退休中老年人抑郁症状发展轨迹及其预测因素

黄菊菊; 马丽; 李鹏鹞; 庞佳雪; 刘乾坤; 徐洋; 陈丹丹; 谢晖

doi:10.16766/j.cnki.issn.1674-4152.004340

退休中老年人抑郁症状发展轨迹及其预测因素

doi: 10.16766/j.cnki.issn.1674-4152.004340

黄菊菊^{1, 2},
马丽¹,
李鹏鹞¹,
庞佳雪¹,
刘乾坤¹,
徐洋¹,
陈丹丹³,
谢晖^1, ,

1.
蚌埠医科大学护理学院，安徽蚌埠 233030
2.
界首市人民医院心身医学科，安徽阜阳 236500
3.
界首市人民医院产科

基金项目:

安徽省高校科学研究项目 2022AH040212

详细信息

通讯作者:
谢晖，E-mail：hui2122@sina.com

中图分类号: R592 R749.16
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- 文章访问数: 8
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- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2025-01-24
- 网络出版日期: 2026-04-01

The trajectory of depression and its influencing factors among retired middle-aged and elderly individuals in China

HUANG Juju^{1, 2},
MA Li¹,
LI Pengyao¹,
PANG Jiaxue¹,
LIU Qiankun¹,
XU Yang¹,
CHEN Dandan³,
XIE Hui^{1
, ,}

1.
Nursing College, Bengbu Medical University, Bengbu, Anhui 233030, China

摘要

摘要: 目的分析退休中老年人群的抑郁症状发展轨迹，识别其潜在的预测因素，为中老年人心理健康干预提供科学依据。方法采用2015—2020年中国健康与养老追踪调查的数据，共选取4 435名退休中老年人作为研究对象。利用潜变量增长混合模型对退休中老年人群的抑郁症状发展轨迹进行分类，并进一步探讨影响发展轨迹的预测因素。结果退休中老年人群抑郁症状发展轨迹可分为4种类别：抑郁缓解型(9.85%)、抑郁加重型(18.85%)、持续高抑郁型(9.50%)和持续无抑郁型(61.80%)。Logistic回归分析发现，性别、年龄、教育程度、婚姻状况、居住地、自评健康、失能情况、住院情况、家庭子女数目、是否为城镇职工、听力能力、认知障碍、社会参与程度以及慢性病患病状况等均为退休中老年人群抑郁症状发展轨迹的影响因素。结论本研究强调了退休中老年人群抑郁症状发展轨迹的多样性和群体间的异质性。医务人员可以根据这些不同的轨迹特征，实施针对性的健康管理策略。通过识别抑郁症状的不同发展轨迹，可以更精确地理解抑郁症状的动态变化过程，并为开发有效的预防和干预措施提供科学依据。
- 中老年人 /
- 退休 /
- 抑郁 /
- 轨迹 /
- 纵向研究
Abstract: Objective To analyze the developmental trajectories of depressive symptoms in retired middle-aged and elderly individuals, to identify potential predictors, and to provide a scientific basis for mental health interventions. Methods This research utilized data from the China Health and Retirement Longitudinal Study spanning the period from 2015 to 2020. The study population comprised of 4 435 retired middle-aged and elderly individuals who were selected as participants. A latent variable growth mixture model was employed in order to classify the developmental trajectories of depressive symptoms in this population. Further analysis was conducted in order to identify the predictors influencing these trajectories. Results The developmental trajectories of depressive symptoms in retired middle-aged and elderly individuals were classified into four categories: depressive remission (9.85%); depressive worsening (18.85%); persistently high depressive symptoms (9.50%); and persistently non-depressive (61.80%). Logistic regression analysis revealed that factors such as gender, age, education level, marital status, place of residence, self-rated health, disability status, history of hospitalization, number of children in the family, employment as urban workers, hearing ability, cognitive impairment, level of social participation, and chronic disease status were influencing factors of depressive symptom trajectories. Conclusion This study underscores the heterogeneity of developmental trajectories of depressive symptoms and the diversity among groups within the retired middle-aged and elderly population. Healthcare providers can utilize these distinct trajectory characteristics to implement targeted health management strategies. By identifying the various developmental trajectories of depressive symptoms, a more nuanced understanding of the dynamic changes in these symptoms can be achieved. This, in turn, offers a scientific foundation for the development of effective prevention and intervention strategies.
- Middle-aged /
- Retirement /
- Depression /
- Trajectory /
- Longitudinal study

