.4910.002
积极0.4700.426~0.518<0.0010.4080.358~0.466<0.001
心理韧性好1.0001.000
说不好1.6961.522~1.890<0.0011.6801.446~1.953<0.001
差2.3452.126~2.588<0.0012.1381.863~2.453<0.001
生活总体满意度不满意1.0001.000
一般0.2080.147~0.294<0.0010.2670.224~0.318<0.001
满意0.1860.162~0.214<0.0010.1540.130~0.182<0.001
无法回答0.3900.337~0.452<0.0010.1430.088~0.231<0.001
), ArticleFig(id=1321169504479072791, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, language=EN, label=Tab.3, caption=

Multinomial logistic regression analysis of the comorbidities of depression and anxiety among the elderly in Jiangsu province

, figureFileSmall=null, figureFileBig=null, tableContent=
特征 分类β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
性别男性1.000
女性0.1730.0617.9400.0051.1891.054~1.342
年龄/岁65~691.000
70~74−0.0180.0790.0520.8200.9820.842~1.146
75~790.0940.0861.2120.2711.0990.929~1.300
80~840.1710.0963.1530.0761.1860.982~1.432
≥850.4110.10914.149<0.0011.5081.217~1.868
受教育年限/年01.000
1~5–0.6390.08655.315<0.0010.5280.446~0.625
6~10–0.5320.08340.814<0.0010.5870.499~0.691
≥110.1430.1002.0370.1541.1530.948~1.402
婚姻在婚1.000
非在婚0.6500.3254.0050.0451.9151.013~3.618
慢性病患病否1.000
是0.8070.073122.707<0.0012.2421.943~2.586
对子女关系满意度无子女1.000
不满意0.5350.2205.8840.0151.7071.108~2.629
一般–0.3030.1942.4410.1180.7390.505~1.080
满意–0.5560.1868.9810.0030.5730.398~0.825
对夫妻关系满意度无老伴1.000
不满意1.0560.3548.9050.0032.8741.437~5.748
一般0.6490.3353.7450.0531.9130.992~3.692
满意0.4900.3332.1670.1411.6320.850~3.134
与朋友关系无朋友1.000
不好0.6160.19010.5380.0011.8511.276~2.685
一般0.5230.10524.912<0.0011.6861.374~2.071
好0.1240.1021.4760.2241.1330.927~1.384
每日最主要日常工作有偿工作1.000
家务0.4690.1638.2580.0041.5991.161~2.203
帮子女带孩子1.3000.18648.602<0.0013.6682.545~5.286
照料其他家人1.9910.186114.507<0.0017.3245.086~10.548
公益活动/志愿者1.6350.28732.383<0.0015.1322.922~9.013
没有固定事做0.7740.16521.937<0.0012.1681.568~2.997
其他0.7730.2598.8940.0032.1661.303~3.600
老年活动参与度从不参加1.000
偶尔参加–0.3070.06423.353<0.0010.7350.649~0.833
经常参加–0.4580.13112.172<0.0010.6330.489~0.818
老化态度说不好1.000
消极0.3110.08613.223<0.0011.3651.154~1.614
积极–1.0510.075197.167<0.0010.3490.302~0.405
心理韧性好1.000
说不好0.6760.08858.435<0.0011.9651.653~2.337
差0.9090.081124.623<0.0012.4822.116~2.911
生活总体满意度不满意1.000
一般–1.4650.096230.636<0.0010.2310.191~0.279
满意–2.1300.094517.912<0.0010.1190.099~0.143
无法回答–2.4290.29866.384<0.0010.0880.049~0.158
), ArticleFig(id=1321169504567153176, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321169498468635120, language=CN, label=表3, caption=

