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－

本研究的目的是探讨健康行为和社会条件与抑郁症之间的关系依赖社区居住的老年人在Republic of Chile.This是一个横截面和推理研究，使用全国代表性的二手资料。两个模型对来自智利各地的640名依赖社区居住的老年人进行了逻辑回归，他们亲自回答了抑郁症评估，不包括服用抗抑郁药的人。结果采用老年抑郁量表（GDS-15）。第一个模型针对任何类型的抑郁症（GDS 5>）。第二种针对严重抑郁症（GDS 10>）。作为暴露，我们使用了老年人的健康行为和社会条件。社会人口学和身体条件作为调整。44.5%的老年人出现抑郁症状。其中，11%的人患有严重的抑郁症。Logistic回归分析显示，两种模式中抑郁的显著危险因素是因急性疾病就诊5次以上、对生活安排感到不舒服、感觉受歧视。另一方面，体育锻炼和独居每增加一天，只有在模式一中才有有利和不利的影响，需要分析如何支持独居老年人和促进体育锻炼，以避免抑郁症，沿着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之间歧视问题的方法。

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.