欧阳一非, 乔媛, 张新景, 张峰, 刘慧琳, 张兵. 中国四省55岁及以上人群身体活动与抑郁症状的关联[J]. 环境与职业医学, 2021, 38(8): 817-824. DOI: 10.13213/j.cnki.jeom.2021.21129
引用本文: 欧阳一非, 乔媛, 张新景, 张峰, 刘慧琳, 张兵. 中国四省55岁及以上人群身体活动与抑郁症状的关联[J]. 环境与职业医学, 2021, 38(8): 817-824. DOI: 10.13213/j.cnki.jeom.2021.21129
OUYANG Yifei, QIAO Yuan, ZHANG Xinjing, ZHANG Feng, LIU Huilin, ZHANG Bing. Relationship between physical activity and depressive symptoms among people aged 55 years and above in four provinces of China[J]. Journal of Environmental and Occupational Medicine, 2021, 38(8): 817-824. DOI: 10.13213/j.cnki.jeom.2021.21129
Citation: OUYANG Yifei, QIAO Yuan, ZHANG Xinjing, ZHANG Feng, LIU Huilin, ZHANG Bing. Relationship between physical activity and depressive symptoms among people aged 55 years and above in four provinces of China[J]. Journal of Environmental and Occupational Medicine, 2021, 38(8): 817-824. DOI: 10.13213/j.cnki.jeom.2021.21129

中国四省55岁及以上人群身体活动与抑郁症状的关联

Relationship between physical activity and depressive symptoms among people aged 55 years and above in four provinces of China

  • 摘要: 背景

    抑郁可引起老年人生活质量降低和失能等问题。目前关于身体活动与抑郁症状之间关联的剂量-效应关系研究较少。

    目的

    分析不同强度身体活动时间、总身体活动量与抑郁症状之间的关系。

    方法

    利用“神经系统疾病专病社区队列研究”2018—2019年基线调查数据,采用问卷调查法收集个人基础资料、身体活动资料,利用老年抑郁量表(GDS-30)判定是否有抑郁症状。选取中国四省有完整人口学信息、身体活动以及抑郁量表资料的55岁及以上的居民作为研究对象,共计5 558人。计算每周低强度身体活动(LPA)和中高强度身体活动(MVPA)时间以及总身体活动量。采用多因素logistic回归分析不同身体活动时间和总身体活动量与抑郁症状之间的关联;采用五节点(P5P50P75P90P95),以身体活动时间或总身体活动量为0作为参考剂量,利用限制性立方样条模型分析其剂量-效应关系。

    结果

    居民抑郁症状检出率为10.2%(567/5 558)。有抑郁症状组的LPA时间、MVPA时间和总身体活动量分别为3.5、4.7 h·周-1和25.6 MET·h·周-1,均小于无抑郁症状组(均P < 0.05)。与每周LPA时间为0的人群相比,调整混杂因素后,LPA时间>10.5 h·周-1时,出现抑郁症状风险下降47%(OR=0.53,95%CI:0.33~0.85)。随着LPA时间增加,出现抑郁症状风险逐渐降低(总趋势P < 0.05,非线性P>0.05)。与每周MVPA时间为0的人群相比,每周MVPA时间超过24.5 h人群出现抑郁症状风险增加至2.35(95%CI:1.50~3.68)倍。随着MVPA时间和总身体活动量的增加,出现抑郁症状风险呈现先下降后上升的趋势(总趋势P < 0.05,非线性P < 0.05)。

    结论

    在一定范围内,LPA时间与出现抑郁症状风险呈近乎线性关系。每周MVPA时间、总身体活动量与出现抑郁症状风险之间呈近似“U”型剂量-效应关系。

     

    Abstract: Background

    Depression can cause a variety of problems such as low quality of life and disability in the elderly. Studies on the dose-response relationship between physical activity and depression symptoms are still insufficient at present.

    Objective

    This study is designed to analyze the relationships of different-intensity physical activity durations and total physical activity volume with depressive symptoms.

    Methods

    The data were derived from the baseline survey of the Community-based Cohort Study on Nervous System Diseases conducted during 2018-2019. Information on demographic characteristics and physical activity was investigated by questionnaire. The Geriatric Depression Scale-30 (GDS-30) was used to screen whether the participant had depressive symptoms. A total of 5 558 participants aged 55 years and above from four provinces of China with complete information on demographic characteristics, physical activity, and GDS-30 were included in the final analysis. Light physical activity (LPA) duration, moderate-to-vigorous physical activity (MVPA) duration, and total physical activity volume were calculated. Multiple logistic regression models were used to analyze the relationships of different physical activity durations and total physical activity volume with depressive symptoms, and restricted cubic spline models for 5 quantile knots (P5, P50, P75, P90, and P95) were employed to evaluate the dose-effect relationships, using zero as reference.

    Results

    The prevalence of depression symptoms was 10.2% (567/5 558). The median LPA duration, MVPA duration, and total physical activity volume were 8.2 h·week-1, 7.0 h·week-1, and 31.5 MET·h·week-1 in the participants with depressive symptoms, which were lower than those in the participants without (P < 0.05). Compared with the residents without LPA, LPA >10.5 h·week-1 was associated with a 47% lower risk of having depressive symptoms (OR=0.53, 95% CI: 0.33-0.85) after selected confounder adjustment. The risk of having depressive symptoms was gradually decreased with increased time spent in LPA (Ptrend < 0.05, non-linear P>0.05). The odds ratio of having depressive symptoms was 2.35 (95% CI: 1.50-3.68) times higher in the people with >24.5 h·week-1 of MVPA than those without MVPA. With the increase of MVPA duration and total physical activity volume, the risk of having depressive symptoms first decreased and then increased (Ptrend < 0.05, non-linear P < 0.05).

    Conclusion

    There is a near linear relationship between the duration of LPA and the risk of having depressive symptoms within a certain range. There is a near U-shaped dose-effect relationship of MVPA duration and total physical activity volume with the risk of having depressive symptoms.

     

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