| Background: As China entering into aged society, health condition and life quality of elder people have caused the attention from all sectors of the society, which has also been an important work content for medical department. Geriatric depression is a most common and also the most serious mental disease of older populations, it is increasingly becoming a severe social public health problem, the condition is even worse in rural areas where is short of health services. In 2001, our work team used random cluster sampling method to research the conditions of metal health service for 1186 older populations in an urban community of Anhui Province ( their ages are not less than 65 years old, and they live there for not less than 5 years, 550 whole moved populations are excluded). In 2003, the same method was used to do the same research for 1600 older populations in a rural community of Anhui Province (their ages are not less than 60 years old, and they live there for not less than 5 years). Our work team carried out return visit to the urban community in 2002 and to the rural community in 2004. The investigation showed that these two groups were stable with small mobility and good compliance. Therefore in 2008, our work team carried out epidemiology and health services research to these two groups. The research of"Cross-Section Survey of Geriatric Depression"is only a part of it. The difference between this research and former research conducted by our work team is that: the researches of urban and rural communities in Anhui Province are carried out at the same time; based on this, the differences of disease level and influencing factors of geriatric depression between urban and rural communities are deeply investigated.Objectives: Through the cross-section survey of an urban and an rural communities in Anhui Province, finding out the distribution characteristics (sex, age, profession, marriage and so on) of the populations with geriatric depression there in 2008, comparing disease levels in urban and rural communities, discussing influencing factors of geriatric depression, and analyzing influencing factor difference between urban and rural communities; these provides scientific basis for further survey of intervening measures of actively and effectively preventing and controlling geriatric depression in community.Methods: This research is a cross-section investigation of geriatric depression, which is conducted in two phases: cases screening phase and cases confirmation phase. In cases screening phase, we interviewed with the Geriatric Mental State Schedule (GMS) and its corresponding computerized diagnostric system , the Automated Geriatric Examination for computer assisted Taxonomy(AGECAT) and the Minimum Data Set (MDS). In cases confirmation phase, referring to CCMD-3 and DSM-IV, clinicians conduct analog diagnosis to suspect depression cases that have been screened out by measuring scale. All data will be inputted into computer with EpiData3.10, and then the result will be analyzed with SPSS11.0 systematic software. The prevalence rates in urban and rural areas will be compared with standardized rate. Data are measured with ( x±sd), which will also be checked and compared with"t". Enumeration data is represented in rate or constituent ratio, which will be tested withχ2 or compared with exact probabilistic method. Influencing factor of senile depression should be analyzed with single factor or multiple-factor logistic regression model. Two states of depression can be diagnosed with GMS measuring scale and AGECAT, one is sub-case state of depression (scale 1 or 2), and another is depression state (level 3 or 4). Because we have few sub-cases (26 cases in urban area and 31 cases in rural area), and in order to improve test efficiency, only the influencing factor of depression cases have been analyzed in this research, sub-cases have been excluded in the Logistic regression model.Results: (1) 902 information was got in the research of urban community (including 279 investigated older people who died due to various diseases), the response rate is 76.1%; 1402 information was got in the research of urban community (including 322 investigated older people who died due to other diseases), the response rate is 88.3%; (2) in this research, the prevalence rate of older populations depression in urban and rural communities is 5.34%, the rate of sub-cases is 3.35%. Among it, the prevalence rate of older populations depression in urban communities is 3.85%, the rate of sub-cases is 4.17%; the prevalence rate of older populations depression in rural communities is 6.20%, the rate of sub-cases is 2.87%; (3) multiple-factor logistic regression model shows that: worrying about children, self-perceived poor health, hearing problem, economic difficulty, and quantity of stressful life events will increase the risk of disease; however, frequent communication with relatives and friends can reduce the risk of geriatric depression; (4)the comparison between urban and rural influence factors prompts that: worrying about children and quantity of stressful life events are common influence factors to both urban and rural older populations; life satisfaction, self-perceived poor health, migraine, religions belief and frequency of communication with neighbors bring various influence to urban and rural older populations depression; (5) GMS-AGECAT has good reliability and effect for diagnosis of geriatric depression.Recommendation: (1) pay more attention to prevention work of geriatric depression; (2) strengthen research on depression and psychology of elder people and improve diagnosis ability of the community; (3) based on the influencing factor difference between urban and rural areas, vigorously conducting various intervening measures; (4) reinforce communication and cooperation in our country and abroad. |
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