江苏省老年人群抑郁症状和焦虑症状共病的多分类logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
特征 分类β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
性别男性1.000
女性0.1730.0617.9400.0051.1891.054~1.342
年龄/岁65~691.000
70~74−0.0180.0790.0520.8200.9820.842~1.146
75~790.0940.0861.2120.2711.0990.929~1.300
80~840.1710.0963.1530.0761.1860.982~1.432
≥850.4110.10914.149<0.0011.5081.217~1.868
受教育年限/年01.000
1~5–0.6390.08655.315<0.0010.5280.446~0.625
6~10–0.5320.08340.814<0.0010.5870.499~0.691
≥110.1430.1002.0370.1541.1530.948~1.402
婚姻在婚1.000
非在婚0.6500.3254.0050.0451.9151.013~3.618
慢性病患病否1.000
是0.8070.073122.707<0.0012.2421.943~2.586
对子女关系满意度无子女1.000
不满意0.5350.2205.8840.0151.7071.108~2.629
一般–0.3030.1942.4410.1180.7390.505~1.080
满意–0.5560.1868.9810.0030.5730.398~0.825
对夫妻关系满意度无老伴1.000
不满意1.0560.3548.9050.0032.8741.437~5.748
一般0.6490.3353.7450.0531.9130.992~3.692
满意0.4900.3332.1670.1411.6320.850~3.134
与朋友关系无朋友1.000
不好0.6160.19010.5380.0011.8511.276~2.685
一般0.5230.10524.912<0.0011.6861.374~2.071
好0.1240.1021.4760.2241.1330.927~1.384
每日最主要日常工作有偿工作1.000
家务0.4690.1638.2580.0041.5991.161~2.203
帮子女带孩子1.3000.18648.602<0.0013.6682.545~5.286
照料其他家人1.9910.186114.507<0.0017.3245.086~10.548
公益活动/志愿者1.6350.28732.383<0.0015.1322.922~9.013
没有固定事做0.7740.16521.937<0.0012.1681.568~2.997
其他0.7730.2598.8940.0032.1661.303~3.600
老年活动参与度从不参加1.000
偶尔参加–0.3070.06423.353<0.0010.7350.649~0.833
经常参加–0.4580.13112.172<0.0010.6330.489~0.818
老化态度说不好1.000
消极0.3110.08613.223<0.0011.3651.154~1.614
积极–1.0510.075197.167<0.0010.3490.302~0.405
心理韧性好1.000
说不好0.6760.08858.435<0.0011.9651.653~2.337
差0.9090.081124.623<0.0012.4822.116~2.911
生活总体满意度不满意1.000
一般–1.4650.096230.636<0.0010.2310.191~0.279
满意–2.1300.094517.912<0.0010.1190.099~0.143
无法回答–2.4290.29866.384<0.0010.0880.049~0.158
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吴洵 , 杜文聪 , 苏健 *, *
中国公共卫生 | 专题报道——关注心理健康,加强精神卫生服务体系建设 2025,41(11): 1301-1308
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中国公共卫生 |专题报道——关注心理健康,加强精神卫生服务体系建设 2025 , 41 (11) : 1301 -1308
江苏省老年人抑郁、焦虑症状及共病影响因素:基于老年心理关爱行动项目数据分析
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吴洵(1992—),主管医师,硕士,研究方向:慢性病及伤害预防控制

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吴洵, 杜文聪, 苏健*, *
作者信息
  • 江苏省疾病预防控制中心慢性非传染病防制所,南京 210009
通讯作者:
苏健,E-mail:
作者简介:

吴洵(1992—),主管医师,硕士,研究方向:慢性病及伤害预防控制

Factors associated with depressive symptoms, anxiety symptoms, and comorbidities in the elderly population of Jiangsu province: an analysis based on data from the Elderly Psychological Care Action Project
Xun WU, Wencong DU, Jian SU
Affiliations
  • Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
  • Corresponding Author:
    SU Jian, E-mail:
出版时间: 2025-11-10 doi: 10.11847/zgggws1147665
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目的

