| Abstract: | 前言：人口老化乃全球性的現象，而老年人之心理健康更是現今社會所關注的議題；其中，又以老年憂鬱最為常見，且常被用以當作老年人心理健康狀態的指標。本研究主要探討台灣老年人憂鬱發生之相關預測因素。 方法：本研究利用行政院衛生署國民健康局所提供的「台灣地區中老年身心社會生活狀況長期追蹤調查」資料庫；以 1993年年底滿 65歲以上之社區老人為抽樣母群，排除居住長照機構及有憂鬱病史者後，共計 1,540人，做為期十年的追蹤。在憂鬱評估方面，本研究係採用簡式之流行病學研究中心憂鬱量表(CES-D 10)，並針對可能潛在影響之相關預測變項，如人口學背景特徵、居住安排、健康功能狀況、休閒活動、經濟及社會支持系統等，採用卡方檢定進行分析，再將有意義之變項以邏輯斯迴歸模式進一步統計處理。 結果：針對1993年之1,540人進行為期十年的追蹤，發現其中有535人(34.7%)死亡，142人(9.2%)無法完成後續訪查或無法評估，故至2003年止僅餘863人；其中304人有憂鬱症狀，佔35.2%。而邏輯斯迴歸分析發現，女性相對男性發生老年人憂鬱之勝算比為1.80﹝95% CI = 1.28 ~ 2.51﹞，且日常生活功能障礙者較無障礙者易發生老年人憂鬱﹝OR = 8.74，95% CI = 1.04 ~ 73.57﹞。 結論：由本研究得知，台灣地區老年人憂鬱的發生相當普遍，平均每三人中即有一人有憂鬱症狀；而日常生活功能狀態及性別更是影響日後老年人憂鬱發生的重要預測因素。因此，及早擬定相關因應策略，更是目前當務之急。
Objectives: Depression, one of the most common mental disorders among the elderly population, is often used as an indicator of psychological health. This study aimed to identify the predictive factors of depression among the elderly in Taiwan. Methods: Data were drawn from the “Survey of Health and Living Status of the Elderly in Taiwan”, a national longitudinal study launched in 1989. We recruited at baseline in 1993 community-dwelling respondents without depressive symptoms or disorders and followed them over a ten-year period. Depressive symptoms were assessed by the ten-item Center for Epidemiologic Studies Depression Scale (CES-D). Independent variables, including age, sex, education, marital status, living arrangement, poverty level, chronic diseases, physical functions, leisure activities, and mental support systems, were gathered at baseline in 1993. Multivariate logistic regression analysis was used to evaluate the predictive factors for geriatric depression. Results and Conclusion: Of the eligible 1,540 respondents, 535 (34.7%) and 142 (9.2%) individuals did not complete the follow-up in 2003 due to death and uncompleted interview respectively. Based on the results, being female (OR = 1.80, 95% CI = 1.28~2.51) and activities of daily living disability (OR = 8.74, 95% CI = 1.04~73.57) were independent predictors for geriatric depression in Taiwan. |
