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中国不同抑郁程度中老年人群慢性病共病患病情况网络分析

Chronic disease comorbidities among middle-aged and elderly Chinese population with different depression levels: a network analysis on 2018 CHARLS data

  • 摘要:
    目的 了解中国不同抑郁程度中老年人群慢性病共病患病情况,为优化抑郁筛查和慢性病防治工作提供科学依据。
    方法 收集2018年中国健康与养老追踪调查(CHARLS)中14222名 ≥ 45岁中老年人群的相关数据,应用复杂网络模型分析不同抑郁程度下中老年人群的慢性病共病模式,并采用Gephi 0.10.1软件将慢性病共病患病网络进行可视化展示。
    结果 中国14222名中老年人群中,患慢性病共病者7020例,慢性病共病患病率为49.36%;无抑郁者9066人(63.8%),轻度抑郁者4141例(29.1%),重度抑郁者1015例(7.1%);无抑郁者、轻度抑郁者和重度抑郁者慢性病共病患病数分别为3841例、2463例和716例,慢性病共病患病率分别为42.37%、59.48%和70.54%,慢性病共病率随抑郁程度的增加而增高(χ2趋势 = 537.35,P < 0.001);无抑郁者、轻度抑郁者和重度抑郁者患2种慢性病的比例分别为43.7%(1679/3841)、34.2%(843/2463)和28.2%(202/716),患3种慢性病的比例分别为26.5%(1016/3841)、26.1%(644/2463)和22.2%(159/716),患 ≥ 4种慢性病的比例分别为29.8%(1146/3841)、39.6%(976/2463)和49.6%(355/716),Gamma相关分析结果显示,慢性病共病患病数量随着抑郁程度的增加而增加(Gamma = 0.209,P < 0.001);无抑郁者高血压&血脂异常慢性病共病模式的患病率最高(9.22%),轻度抑郁者和重度抑郁者胃部疾病或消化系统疾病&关节炎或风湿病慢性病共病模式的患病率均最高(16.95%和24.33%);网络分析结果显示,无抑郁者、轻度抑郁者和重度抑郁者慢性病共病患病网络的绝对网络密度分别为11.46、16.24和20.30,慢性病共病患病网络绝对网络密度随抑郁程度的增加而增加。
    结论 中国中老年人群慢性病共病患病率较高,不同抑郁程度中老年人群的慢性病共病模式存在差异,慢性病共病患病率随抑郁程度的增加而增高。

     

    Abstract:
    Objective To understand the chronic disease comorbidities among middle-aged and elderly Chinese population with different depression levels and provide a scientific basis for optimizing depression screening and chronic disease prevention and treatment.
    Methods Data from 14 222 middle-aged and elderly individuals aged ≥ 45 years old were collected from the 2018 China Health and Retirement Longitudinal Study (CHARLS). A complex network model was used to analyze the patterns of chronic disease comorbidities in middle-aged and elderly population with different depression levels, and Gephi 0.10.1 software was used to visualize the chronic disease comorbidity network.
    Results  Among the 14 222 middle-aged and elderly Chinese individuals, 7 020 had chronic disease comorbidities, with a comorbidity rate of 49.36%. There were 9 066 (63.8%) individuals without depression, 4 141 (29.1%) with mild depression, and 1 015 (7.1%) with severe depression. The number of chronic disease comorbidities was 3 841, 2 463, and 716 among those without depression, with mild depression, and with severe depression, respectively, and the comorbidity rates were 42.37%, 59.48%, and 70.54%, respectively. The comorbidity rate increased with the severity of depression (χ2trend = 537.35, P < 0.001). The proportions of individuals with 2, 3, and ≥ 4 chronic diseases were 43.7% (1 679/3 841), 26.5% (1 016/3 841), and 29.8% (1 146/3 841) among those without depression; 34.2% (843/2 463), 26.1% (644/2 463), and 39.6% (976/2 463) among those with mild depression; and 28.2% (202/716), 22.2% (159/716), and 49.6% (355/716) among those with severe depression, respectively. Gamma correlation analysis showed that the number of chronic disease comorbidities increased with the severity of depression (Gamma = 0.209, P < 0.001). The comorbidity pattern of hypertension & dyslipidemia had the highest prevalence (9.22%) among individuals without depression, while the comorbidity pattern of gastrointestinal or digestive system diseases & arthritis or rheumatism had the highest prevalence among those with mild (16.95%) and severe (24.33%) depression. Network analysis results showed that the absolute network densities of the chronic disease comorbidity networks were 11.46, 16.24, and 20.30 for individuals without depression, with mild depression, and with severe depression, respectively, and the absolute network density increased with the severity of depression.
    Conclusion The chronic disease comorbidity rate was high among middle-aged and elderly Chinese population, and the patterns of chronic disease comorbidities differed among middle-aged and elderly population with different depression levels. The chronic disease comorbidity rate increased with the severity of depression.

     

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