Prevalence And Risk Factors Of Depression Among Elderly With Hypertension

Objective:To estimate the prevalence of depressive symptoms among elderly with hypertension screening by the PHQ-9scale; to determine risk factors of depressive symptoms.Method:Survey sites are primary care settings in a Street of Shangcheng District, Hangzhou, Zhejiang province. Sampling methods: to choose elderly hypertensive patients who are in the Hypertension Management System in the Street as sampling frame, cluster sampling method was used for sample size, and screening data are collected by face-to-face interview, PCPs and nurses have a responsibility for screening depressive symptoms from elderly hypertensive patients through phone appointment or visit, and a1:1matched in gender and age case-control study was conducted to analysis the impact of demographic data, major chronic disease, direct cost of chronic diseases,self-rating healthy, health-related behaviors, activities of daily living, negative life events and social support on depression among elderly with hypertension.Results:1. This study investigated1000hypertensive patients, actually investigate961cases, response rate was96.1%. Slightly more than half of the sample are female cases (57.40%); age ranges from60years old to99years old, with a median age is74.19years old, QR=14.12(P25=66.55, P75=66.55);309of them has a junior education degree (32.2%);729of them are married (75.9%),207of them are widowed (21.5%). The maximum number of children is eight, a median number of children is2.00, QR=2.00(P25=1.00, P75=1.00),633of them has one or two children (65.9%).258depressive symptom patients have been screened, the incidence of depressive symptoms was26.8%(258/961), including13.1%(126/961), moderate depression. The score of PHQ-9ranges from0to27point, median score is2.00, QR=4.00(P25=1.00, P75=5.00). In depressive symptoms patients,"feeling tired or having little energy" has a highest rate of occurrence, followed by "trouble falling or staying asleep, or sleep too much". 2. To analysis the effect of demographic data on depression among elderly with hypertension by ordinal regression, gender (OR=1.718,95%CI:1.240-2.380), numbers of children(OR=3.619,95%CI:1.655-7.917) are risk factors of depressive symptoms in hypertensive patients.3. Hypertensive patients usually coexist with other chronic diseases, the highest comorbidity rate of chronic diseases are heart disease (42.4%), followed by diabetes (33.1%) and hyperlipidemia (26.7%), while the control group is back problems (26.7%), diabetes (26.2%), heart disease (22.7%). There is statistically significant difference in heart disease, stroke, hyperlipidemia and diabetes.4. By the single factor analysis, there is statistically significant difference in the annual income, the degree of economic satisfaction, hypertension management stages, duration of hypertension, major chronic diseases, direct cost of chronic diseases, pain, self-rating healthy, physical exercise, leisure activities, activities of daily living, negative life events and social support between case group and control group.5. Conditional logistic regression analysis:diabetes(OR=3.953,95%CI:1.412～11.067), ADL(OR=6.054,95%CI:1.401-26.158), negative life event(OR=16.403,95%CI:5.653-47.58) is risk factors of depression symptoms among elderly with hypertension, having diabetes, functional impairment and suffering more negative life event, higher possibility of depressive symptoms may have.Conclusions:1. This study found that the prevalence of depressionsymptoms was26.8%among elderly with hypertension in community Hangzhou city, followed by moderate depression symptoms is13.1%. Gender and numbers of children are risk factors of depressive symptoms, female and having no children have a higher degree of depression symptoms.2. Having diabetes, functional impairment and suffering more negative life event, higher possibility of depressive symptoms among elderly with hypertension may have.