分析江苏省老年人抑郁、焦虑症状及共病情况及影响因素,为老年人抑郁和焦虑防控提供科学依据。

方法

采用2022—2024年在江苏省开展的老年心理关爱行动项目数据,纳入分析67 817名≥65岁老年人,采用二元logistic回归和无序多分类logistic回归模型分析抑郁、焦虑症状及共病相关影响因素。

结果

江苏省≥65岁老年人抑郁症状检出率为5.1%,焦虑症状检出率为2.7%,抑郁和焦虑症状共病检出率为2.1%。二元多分类logistic回归和无序多分类logistic回归分析显示,女性老年人抑郁、焦虑及共病风险分别为男性的1.206、1.211和1.189倍;≥85岁老年人分别为65~69岁老年人的1.313、1.389和1.508倍;患有慢性病的老年人分别为未患慢性病的2.217、2.079和2.242倍;受教育年限1~5年的老年人分别为未受教育的0.689、0.594和0.528倍;受教育年限6~10年的老年人分别为未受教育的0.856、0.619和0.587倍;对子女关系满意的老年人分别为无子女的0.742、0.500和0.573倍;而子女关系不满意的老年人抑郁和共病风险分别为无子女的1.797和1.707倍;焦虑和共病风险非在婚的老年人分别为在婚的2.013和1.915倍;对夫妻关系不满意的老年人分别为无老伴的2.931和2.874倍,与朋友关系不好的老年人为无朋友的1.891和1.851倍;经常参加老年活动的老年人抑郁、焦虑及共病风险分别为不参加的0.649、0.630和0.633倍;抑郁、焦虑及共病风险老化态度消极的老年人分别为说不好的1.363、1.277和1.365倍;而老化态度积极的老年人分别为说不好的0.470、0.408和0.349倍;心理韧性差的老年人分别为心理韧性好的2.345、2.138和2.482倍;对生活总体满意的老年人分别为不满意的0.186、0.154和0.119倍,每日最主要从事各种非有偿工作的老年人抑郁、焦虑及共病风险均高于每日最主要从事有偿工作的老年人(均P<0.05)。

结论

江苏省≥65岁老年人抑郁和焦虑症状检出率较低,性别、年龄、婚姻、受教育程度、慢性病患病情况、亲朋关系状况、每日最主要日常工作、老年活动参与度、老化态度、心理韧性和目前生活总体满意度是老年人抑郁、焦虑症状及共病的影响因素。

老年人  /  抑郁症状  /  焦虑症状  /  共病  /  影响因素  /  江苏省
Objective

To analyze the depressive symptoms, anxiety symptoms, and comorbidities among the elderly in Jiangsu province and their influencing factors, thus providing data support for the prevention and control of depression and anxiety in the elderly.

Methods

The data from the Elderly Psychological Care Action Project that was carried out in Jiangsu province from 2022 to 2024 were used, a total of 67 817 elderly people aged 65 and above were included in the analysis. Binary logistic regression and unordered multinomial logistic regression models were used to analyze the influencing factors of depressive symptoms, anxiety symptoms, and comorbidities.

