老年慢性病住院患者抑郁相关影响因素分析

摘要

目的 分析老年慢性病住院患者抑郁检出率及其相关影响因素. 方法 通过老年综合评估对438例患有多种慢性疾病的老年住院患者的抑郁情况进行分析. 结果 438例老年慢性病住院患者中伴有抑郁者154例(35.15%).抑郁组中女性、非婚姻状态、低收入、跌倒及失眠的发生率与非抑郁组比较,差异有统计学意义(P=0.02、0.00、0.00、0.00、0.00).抑郁组中认知功能、营养状况及日常生活能力评分显著低于非抑郁组,疼痛评分显著高于对照组(P= 0.03、0.00、0.00、0.00).糖尿病和慢性阻塞性肺疾病的患病率在抑郁组中显著高于非抑郁组(P= 0.03、0.04).Logistic多元回归分析发现,非婚姻状态、认知功能障碍、低收入、失眠、营养不良及糖尿病会增加老年慢性病患者抑郁的风险(OR=2.291、2.065、2.384、2.965、2.561、1.949,均 P<0.05). 结论 老年期抑郁与女性、非婚姻状态、跌倒、失眠、认知功能障碍、营养不良、日常生活能力下降、慢性疼痛及糖尿病、慢性阻塞性肺疾病有关,其中非婚姻状态、认知功能障碍、低收入、失眠、营养不良及合并糖尿病会增加老年慢性病患者抑郁的风险.%Objective To investigate the relative factors of depression in elderly inpatients with multiple chronic diseases. Methods A total of 438 elderly inpatients with multiple chronic diseases were investigated and analyzed by the comprehensive geriatric assessment. Results Among 438 elderly inpatients with chronic diseases, 154 cases(35.15%)were accompanied by depression.The rates of female,non-marital status(single/widowed/divorced),lower income,frequent fall and insomnia were significantly higher in depression group than in non-depression group(P=0.02,0.00,0.00,0.00,0.00,respectively).The scores of cognitive function,nutritional status and activities of daily living were significantly lower in depression group than in non-depression group(P=0.03, 0.00,0.00,respectively),and the pain score was significantly higher in depression group than in non-depression group(P=0.00).The prevalence of diabetes and chronic obstructive pulmonary disease was significantly higher in depression group(P= 0.03,0.04;respectively).Multiple Logistic regression analysis revealed that non-marital status,low income,insomnia,cognitive impairment,malnutrition and diabetes could significantly increase the risk of depression in elderly patients with chronic diseases(OR=2.291,2.065,2.384,2.965,2.561,1.949,respectively,all P<0.05). Conclusions Female,non-marital status,falls,insomnia,cognitive dysfunction,malnutrition,decreased viability of daily life,diabetes,chronic pain and chronic obstructive pulmonary disease are positively associated with the late-life depression.Among them,non-marital status,low income,insomnia,cognitive dysfunction,malnutrition and diabetes could markedly increase the risk of depression in elderly patients with chronic diseases.