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우리나라 노인의 우울증과 관련 요인 - 생활습관, 정신건강, 만성질환 및 영양상태 중심으로 - : 2014 국민건강영양조사 자료

Depression and Related Risk Factors in the Elderly with a Focused on Health Habits, Mental Health, Chronic Diseases, and Nutrient Intake Status: Data from the 2014 Korea National Health and Nutrition Examination Survey

  • Lee, Hye-Sang (Dept. of Food & Nutrition, Andong National University)
  • 투고 : 2018.03.13
  • 심사 : 2018.04.04
  • 발행 : 2018.05.02

초록

Depression is a major health problem that can lead to mortality. This study was conducted to assess the risk factors associated with depression in a group aged over 65 years by analyzing nationally representative Korean survey data. A total of 1,209 subjects were analyzed among the participants of the 2014 Korean National Health and Nutrition Examination Survey. Statistical methods for a complex sample were applied by using SPSS program(windows ver. 24.0). Depression assessments were carried out by using the 9-item depression module of the Patient Health Questionnaire-9 (PHQ-9). Depression ($PHQ-9{\geq}5$) was more frequently found in females (33.2%) compared to males (16.1%). However, there was no evidence suggesting that characteristics such as residence area, income level and age, except for educational level, were related with depression. The results of the logistic regression analysis showed that i) health habits such as smoking (OR: 2.26) and lack of aerobic physical activity (OR: 1.62), ii) mental health status such as bad self-rating of health status (OR: 4.30), more stress (OR: 8.31), and bad health-related quality of life (by EQ_5D, OR: 3.41), iii) chronic diseases such as obesity (OR: 0.66), hypercholesterolemia (OR: 1.57), anemia (OR: 1.91), and iv) low intake of energy (OR: 1.84) and calcium (OR: 1.71) were significantly associated with depression. This study suggests that certain characteristics of health habits, mental health status, chronic diseases and nutrient intake may be associated with depression. Prospective research on long-term control is needed to establish causal connections among those factors with depression.