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图 1 退休中老年人抑郁症状发展轨迹

Figure 1. The trajectory of depressive symptoms in retired middle-aged and older adults

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表 1 潜变量增长混合模型指标拟合结果

Table 1. Fitting results of the Latent variable growth mixed model (LGMM)

类别	k	AIC	BIC	aBIC	Entropy	LMR	BLRT	类别概率
1	5	88 817.958	88 849.944	88 834.056
2	8	85 514.874	85 566.052	85 540.631	0.837	＜0.001	＜0.001	0.771 76/0.228 24
3	11	85 098.723	85 169.093	85 134.139	0.753	＜0.001	＜0.001	0.643 52/0.089 84/0.266 64
4	14	84 522.771	84 612.333	84 567.846	0.810	＜0.001	＜0.001	0.105 33/0.193 19/0.094 16/0.607 32
5	17	84 415.278	84 524.032	84 470.012	0.780	＜0.05	＜0.001	0.546 35/0.214 76/0.095 12/0.088 42/0.055 35
注：k为自由估计参数数目，AIC为赤池信息准则，BIC为贝叶斯信息准则；aBIC为校正样本的贝叶斯信息准则；Entropy为信息熵；LMR为似然比检验；BLRT为基于Bootstrap的似然比检验。

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表 2 各抑郁症状潜在类别退休中老年人基本特征比较

Table 2. Comparison of the basic characteristics of each potential category of depressive symptoms in retired middle-aged and elderly adults

项目	抑郁缓解型(n=437)	抑郁加重型(n=836)	持续高抑郁型(n=421)	持续无抑郁型(n=2 741)	统计量	P值	项目	抑郁缓解型(n=437)	抑郁加重型(n=836)	持续高抑郁型(n=421)	持续无抑郁型(n=2 741)	统计量	P值
年龄(岁)					30.706^a	＜0.001	住院情况					41.770^b	＜0.001
45~59	121	260	146	804			有	119	175	126	430
60~74	244	473	244	1 385			无	318	661	295	2 311
≥75	72	103	31	552			家庭子女数目					30.365^a	＜0.001
性别					54.615^b	＜0.001	无	4	9	5	16
男性	129	241	95	1 118			1个	48	81	33	457
女性	308	595	326	1 623			2个	126	280	128	860
教育程度					121.836^a	＜0.001	3个及以上	259	466	255	1 408
小学及以下	355	631	341	1 738			城镇职工					77.447^b	＜0.001
初中	57	134	51	574			是	40	133	32	661
高中及以上	25	71	29	429			否	397	703	389	2 080
婚姻状况					11.945^b	＜0.001	听力能力					44.744^b	＜0.001
在婚	302	628	305	2 117			好	95	238	90	973
不在婚	135	208	116	624			不好	342	598	331	1 768
居住地					16.213^b	＜0.001	认知障碍					30.221^b	＜0.001
农村	232	434	294	1 274			有	409	777	393	2 402
城市	205	402	127	1 467			无	28	59	28	339
自评健康					717.813^a	＜0.001	社会参与					21.148^b	＜0.001
好	33	102	17	886			有	195	423	187	1 516
一般	180	440	130	1 441			无	242	413	234	1 225
不好	224	294	274	414			慢性病					60.196^b	＜0.001
失能					208.644^b	＜0.001	有	393	757	402	2 226
有	199	267	240	497			无	44	79	19	515
无	238	569	181	2 244
注：^a为H值，^b为χ²值。

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表 3 退休中老年人抑郁症状变化轨迹潜在类别影响因素的logistic回归分析

Table 3. Logistic regression analysis of the influencing factors of depressive symptoms in retired middle-aged and elderly adults

