■目前尚不清楚抑郁症状是否与全因死亡率增加相关,以及抑郁症状在多大程度上与慢性病和全因死亡率相关。本研究旨在探讨抑郁症状与全因死亡率的关系,以及抑郁症状可能有多大,反过来,慢性疾病影响中国中老年人全因死亡率。
■数据来自中国健康与退休纵向研究(CHARLS)。这项队列研究涉及从CHARLS的第1波(2011年)到第6波(2020年)的13,855名个体,这是一项具有全国代表性的调查,收集45岁及以上中国居民的信息,以探索抑郁症状和全因死亡率之间的内在机制。流行病学研究中心抑郁量表(CES-D-10)通过CHARLS进行了验证。协变量包括社会经济变量,生活习惯,和自我报告的慢性病史。Kaplan-Meier曲线通过抑郁症状水平描述了死亡率,Cox比例风险回归模型估计全因死亡率的风险比(HRs)。
■在总共13,855名参与者中,中位(Q1,Q3)年龄为58.00(51.00,63.00)岁.对所有协变量进行了调整,有抑郁症状的中老年人的全因死亡率较高(HR=1.20[95%CI,1.09-1.33]).观察到55-64岁(HR=1.23[95%CI,1.03-1.47])和65岁以上(HR=1.32[95%CI,1.18-1.49])的比率增加,农业户口(HR=1.44,[95%CI,1.30-1.59]),和非农业工作量(HR=1.81[95%CI,1.61-2.03])。抑郁症状增加了高血压患者全因死亡的风险(HR=1.19[95%CI,1.00-1.40]),糖尿病(HR=1.41[95%CI,1.02-1.95]),和关节炎(HR=1.29[95%CI,1.09-1.51])。
■抑郁症状增加全因死亡风险,特别是在55岁及以上的人群中,农村户籍(农业户口),非农业工人,中老年人高血压患者,糖尿病,和关节炎。通过本研究收集的纵向数据,我们的发现为针对抑郁症的干预措施提供了有价值的见解。例如早期检测,综合慢性病护理管理,和健康的生活方式;和社区支持抑郁症状可能有助于降低中老年人的死亡率。
UNASSIGNED: It remains unclear whether depressive symptoms are associated with increased all-cause mortality and to what extent depressive symptoms are associated with chronic disease and all-cause mortality. The study aims to explore the relationship between depressive symptoms and all-cause mortality, and how depressive symptoms may, in turn, affect all-cause mortality among Chinese middle-aged and older people through chronic diseases.
UNASSIGNED: Data were collected from the
China Health and Retirement Longitudinal Study (CHARLS). This cohort study involved 13,855 individuals from Wave 1 (2011) to Wave 6 (2020) of the CHARLS, which is a nationally representative survey that collects information from Chinese residents ages 45 and older to explore intrinsic mechanisms between depressive symptoms and all-cause mortality. The Center for Epidemiological Studies Depression Scale (CES-D-10) was validated through the CHARLS. Covariates included socioeconomic variables, living habits, and self-reported history of chronic diseases. Kaplan-Meier curves depicted mortality rates by depressive symptom levels, with Cox proportional hazards regression models estimating the hazard ratios (HRs) of all-cause mortality.
UNASSIGNED: Out of the total 13,855 participants included, the median (Q1, Q3) age was 58.00 (51.00, 63.00) years. Adjusted for all covariates, middle-aged and older adults with depressive symptoms had a higher all-cause mortality rate (HR = 1.20 [95% CI, 1.09-1.33]). An increased rate was observed for 55-64 years old (HR = 1.23 [95% CI, 1.03-1.47]) and more than 65 years old (HR = 1.32 [95% CI, 1.18-1.49]), agricultural Hukou (HR = 1.44, [95% CI, 1.30-1.59]), and nonagricultural workload (HR = 1.81 [95% CI, 1.61-2.03]). Depressive symptoms increased the risks of all-cause mortality among patients with hypertension (HR = 1.19 [95% CI, 1.00-1.40]), diabetes (HR = 1.41[95% CI, 1.02-1.95]), and arthritis (HR = 1.29 [95% CI, 1.09-1.51]).
UNASSIGNED: Depressive symptoms raise all-cause mortality risk, particularly in those aged 55 and above, rural household registration (agricultural Hukou), nonagricultural workers, and middle-aged and older people with hypertension, diabetes, and arthritis. Our findings through the longitudinal data collected in this study offer valuable insights for interventions targeting depression, such as early detection, integrated chronic disease care management, and healthy lifestyles; and community support for depressive symptoms may help to reduce mortality in middle-aged and older people.