Do older adults become more depressed with age in Taiwan? The role of social position and birth cohort
Do older adults become more depressed with age in Taiwan? The role of social position and birth cohort
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DOI：
10.1136/jech.2008.082230
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发表时间：
2009-08-01
影响因子：
6.3
通讯作者：
Botticello, A.
中科院分区：
文献类型：
--
作者：
Chiao, C.;Weng, L-J;Botticello, A.
背景：抑郁症是老年人最常见的心理健康问题之一。摘要本研究探讨台湾老年人抑郁症状轨迹的差异，并探讨社会经济地位（SEP）变量与症状轨迹之间的关系。方法：对1989 ~ 2003年台湾省老龄化纵向研究（TLSA）资料进行分析。具有全国代表性的样本由60岁及以上的台湾社区生活成年人（n = 2458）组成。所有的分析都使用了流行病学研究中心抑郁量表（CES-D）的简短形式来评估抑郁症状的两个不同领域，消极影响和缺乏积极影响。生长曲线模型被用来评估抑郁症状随时间的发展轨迹。结果：年龄与抑郁症状呈线性关系，有轻微的曲线效应。消极情绪组抑郁症状随年龄增长而增加（平均线性增长率= 0.26,p < 0.001），但趋于平稳（平均二次增长率= -0.01,p < 0.001），而缺乏积极情绪组抑郁症状呈相反趋势。SEP变量的影响也因队列和结果域而异。结论：保持运动、与家人同住和受教育程度高与晚年生活的积极影响相关，而经济压力和健康状况不佳与晚年生活的消极影响密切相关。这些结果强调了SEP在一个人的一生中独立于年龄的心理调节中所起的持续作用。
Background: Depression is one of the most commonly encountered mental health problems during older adulthood. This study examines differences in depressive symptom trajectories among older Taiwanese adults across two birth cohorts (1920-1924 and 1925-1929), and explores the relationships between socioeconomic position (SEP) variables and symptom trajectories.Methods: Data from the Taiwan Longitudinal Study on Aging (TLSA) collected between 1989 and 2003 were analysed. The nationally representative sample is composed of community-living adults (n = 2458) in Taiwan aged 60 years and above. Two distinct domains of depressive symptomatology, negative affect and lack of positive affect, assessed by the short form of the Center of Epidemiological Studies-Depression (CES-D) scale were used for all the analyses. Growth curve models were employed to assess the trajectories of depressive symptoms over time.Results: The relationship between ageing and depressive symptoms appeared linear with a minor curvilinear effect. The depressive symptoms in negative affect increased with age (mean linear growth rate = 0.26, p < 0.001) but levelled off (mean quadric growth rate = -0.01, p < 0.001), while the symptoms in lack of positive affect displayed an opposite trend. The effects of SEP variables also differed by cohort and outcome domain.Conclusions: Remaining active, living with family and having a high level of education are associated with positive affect later in life, while financial strain and poor health are strongly related to negative affect. These results underline the continued role that SEP plays in psychological adjustment over the course of one's life, independently of ageing.