Results

The detection rates of depressive symptoms, anxiety symptoms, and comorbid depressive and anxiety symptoms among elderly people aged 65 and above in Jiangsu province were 5.1%, 2.7%, and 2.1%, respectively. Binary logistic regression and unordered multinomial logistic regression analyses showed that the risks of depression, anxiety, and comorbidities in female elderly people were 1.206, 1.211, and 1.189 times that in male elderly people, respectively. The risks of depression, anxiety, and comorbidities in elderly people aged 85 and above were 1.313, 1.389, and 1.508 times that of those aged 65–69, respectively. The risks of depression, anxiety, and comorbidities in elderly people with chronic diseases were 2.217, 2.079, and 2.242 times that of those without chronic diseases, respectively. The risks of depression, anxiety, and comorbidities in elderly people with 1–5 years of education were 0.689, 0.594, and 0.528 times that of those with no education, respectively. The risks of depression, anxiety, and comorbidities in elderly people with 6–10 years of education were 0.856, 0.619, and 0.587 times that of those with no education, respectively. The risks of depression, anxiety, and comorbidities in elderly people satisfied with their relationship with their children were 0.742, 0.500, and 0.573 times that of those without children, respectively. The risks of depression and comorbidities in elderly people dissatisfied with their relationship with their children were 1.797 and 1.707 times that of those without children, respectively. The risks of anxiety and comorbidities in unmarried elderly people were 2.013 and 1.915 times that of married elderly people, respectively. The risks of anxiety and comorbidities in elderly people dissatisfied with their relationship with their spouse were 2.931 and 2.874 times that of those without a spouse, respectively. The risks of anxiety and comorbidities in elderly people with poor relationships with friends were 1.891 and 1.851 times that of those without friends, respectively. The risks of depression, anxiety, and comorbidities in elderly people who regularly participated in elderly activities were 0.649, 0.630, and 0.633 times that of those who did not participate, respectively. The risks of depression, anxiety, and comorbidities in elderly people with negative attitudes towards aging were 1.363, 1.277, and 1.365 times that of those who did not have a clear attitude, respectively. The risks of depression, anxiety, and comorbidities in elderly people with positive attitudes towards aging were 0.470, 0.408, and 0.349 times that of those who did not have a clear attitude, respectively. The risks of depression, anxiety, and comorbidities in elderly people with poor psychological resilience were 2.345, 2.138, and 2.482 times that of those with good psychological resilience, respectively. The risks of depression, anxiety, and comorbidities in elderly people satisfied with their overall life were 0.186, 0.154, and 0.119 times that of those dissatisfied, respectively. The risks of depression, anxiety, and comorbidities in elderly people engaged in various non-paid work in daily life were higher than those engaged in paid work (all P<0.05).

Conclusions

The detection rates of depressive and anxiety symptoms among elderly people aged 65 and above in Jiangsu province are relatively low. Gender, age, marital status, educational background, chronic diseases status, the relationships with relatives and friends, the main daily work, participation in elderly activities, attitude towards aging, psychological resilience, and overall satisfaction with current life are influencing factors for depressive symptoms, anxiety symptoms, and comorbidities in the elderly.

