高齢者に対するコミュニティーケアに関する国際比較研究－根拠ある政策立案に向けて－

本研究的目的是研究智利共和国依赖社区居住的老年人的健康行为和社会条件与抑郁症之间的关系。这是一项横断面和推理研究，使用具有全国代表性的二手数据。两个模型对来自智利各地的640名依赖社区生活的老年人进行了逻辑回归，这些老年人亲自回答了抑郁症评估，不包括服用抗抑郁药的老年人。结果采用老年抑郁量表（GDS-15）。第一个模型针对的是任何类型的萧条（GDS 5亿美元）。第二个目标是严重萧条（GDS 10亿美元）。作为暴露，我们使用老年人的健康行为和社会条件。以社会人口统计学和身体状况作为调整因素，44.5%的老年人出现抑郁症状。其中，11%患有严重抑郁症。Logistic回归结果显示，因急症就诊5次及以上、对生活安排感到不舒服、感觉受到歧视是两种模式抑郁的显著不利因素。另一方面，每增加一天的体育锻炼和独自生活只在模型一中有有益和有害的影响。需要分析支持独居老人的方法和促进体育锻炼以避免抑郁，以及更深入地了解他们的生活安排的舒适度。最后，应进一步探讨解决老年人歧视问题的途径。

The aim of this study was to examine the relation between health behavior and social conditions with depression among dependent community-dwelling older persons in the Republic of Chile.This is a cross-sectional and inferential study, using nationally representative secondary data. Two models used logistic regression on 640 dependent community-dwelling older persons from all over Chile, who personally answered a depression assessment, excluding those taking antidepressants. The geriatric depression scale (GDS-15) was used as outcome. The first model aims at any kind of depression (GDS 5>). The second aims at severe depression (GDS 10>). As exposure, we used the health behavior and social conditions of the older persons. Socio-demographic and physical conditions were used as adjustment.44.5% of the older persons presented depressive symptoms. Among them, 11% had severe depression. Logistic regression showed that significant detrimental factors for being depressed in both models were visiting the doctor five times or over because of acute diseases, feeling uncomfortable with their living arrangement, and feeling discriminated. On the other hand, every additional day of physical exercise and living alone had a beneficial and detrimental effect only in model one.Analyses on ways to support older persons living alone and the promotion of physical exercise to avoid depression are needed, along with a deeper understanding of the comfort with their living arrangement. Finally, ways to address the discrimination among older persons should be further explored.