因变量	自变量	分类	B	SE	Waldχ²	P值	OR值	95% CI
抑郁缓解型^a	年龄	45~59岁	0.692	0.197	12.308	＜0.001	1.997	1.357~2.938
		60~74岁	0.653	0.162	16.277	＜0.001	1.921	1.399~2.637
	性别	男性	-0.326	0.125	6.855	0.009	0.722	0.565~0.921
	教育程度	小学及以下	0.619	0.237	6.817	0.009	1.857	1.167~2.957
	婚姻状况	在婚	-0.407	0.128	10.063	0.002	0.665	0.517~0.856
	自评健康	好	-2.343	0.205	130.036	＜0.001	0.096	0.064~0.144
		一般	-1.175	0.123	91.026	＜0.001	0.309	0.243~0.393
	失能情况	有	0.815	0.119	47.093	＜0.001	2.259	1.790~2.851
	住院情况	无	-0.319	0.131	5.899	0.015	0.727	0.562~0.940
	城镇职工	否	0.688	0.191	13.040	＜0.001	1.990	1.370~2.892
	听力能力	好	-0.327	0.131	6.195	0.013	0.721	0.557~0.933
	认知障碍	有	0.453	0.218	4.322	0.038	1.573	1.026~2.412
	社会参与	有	-0.240	0.112	4.545	0.033	0.787	0.631~0.981
抑郁加重型^a	年龄	45~59岁	0.918	0.156	34.823	＜0.001	2.504	1.846~3.396
		60~74岁	0.796	0.132	36.572	＜0.001	2.217	1.713~2.870
	性别	男性	-0.391	0.094	17.303	＜0.001	0.676	0.562~0.813
	教育程度	小学及以下	0.447	0.155	8.312	0.004	1.563	1.154~2.117
	自评健康	好	-1.574	0.138	129.832	＜0.001	0.207	0.158~0.272
		一般	-0.675	0.100	45.473	＜0.001	0.509	0.419~0.620
	失能情况	有	0.430	0.97	19.486	＜0.001	1.538	1.270~1.862
	家庭孩子数目	1个	-0.469	0.151	9.645	0.002	0.625	0.465~0.841
	认知障碍	有	0.529	0.155	11.631	0.001	1.698	1.252~2.301
	慢性病	有	0.411	0.136	9.131	0.003	1.509	1.155~1.970
持续高抑郁型^a	年龄	45~59岁	1.884	0.244	59.400	＜0.001	6.577	4.074~10.618
		60~74岁	1.499	0.218	47.338	＜0.001	4.479	2.922~6.866
	性别	男性	-0.653	0.141	21.285	＜0.001	0.521	0.395~0.687
	婚姻	在婚	-0.338	0.141	5.768	0.016	0.713	0.541~0.940
	居住地	农村	0.831	0.124	44.610	＜0.001	2.296	1.799~2.931
	自评健康	好	-2.906	0.268	117.915	＜0.001	0.055	0.032~0.092
		一般	-1.603	0.132	147.639	＜0.001	0.201	0.155~0.261
	失能情况	有	1.190	0.125	90.566	＜0.001	3.288	2.573~4.201
	住院情况	无	-0.295	0.139	4.527	0.033	0.745	0.568~0.977
	城镇职工	否	0.763	0.216	12.438	＜0.001	2.146	1.404~3.280
	家庭孩子数目	1个	-0.536	0.227	5.578	0.018	0.585	0.375~0.913
		2个	-0.282	0.141	3.993	0.046	0.754	0.572~0.995
	听力能力	好	-0.321	0.141	5.194	0.023	0.725	0.550~0.956
	慢性病	有	0.715	0.258	7.688	0.006	2.044	1.233~3.387
注: ^a以“持续无抑郁型”为参照。年龄以≥75岁为参照, 教育程度以高中及以上为参照，家庭子女数目以3个及以上为参照，自评健康以不好为参照。各变量赋值方法如下, 年龄(45~59岁=1, 60~74岁=2, ≥75岁=3)、性别(女性=0, 男性=1)、教育程度(小学及以下=1, 初中=2, 高中及以上=3)、婚姻状况(不在婚=0, 在婚=1)、家庭子女数目(无=0，1个=1，2个=2，3个及以上=3)、居住地(城市=0, 农村=0)、城镇职工(否=0, 是=1)、住院情况(无=0, 有=1)、失能(无=0, 有=1)、慢性病(无=0, 有=1)、自评健康(好=1, 一般=2, 不好=3)、认知障碍(无=0, 有=1)、听力能力(不好=0, 好=1)以及社会参与(无=0, 有=1)。

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