the elderly  /  depression  /  anxiety  /  comorbidity  /  influencing factors  /  Jiangsu province
吴洵, 杜文聪, 苏健. 江苏省老年人抑郁、焦虑症状及共病影响因素:基于老年心理关爱行动项目数据分析. 中国公共卫生, 2025 , 41 (11) : 1301 -1308 . DOI: 10.11847/zgggws1147665
Xun WU, Wencong DU, Jian SU. Factors associated with depressive symptoms, anxiety symptoms, and comorbidities in the elderly population of Jiangsu province: an analysis based on data from the Elderly Psychological Care Action Project[J]. Chinese Journal of Public Health, 2025 , 41 (11) : 1301 -1308 . DOI: 10.11847/zgggws1147665
抑郁症和焦虑症是最常见的两种精神障碍疾病,也是精神障碍疾病负担的主要来源[1]。抑郁症和焦虑症等精神障碍疾病严重影响患者的生活质量与主观幸福感,甚至会使患者产生自杀倾向,致残致死[2–5]。据世界卫生组织报告显示,抑郁和焦虑是≥60岁老年人最常见的心理健康问题,约14%的老年人患有抑郁症状等精神障碍[6]。中国精神障碍疾病负担亦明显增加,尤其是老年人群精神障碍疾病负担较高[7 – 8]。全国精神卫生调查结果显示,中国抑郁障碍终生患病率为6.8% ,其中老年人患病率为7.3%,且仍呈现高增长趋势[5,9]。第五次中国城乡老年人生活状况抽样调查数据显示,有26.4%的老年人存在不同程度的抑郁症状[10]。2019年Huang Y Q等[11]报道,中国成人焦虑障碍的终生患病率为7.6%。中国老年人健康影响因素跟踪调查结果显示,我国老年人焦虑症状检出率为12.15%[12]。随着我国人口老龄化,≥65岁老年人口比例增加[13],老年人群抑郁和焦虑问题越来越引起关注。本研究采用2022—2024年在江苏省开展的老年心理关爱行动项目数据,分析≥65岁老年人抑郁、焦虑症状与共病情况及影响因素,为老年人抑郁和焦虑防控提供科学依据。
本研究数据来源于2022—2024年在江苏省开展的中国老年心理关爱行动项目的调查数据。2022—2024年项目行动共覆盖江苏省13个设区市70个县(区、市),覆盖率为73.7%。通过媒体宣传和社区动员等方式募集项目点内≥65岁常住居民参与调查,共计69 004名老年人参与完成调查。本研究剔除问卷信息不完整和逻辑错误1 187人后,最终67 817人纳入分析。本研究获得中国疾病预防控制中心(简称中国疾控中心)慢病中心伦理委员会批准(批件号:201917)。所有调查对象均签署知情同意书。
本研究主要采用面对面集中调查的方式进行,对于行动不便的老人或质控需要补充询问者采用入户调查和电话调查相结合的方式。项目点调查工作人员为基层卫生人员,需培训并考核合格方可上岗开展工作。采用中国疾控中心慢病中心统一设计制定的调查问卷进行调查。内容包括:社会人口学特征、老年活动参与度、亲朋关系、自报慢性病患病情况、老化态度和心理韧性等[14]。心理健康评估采用抑郁症筛查量表(Patient Health Questionnaire-9, PHQ-9)和广泛性焦虑量表(Generalized Anxiety Disorder, GAD-7)。两个量表广泛用于筛选、评估焦虑症及抑郁症[15–17]。PHQ-9量表共包括9个条目,每个条目采用0~3分4级评定,将各条目分数相加即得总分,总分值范围为0~27分,评分越高,代表抑郁症状程度越高。在本研究中,当PHQ-9评分≥5分,即视为研究对象具有抑郁症状[18]。GAD-7量表共包括7个条目,每个条目采用0~3分4 级评定,将各条目分数相加即得总分,总分值范围为0~21分,评分越高,代表焦虑程度越严重。在本研究中,当GAD-7评分≥5分,即视为研究对象具有焦虑症状[19]。慢性病患病通过询问调查对象是否被医院诊断有高血压、糖尿病、骨质疏松、心脑血管疾病、慢性支气管炎、消化道疾病、肾脏疾病、肝脏疾病、肿瘤、前列腺疾病、泌尿系统疾病、颈/腰椎病、耳聋、青光眼或白内障等慢性病患病情况,如有患病则定义为“是”,回答没有患病则定义为“否”。