키워드

참고문헌

  1. An JY, Seo ER, Lim KH, Shin JH, Kim JB (2013): Standardization of the Korean version of screening tool for depression (patient health questionnaire-9, PHQ-9). J Korean Soc Biol Ther Psychiatry 19(1):47-56
  2. Cho HA, Choi ES (2016): Association between depression and poor oral health in Korean elderly: the six Korean National Health and Nutrition Examination Survey (KNHANES VI-2). J Korean Soc Dent Hyg 16(6):931-941 https://doi.org/10.13065/jksdh.2016.16.06.931
  3. Choi HS, Choi JH, Park KH, Joo KJ, Ga H, Ko HJ, Kim SR (2007): Standardization of the Korean version of patient health questionnaire-9 as a screening instrument for major depressive disorder. J Korean Acad Fam Med 2007;28(2): 114-119
  4. Corona LP, Duarte YA, Lebrao ML (2014): Prevalence of anemia and associated factors in older adults: evidence from the SABE Study. Rev Saude Publica 48(5):723-731 https://doi.org/10.1590/S0034-8910.2014048005039
  5. de Wit LM, van Straten A, van Herten M, Penninx BW, Cuijpers P (2009): Depression and body mass index, a u-shaped association. BMC Public Health 9:14 https://doi.org/10.1186/1471-2458-9-14
  6. Han C, Jo SA, Kwak JH, Pae CU, Steffens D, Jo I, Park MH (2008): Validation of the patient health questionnaire-9 Korean version in the elderly population: the Ansan Geriatric study. Compr Psychiatry 49(2):218-223 https://doi.org/10.1016/j.comppsych.2007.08.006
  7. Jia H, Lubetkin EI (2017): Incremental decreases in quality-adjusted life years (QALY) associated with higher levels of depressive symptoms for U.S. adults aged 65 years and older. Health Qual Life Outcomes 15(1):9 https://doi.org/10.1186/s12955-016-0582-8
  8. Kahng SK (2010): Does depression predict suicide?: gender and age difference in the relationship between depression and suicidal attitudes. Korean J Soc Welf Stud 41(2):67-99 https://doi.org/10.16999/kasws.2010.41.2.67
  9. Kahng SK, Boo KC (2010): Predictors of elderly depression using the Anderson model. Korean J Gerontol Soc Welf 49(1):7-29
  10. Kahng SK, Kwon TY (2008): An exploratory study on the effects of socioeconomic status on depression symptoms across lifespan. Ment Health Soc Work 30(4):332-355
  11. Kim BH, Jung E (2008): The changes of types of nutritional risk and nutritional intake according to depression and self-esteem among the elderly in Chunnam province. J Korean Home Econ Assoc 46(8):97-107
  12. Kim DB, Sohn ES (2005): A meta-analysis of the variables related to depression in elderly. J Korean Gerontol Soc 25(4):167-187
  13. Kim DB, Yoo BS, Min JS (2011): Analysis of factors affecting health inequalities among Korean elderly. Korean J Soc Welf Stud 42(3):267-290 https://doi.org/10.16999/kasws.2011.42.3.267
  14. Kim J, Lee JA (2010): Depression and health status in the elderly. J Korean Gerontol Soc 30(4):1311-1327
  15. Kim KN, Choi YH, Lim YH, Hong YC (2016): Urinary phthalate metabolites and depression in an elderly population: National Health and Nutrition Examination Survey 2005-2012. Environ Res 145:61-67 https://doi.org/10.1016/j.envres.2015.11.021
  16. Korea Centers for Disease Control and Prevention. Guidebook for using the 6th Korean National Health and Nutrition Examination Survey (KNHANES VI). Available from: https://knhanes.cdc.go.kr/knhanes/sub03/sub03_06_02.do. Accessed August 8, 2017.
  17. Kroenke K, Spitzer RL, Williams JB (2001): The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606-613 https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  18. Lee HJ, Kahng SK, Lee JY (2008): The effects of socioeconomic position and health behavior on geriatric depressive symptom. J Korean Gerontol Soc 28(4):1129-1145
  19. Lee HS (2014): The factors influencing health-related quality of life in the elderly: focused on the general characteristics, health habits, mental health, chronic disease, and nutrient intake status: data from the fifth Korean National Health and Nutrition Examination Survey (KNHANES V), 2010-2012. Korean J Community Nutr 19(5):479-489 https://doi.org/10.5720/kjcn.2014.19.5.479
  20. Lee HS (2016): Prevalence of osteopenia/osteoporosis and related risk factors of men aged 50 years and older: Korea National Health and Nutrition Examination Survey 2010-2011 data. J Korean Diet Assoc 22(2):106-117 https://doi.org/10.14373/JKDA.2016.22.2.106
  21. Liang Y, Yan Z, Cai C, Jiang H, Song A, Qiu C (2014): Association between lipid profile and depressive symptoms among Chinese older people: mediation by cardiovascular diseases? Int J Behav Med 21(4):590-596 https://doi.org/10.1007/s12529-013-9358-2
  22. Liu Y, Ozodiegwu ID, Yu Y, Hess R, Bie R (2017): An association of health behaviors with depression and metabolic risks: data from 2007 to 2014 U.S. National Health and Nutrition Examination Survey. J Affect Disord 217:190-196 https://doi.org/10.1016/j.jad.2017.04.009
  23. Lopresti AL, Hood SD, Drummond PD (2013): A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise. J Affect Disord 148:12-27 https://doi.org/10.1016/j.jad.2013.01.014
  24. Mann JJ, Bortinger J, Oquendo MA, Currier D, Li SH, Brent DA (2005): Family history of sucidal behavior and mood disorders in probands with mood disorders. Am J Psychiatry 162(9):1672-1679 https://doi.org/10.1176/appi.ajp.162.9.1672
  25. Oh J, Kim TS (2017): Serum lipid levels in depression and suicidality: The Korea National Health and Nutrition Examination Survey (KNHANES) 2014. J Affect Disord 213:51-58 https://doi.org/10.1016/j.jad.2017.02.002
  26. Oh SW (2011): Obesity and metabolic syndrome in Korea. Diabetes Metab J 35(6):561-566 https://doi.org/10.4093/dmj.2011.35.6.561
  27. Park PS, Park KO, Jeong GB, Chun BY, Choi MW, Park MY (2009): A survey on stages of dietary behaviors change and nutrient intake status of old people in islands areas according to depression degree. Korean J Hum Ecol 18(6): 1349-1361 https://doi.org/10.5934/KJHE.2009.18.6.1349
  28. Park SJ, Choi HR, Choi JH, Kim K, Hong JP (2010): Reliability and validity of the Korean version of the patient health questionnaire-9 (PHQ-9). Anxiety Mood 6(2):119-124
  29. Rotella F, Mannucci E (2013): Depression as a risk factor for diabetes: a meta-analysis of longitudinal studies. J Clin Psychiatry 74(1):31-37 https://doi.org/10.4088/JCP.12r07922
  30. Sohn JN (2013): Factors influencing depressive symptoms in community dwelling older people. J Korean Acad Psychiatr Ment Health Nurs 22(2):107-116 https://doi.org/10.12934/jkpmhn.2013.22.2.107
  31. Spitzer RL, Kroenke K, Wiliams JB (1999): Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary evaluation of mental disorders. Patient Health Questionnaire. JAMA 282(18):1737-1744 https://doi.org/10.1001/jama.282.18.1737
  32. Statistics Korea. Major indicators of Korea. Available from: http://kosis.kr/conts/nsportalStats/nsportalStats_0101Body.jsp?menuId=all. Accessed January 8, 2018
  33. Stewart R, Hirani V (2012): Relationship between depressive symptoms, anemia, and iron status in older residents from a national survey population. Psychosom Med 74(2):208-213 https://doi.org/10.1097/PSY.0b013e3182414f7d
  34. Sung HN, Chae HS, Kim ES, Kim JS (2014): Diabetes and depressive symptoms in Korean women: the fifth Korean National Health and Nutrition Examination Survey (2010-2011). Korean J Fam Med 35(3):127-135 https://doi.org/10.4082/kjfm.2014.35.3.127
  35. The Korean Nutrition Society (2010): Dietary reference intakes for Koreans. The Korean Nutrition Society. Seoul. pp.578-583
  36. Won MS, Kim S, Yang YJ (2016): Comparison of health status and nutrient intake between depressed women and non-depressed women: based on the 2013 Korea National Health and Nutrition Examination Survey. Clin Nutr Res 5(2): 112-125 https://doi.org/10.7762/cnr.2016.5.2.112
  37. Yu Y, Song Y (2015): Three clustering patterns among metabolic syndrome risk factors and their associations with dietary factors in Korean adolescents: based on the Korea National Health and Nutrition Examination Survey of 2007-2010. Nutr Res Pract 9(2):199-206 https://doi.org/10.4162/nrp.2015.9.2.199