山西医科大学健康管理团队揭示空巢老人超重与焦虑的关系
我国是当今世界老年人口最多的国家,同时也是世界老龄化进程最为迅速的国家之一。根据老龄委相关数据,截至2017年底,我国60岁及以上老年人口数量已达2.4亿,约占总人口的17.3%。预计到2030年,我国老年人口将超过3亿,“未富先老”的老龄化难题亟需解决。提高老年人健康水平是积极应对人口老年化的重要支撑,尤其关注其心理健康已成为实现“积极老龄化、健康老龄化”目标必须研究和解决的重要课题之一。BMI是影响焦虑症状的重要因素,但目前研究多集中在青少年群体,而此种关系在老年群体中也同样值得重点关注。
2019年4月山西医科大学健康管理团队在International journal of geriatric psychiatry发表题为“Are overweight people more susceptible to anxiety?”文章。研究发现,山西省空巢老人焦虑症状检出率为44.5%,其中男性为43.2%,女性为45.9%。调整人口学变量、日常饮食健康注重度、自理能力和抑郁等因素后,超重空巢老人发生焦虑的可能性是正常体重空巢老人发生的81.3%(OR=0.813,95%CIs=0.692-0.954),且体重指数与焦虑存在性别差异,仅女性超重与焦虑发生关系有统计学意义(OR=0.718,95%CIs=0.572-0.901)。此外,收入、受教育程度、生活自理能力和抑郁也是焦虑症状的重要影响因素。提示政府、媒体和相关专家超重是女性空巢老人患焦虑的保护性因素,应采取措施改变以往存在的体重偏见,切实提高空巢老人的身心健康水平和生活质量。
Table1 Logistic regression analysis of anxiety among empty nesters in Shanxi, China
Independent variables |
Total(N = 4901) |
Male(N = 2546) |
Female(N = 2355) |
|
Region |
0.981 (0.835,1.153) |
0.909 (0.728,1.136) |
1.069 (0.842,1.357) |
|
Education (Reference = No) |
|
|
|
|
|
Primary school |
0.844 (0.711,1.003) |
0.607 (0.470,0.783)*** |
1.124 (0.886,1.426) |
|
Secondary school |
0.896 (0.733,1.095) |
0.693 (0.523,0.918)* |
1.113 (0.830,1.492) |
|
High school |
0.864 (0.659,1.133) |
0.640 (0.444,0.921)* |
1.152 (0.758,1.751) |
|
Junior college |
0.766 (0.455,1.290) |
0.450 (0.230,0.8790* |
1.530 (0.642,3.646) |
|
University or higher |
0.977 (0.603,1.583) |
0.521 (0.276,0.986)* |
2.066 (0.965,4.421) |
|
BMI (Reference = Normal) |
|
|
|
|
|
|
Underweight (<18.5) |
1.110 (0.897,1.374) |
1.116 (0.818,1.523) |
1.115 (0.829,1.499) |
|
Overweight (³24.0) |
0.813 (0.692,0.954)* |
0.920 (0.732,1.155) |
0.718 (0.572,0.901)** |
|
Monthly income (Reference = No) |
|
|
|
|
|
|
Low (<1000RMB) |
1.076 (0.905,1.280) |
1.059 (0.820,1.368) |
1.089 (0.857,1.382) |
|
Middle (1000–3000RMB) |
0.906 (0.749,1.096) |
0.893 (0.679,1.172) |
0.923 (0.703,1.211) |
|
High (>3000RMB) |
0.643 (0.490,0.844)*** |
0.617 (0.432,0.880)* |
0.681 (0.431,1.074) |
|
Attention to daily nutritional health (Reference = No at all) |
|
|
|
|
|
No |
1.304 (0.875,1.945) |
1.325 (0.769,2.285) |
1.247 (0.690,2.254) |
|
Yes, somewhat |
1.311 (0.885,1.942) |
1.346 (0.786,2.306) |
1.246 (0.698,2.224) |
|
Yes, very much |
1.412 (0.929,2.146) |
1.607 (0.899,2.871) |
1.205 (0.654,2.220) |
|
Self-care ability (Reference = Unable) |
|
|
|
|
|
|
Partial |
0.470 (0.213,1.034) |
0.286 (0.079,1.034) |
0.626 (0.223,1.757) |
|
Complete |
0.220 (0.101,0.477)*** |
0.137 (0.038,0.487)** |
0.278 (0.101,0.764)* |
|
Depression (Reference = No) |
10.955 (9.507,12.623)*** |
11.288 (9.255,13.768)*** |
10.733 (8.752,13.164)*** |
|
Constant |
0.785 |
1.665 |
0.498 |
|
R2 |
0.389 |
0.406 |
0.379 |
|
Table2 The association between anxiety and BMI stratified by age among empty nesters
Independent variables |
Total(N = 4901) |
60~(N = 2440) |
70~(N = 1910) |
80~(N = 551) |
BMI(Reference = Normal) |
|
|
|
|
Underweight (<18.5) |
1.111(0.898,1.375) |
1.123(0.807,1.562) |
1.231(0.879,1.724) |
0.964(0.563,1.650) |
Overweight (≥24.0) |
0.807(0.687,0.948)** |
0.823(0.659,1.028) |
0.710(0.541,0.930)* |
1.039(0.622,1.737) |
山西医科大学健康团队负责人张持晨为文章的第一及通讯作者,山西医科大学管理学院硕士研究生李咪咪为文章第二作者。该研究得到国家自然科学基金、山西省高等学校人文社会科学重点研究基地项目、山西省留学回国人员科技活动择优资助项目、山西省回国留学人员科研资助项目和山西省软科学研究计划项目的资助。