老年活动参与度,通过询问对象“您经常参加社区老年活动吗?”,自定义标准为“不参加”是几乎没有参加过,“偶尔参加”是一年参加几次,“经常参加”是平均每个月至少1次。老化态度通过询问调查对象“您认为老年人是社会的负担吗?”,回答“不是”的定义为积极老化态度,回答“是”的定义为消极老化态度[14]。心理韧性,通过询问调查对象“生活中遇到重大事故您的心情能不能比较快地恢复过来?”,回答“比较快”的定义为心理韧性好,回答“比较慢”的定义为心理韧性差[14]。本研究相关满意度,包括对子女关系满意度、对夫妻关系满意度、与朋友关系、与邻居关系和生活总体满意度,均通过询问老年人的主观感受判断选择。
使用R 4.3软件进行分析。分类变量采用率或构成比表示,组间比较采用χ2检验。本研究分别以抑郁症状、焦虑症状及共病情况为因变量,以性别、年龄、城乡、受教育年限、婚姻、慢性病患病、对子女关系满意度、对夫妻关系满意度、与朋友关系、与邻居关系、老年活动参与度、老化态度、心理韧性和生活总体满意度为自变量,采用二元logistic回归模型分析抑郁、焦虑症状的影响因素;因不符合平行线检验,故采用无序多分类logistic回归模型分析抑郁和焦虑症状共病相关影响因素。双侧检验,检验水准为α=0.05。
本研究共纳入67 817人,其中男性32 120人(47.4%),女性35 697人(52.6%);在婚54 372人(80.2%),非在婚13 445人(19.8%);城市46 281人(68.2%),农村21 536人(31.8%);65~69、70~74、75~79、80~84和≥85岁年龄组各占32.7%、30.1%、19.7%、11.3%和6.2%;受教育年限0、1~5、6~10和≥11年各占12.8%、27.7%、47.7%和11.8%。抑郁症状检出3 476人(5.1%),焦虑症状检出1 808人(2.7%),抑郁和焦虑症状共病检出1 452人(2.1%)。不同特征老年人抑郁症状和焦虑症状比较差异均有统计学意义(均P<0.05)。
二元多分类logistic回归分析显示,女性、75~79岁、≥85岁、慢性病患病、对子女关系不满意、与朋友关系一般、日常从事非有偿工作、老化态度消极和心理韧性差的老年人抑郁症状风险更高;受教育年限1~5年和6~10年、对子女关系满意、偶尔或经常参加老年活动、老化态度积极、生活总体满意或一般的老年人抑郁症状风险更低(均P<0.05)。二元多分类logistic回归分析还显示,女性、≥85岁、非在婚、慢性病患病、对夫妻关系不满意或一般、与朋友关系不好或一般、日常从事非有偿工作、老化态度消极和心理韧性差的老年人焦虑症状风险更高;受教育年限1~5年和6~10年、对子女关系满意或一般、偶尔或经常参加老年活动、老化态度积极、对生活总体满意或一般的老年人焦虑症状风险更低(均P<0.05)。
无序多分类logistic回归分析显示,女性、≥85岁、非在婚、慢性病患病、对子女关系不满意、对夫妻关系不满意、与朋友关系不好或一般、日常从事非有偿工作、老化态度消极和心理韧性差的老年人抑郁和焦虑及共病的风险更高(均P<0.05);受教育年限1~5年和6~10年、对子女关系满意、偶尔或经常参加老年活动、老化态度积极、对生活总体满意或一般的老年人抑郁和焦虑共病的风险更低(均P<0.05)。
本研究结果显示,江苏省≥65岁老年人抑郁症状检出率为5.1%,低于目前多项国内外流行病学研究报告结果[10,20–21]。江苏省≥65岁老年人焦虑症状检出率为2.7%,也低于我国居民心理健康状况调查和老年人健康影响因素跟踪调查等多项调查结果[8,12,19,22]。目前,不同研究的抑郁和焦虑症状检出率存在一定差异。除研究地区的差异外,一方面是各研究采用的抑郁和焦虑量表不同,另一方面可能是研究纳入样本数量和质量限制等因素造成,老年人抑郁和焦虑症状流行状况仍需更多高质量研究予以验证[20,23]。
本研究结果显示,女性人群抑郁、焦虑症状及共病风险更大,与既往众多研究一致[12,17,20,24–29]。性别差异一方面可能由男、女性的遗传因素、性激素及神经肽等不同所导致[27,30–31];另一方面可能是女性心理因素和社会因素导致,如女性心理感知更为敏感,社会家庭存在性别不平等问题[25,32–33]。但是,也有学者发现,男性承认和报告精神障碍疾病的可能性较低,在调查过程中可能存在男性精神障碍疾病的漏报[34]。
