| Objective:Older Chinese veterans in the community are special cohort with large members and stable structure, and the nationwide epidemiological research with large sample on the elderly depressive symptoms is insufficient. The main objective of our work is to investigate the prevalence of depressive symptoms, the potentially associated factors of depressive symptoms (including risk factors and protective factors), and the influence of depressive symptoms on caregiver’s burden.Methods:A community-based cross-sectional study with stratified cluster sampling design was conducted, the Chinese older veterans in the community as subjects. The level of depressive symptoms was measured by the Center for Epidemiological Survey, Depression Scale (CES-D) Chinese edition, categorized to "no depressive symptoms" with CES-D score<16 and "depressive symptoms" with that≥16. Prevalence of depressive symptoms was evaluated. Information about demographics, life styles, special experiences, family histories of diseases, physical condition, and cognitive level was obtained through a questionnaire-based interview. Associated factors of depressive symptoms were estimated using stepwise logistic regression, with depressive symptoms as dependent variable. Another part of the study was conducted with the assisted living elderly and their caregivers as subjects. The caregiver’s burden was measured by the Caregiver Burden Inventory (CBI) Chinese edition. Influence of CES-D score on CBI score was also estimated using general linear model (GLM), with CBI score as dependent variable.Results:Firstly, the prevalence of depressive symptoms and its demographic distribution:The crude prevalence was 7.46% in all elderly and 8.52% in the oldest old. The distributions of it on age, gender, educational level, and marital status were statistically significant (P<0.05). Secondly, the potentially associated factors:The oldest old (OR=1.261,95% CI 1.027-1.547), assisted living (1.717,1.356-2.175), negative life events (1.165,1.040-1.305), poor self-rated health (1.616,1.424-1.834), the history of Parkinson’s disease (1.530,1.242-1.884), insomnia (4.693,3.831-5.749), hyperlipidemias (1.116,1.011-1.232), and osteoarthritis (1.099,1.091-1.185) were related to depressive symptoms (P<0.05), and they were identified as independent risk factors. Active physical activity (0.566,0.444-0.722) was inversely related to depressive symptoms (β=-0.569, P<0.0001), and it was identified as independent protective factor. Thirdly, the influence of depressive symptoms on caregiver’s burden:The influence of CES-D score in elderly on CBI score was statistically significant (F=9.075, P=0.003) and the correlation was positive (β=0.324, P=0.003).Conclusions:Firstly, the crude prevalence of depressive symptoms in Chinese older veterans and in the oldest old was lower than reported rate for the general older adults of China. It’s the first and largest national epidemiological study in the older Chinese veterans that explores depressive symptoms. The major strengths are its large sample size resulting in good statistical power, and predominant the oldest-old providing a special cohort. Secondly, The risk of prevalent depressive symptoms is increased in the elderly being oldest old, with assisted living, poor self-rated health, negative life events, the history of Parkinson’s disease, insomnia, hyperlipidemias, and osteoarthritis. And that is decreased in those with active physical activity. Our results provide useful information for addressing further intervention protocols for those modifiable factors to prevent or reduce depressive symptoms in older veterans. It may be a better source of data for policy judgments and be of great importance to reduce the burden on public health. Thirdly, the caregiver’s burden is influenced by depressive symptoms in older veterans. It’s shown the social impact of depressive symptoms and in the service of whole disease burden. Some interventions for reducing caregiving burden were suggested. |
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