中老年高血压患者社会隔离和抑郁的双轨迹-基于CHARLS数据的纵向研究
Dual trajectories of social isolation and depression among middle-aged and older patients with hypertension:a longitudinal study based on CHARLS
张瑞芹 1刘瀚文 2聂丽 3孙翠勇3
作者信息
- 1. 新乡医学院护理学院,河南新乡 453003
- 2. 新乡医学院第二附属医院早期干预科
- 3. 新乡医学院管理学院
- 折叠
摘要
目的 识别中老年高血压患者社会隔离和抑郁的双轨迹,探讨他们之间的相互关系及共同影响因素.方法 使用中国健康与养老追踪调查(CHARLS)2013-2020年数据进行分析.采用GBTM双轨迹模型和logistic回归,分析3 223例中老年高血压患者社会隔离与抑郁的双轨迹和共同影响因素.结果 识别出社会隔离有无社会隔离低稳定、无社会隔离中稳定、社会隔离高上升3种轨迹,抑郁有无抑郁低稳定、抑郁中增加、抑郁高持续3种轨迹.双轨迹分析表明,社会隔离处于无社会隔离中稳定和社会隔离高上升轨迹组的中老年高血压患者,抑郁处于抑郁中增加和抑郁高持续轨迹组的概率在61.84％～87.46％;抑郁处于抑郁中增加和抑郁高持续轨迹组的中老年高血压患者,社会隔离处于无社会隔离中稳定和社会隔离高上升轨迹组的概率在70.03％～91.63％.文化程度(初中社会隔离轨迹组RRR=0.756,95％CI:0.599～0.954,RRR=0.496,95％CI:0.326～0.755;高中及以上社会隔离轨迹组 RRR=0.516,95％CI:0.375～0.709,RRR=0.262,95％CI:0.137～0.501;初中抑郁轨迹组 RRR=0.773,95％CI:0.622～0.959,RRR=0.728,95％CI:0.574～0.994;高中及以上抑郁轨迹组RRR=0.421,95％CI:0.309～0.571,RRR=0.439,95％CI:0.253～0.763)、夜间睡眠7～9 小时(社会隔离轨迹组 RRR=0.824,95％CI:0.681～0.997,RRR=0.596,95％CI:0.440～0.806;抑郁轨迹组 RRR=0.597,95％CI:0.501～0.711,RRR=0.486,95％CI:0.362～0.653)是社会隔离轨迹和抑郁轨迹的共同影响因素(均P＜0.05).结论 社会隔离轨迹和抑郁轨迹有高度一致性和显著相关性.应考虑针对社会隔离、抑郁的双重轨迹和共同影响因素进行干预.
Abstract
Objective This study aimed to identify the dual trajectories of social isolation and depression among middle-aged and older patients with hypertension,discuss the relationship between the dual trajectories,and investigate common influential factors.Method Using data from 2013 to 2020 of the China Health and Retirement Longitudinal Study(CHARLS),a longitudinal cohort was formed for the study.A group-based trajectory model was used to identify trajectories of social isolation and depression in 3 223 middle-aged and older patients with hypertension and the relationship between the dual trajectories.Multi-class logistic regression was used to analyze common influential factors of the dual trajectories.Results Three trajectories of social isolation were identified:low-stable without social isolation,medium-stable without social isolation,and high-increasing with social isolation.Three depression trajectories were observed:low-stable without depression,medium-increasing with depression,and high-stable with depression.Dual-trajectory analysis showed in middle-aged and older patients with hypertension who were in the medium-stable without social isolation and high-increasing with social isolation trajectory groups,the probability of depression trajectories in the medium-increasing with depression and high-stable with depression groups was 61.84％to 87.46％.In middle-aged and older patients with hypertension who belonged to the medium-increasing with depression and high-stable with depression trajectory groups,the probability of social isolation in the medium-stable without social isolation and high-increasing with social isolation trajectory groups was 70.03％to 91.63％.The level of education(social isolation trajectories in middle school RRR=0.756,95％CI:0.599-0.954,RRR=0.496,95％CI:0.326-0.755;social isolation trajectories in high school or above RRR=0.516,95％CI:0.375-0.709,RRR=0.262,95％CI:0.137-0.501;depression trajectories in middle school RRR=0.773,95％CI:0.622-0.959,RRR=0.728,95％CI:0.574-0.994,depression trajectories in high school or above RRR=0.421,95％CI:0.309-0.571,RRR=0.439,95％CI:0.253-0.763)and sleeping 7-9 hours a night(social isolation trajectories RRR=0.824,95％CI:0.681-0.997,RRR=0.596,95％CI:0.440-0.806;depression trajectories RRR=0.597,95％CI:0.501-0.711,RRR=0.486,95％CI:0.362-0.653)were common influential factors of the dual trajectories of social isolation and depression.Conclusion There is a high degree of consistency and significant correlation between the social isolation trajectory and the depression trajectory.Interventions targeting the dual trajectories and co-factors of social isolation and depression should be considered to improve their effectiveness.
关键词
社会隔离/抑郁/双轨迹/中老年/高血压患者Key words
Social isolation/Depression/Dual trajectories/Middle-aged and older/Patients with hypertension引用本文复制引用
出版年
2025
NETL
NSTL
万方数据