婚姻对老年人心理健康有保护作用,缺失配偶会导致心理健康的下滑[35]。本研究发现,非在婚老年人具有更高的焦虑风险,与闫语等[28]研究一致。进一步分析显示,与无配偶的老年人相比,对夫妻关系不满意或一般的老年人反而具有更高的焦虑症状风险。提示预防焦虑,老年人群更需要和谐的婚姻关系。既往研究表明,老年夫妇与子女关系和社会交往活动在夫妻的婚姻与抑郁和焦虑的关系中可能存在调节作用[26,28,36–37]。情感支持对空巢老人生理、心理健康也均有促进作用[35,38]。本研究中,对子女关系满意的老年人群具有较低的抑郁、焦虑症状及共病风险。此外,参加老年活动也可降低老年人患抑郁、焦虑症状及共病的风险。通过积极参加社会活动,构建社交网络,增加与外界的沟通与交流,有利于老年人调整情绪状态,降低抑郁风险[39–40]。社会支持还可提高老年人心理韧性,对老年人的心理健康有积极的影响[18]。本研究也显示,心理韧性差的老年人抑郁、焦虑症状及共病的风险更高。
既往研究表明,老年人教育水平低和教育水平高均呈现较高抑郁和焦虑风险[29,41]。本研究显示,受教育年限为1~5年和6~10年的老年人群抑郁和焦虑症状发生风险较低。受教育年限过低可能导致个体在社会经济地位、社会支持和生活方式等方面均处于劣势,从而增加抑郁和焦虑的发生风险。而受教育年限过高则可能导致个体面临更大的社会竞争压力和心理负担等,也可能增加抑郁和焦虑症状的发生风险[29,41]。受教育年限与抑郁和焦虑症状的发生风险还有待今后进一步研究。
我国农村老年人抑郁和焦虑症状检出率高于城市老年人[20,23–26,29,42–43]。与农村相比,城市地区拥有更好的社会经济条件及与之相匹配的文化教育资源和医疗资源,使得城市老年人的生活条件、社会支持及健康意识更高,这些均有利于减少抑郁和焦虑的发生[23,42,44–46]。但本研究并未发现抑郁和焦虑症状及共病存在城乡差异,相关关系还有待于今后进一步研究。
随着年龄增长,老年人各项生理机能和活动能力不断下降,且合并诸多慢性病,同时自理能力下降导致自我价值感也会降低,这都会促使老年人心理状况恶化[47]。本研究发现,患有慢性病的老年人抑郁、焦虑症状及共病风险更高,与相关研究结果一致[22,24,48]。患有慢性病的老年人常存在不同程度活动受限,参与老年活动减少,而且长期处于患病状态,遭受病痛折磨,甚至存在经济压力,久而久之易产生负性情绪[22,24,33,48]。此外,老年人的自我价值感也是老年人抑郁的重要因素[49]。既往研究认为,退休是老年人面临的新阶段,由于原有社会身份的剥离和交际关系重组,容易让退休老年人产生被抛弃感和失落感,进而诱发抑郁情绪[50]。本研究也发现,日常主要从事非有偿工作的老年人患抑郁、焦虑及共病的风险均更高。日常主要从事有偿劳动的老年人可能具有更高的自我价值感。
本研究也存在一定的局限性。首先,本研究为横断面研究,无法直接判断因果关系,还有待于前瞻性队列研究;其次,本研究采用项目点自行申报和研究对象自愿招募,可能使研究存在一定的偏倚,抑郁、焦虑症状等检出率偏低;最后,本研究虽纳入较多调整因素,但未纳入老年人经济状况、睡眠情况等可能影响抑郁和焦虑症状的其他影响因素,有待今后的研究进一步补充完善。
综上所述,今后应继续重视老年人群抑郁和焦虑的防控工作,落实重点人群心理健康筛查和关爱行动,重点关注女性、高龄、非在婚、受教育程度低和患有慢性病的高危老年人。

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doi: 10.11847/zgggws1147665
  • 接收时间:2025-04-14
  • 首发时间:2026-10-25
  • 出版时间:2025-11-10
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  • 收稿日期:2025-04-14
  • 修回日期:2025-07-22
  • 录用日期:2025-08-12
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    江苏省疾病预防控制中心慢性非传染病防制所,南京 210009

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
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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