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首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >Health, Social, and Economic Variables Associated with Depression Among Older People in Low and Middle Income Countries: World Health Organization Study on Global AGEing and Adult Health
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Health, Social, and Economic Variables Associated with Depression Among Older People in Low and Middle Income Countries: World Health Organization Study on Global AGEing and Adult Health

机译：与中低收入国家老年人的抑郁症相关的健康，社会和经济变量：世界卫生组织关于全球老龄化和成人健康的研究

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Objective: Although depression among older people is an important public health problem worldwide, systematic studies evaluating its prevalence and determinants in low and middle income countries (LMICs) are sparse. The biopsychosocial model of depression and prevailing socioeconomic hardships for older people in LMICs have provided the impetus to determine the prevalence of geriatric depression; to study its associations with health, social, and economic variables; and to investigate socioeconomic inequalities in depression prevalence in LMICs. Methods: The authors accessed the World Health Organization Study on Global AGEing and Adult Health Wave 1 data that studied nationally representative samples from six large LMICs (N = 14,877). A computerized algorithm derived depression diagnoses. The authors assessed hypothesized associations using survey multivariate logistic regression models for each LMIC and pooled their risk estimates by meta-analyses and investigated related socioeconomic inequalities using concentration indices. Results: Cross-national prevalence of geriatric depression was 4.7% (95% CI: 1.9%-11.9%). Female gender, illiteracy, poverty, indebtedness, past informal-sector occupation, bereavement, angina, and stroke had significant positive associations, whereas pension support and health insurance showed significant negative associations with geriatric depression. Pro-poor inequality of geriatric depression were documented in five LMICs. Conclusions: Socioeconomic factors and related inequalities may predispose, precipitate, or perpetuate depression among older people in LMICs. Relative absence of health safety net places socioeconomically disadvantaged older people in LMICs at risk. The need for population-based public health interventions and policies to prevent and to manage geriatric depression effectively in LMICs cannot be overemphasized.
机译：目的：尽管老年人的抑郁症是全球范围内重要的公共卫生问题，但对中低收入国家（LMIC）的患病率和决定因素进行系统的研究很少。低收入和中等收入国家的抑郁症的生物心理社会模型和普遍存在的社会经济困难为确定老年抑郁症的流行提供了动力。研究其与健康，社会和经济变量之间的关系;并调查中低收入国家抑郁症患病率的社会经济不平等状况。方法：作者访问了世界卫生组织关于全球老龄化和成人健康第一波的数据，该数据研究了来自六个大型LMIC（N = 14,877）的全国代表性样本。一种计算机算法可得出抑郁症诊断。作者使用针对每个LMIC的调查多元逻辑回归模型评估了假设的关联，并通过荟萃分析汇总了其风险估计，并使用集中指数调查了相关的社会经济不平等。结果：全国老年人抑郁症患病率为4.7％（95％CI：1.9％-11.9％）。女性，文盲，贫穷，债务，非正规部门的过往职业，丧亲，心绞痛和中风有显着的正相关，而养老金支持和健康保险则与老年抑郁症有显着的负相关。在五个低收入和中等收入国家中，老年人抑郁症的贫民不平等现象得到了记录。结论：中低收入国家老年人的社会经济因素和相关的不平等现象可能诱发，加剧或使抑郁症长期持续下去。相对缺乏卫生安全网使中低收入国家的社会经济处境不利的老年人处于危险之中。不能过分强调以人群为基础的公共卫生干预措施和政策，以有效预防和管理中低收入国家的老年性抑郁症。

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