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－

这项研究的目的是检验健康行为和社会条件之间的关系，在独立的社区居住的老年人在智利共和国。这是一项横断面和推论研究，使用具有全国代表性的二级数据。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Logistic回归，他们亲自回答了抑郁评估，不包括那些服用抗抑郁药物的人。采用老年抑郁量表(GDS-15)作为结果。第一个模型针对的是任何类型的抑郁症(GDS 5&>)。第二个针对的是重度抑郁症(GDS 10&>)。作为暴露，我们使用了老年人的健康行为和社会条件。以社会人口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%的人患有严重的抑郁症。Logistic回归分析显示，在两种模型中，抑郁的显著有害因素是因急性疾病就诊五次或以上、对生活安排感到不舒服和感觉受到歧视。另一方面，增加一天的体育锻炼和独居只有在模式一中才有好处和坏处。需要分析支持独居老年人的方法，促进体育锻炼以避免抑郁，并更深入地了解他们生活安排的舒适性。最后，应进一步探讨如何解决老年人之间的歧视问题。

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.