Table_1_Less Social Participation Is Associated With a Higher Risk of Depressive Symptoms Among Chinese Older Adults: A Community-Based Longitudinal Prospective Cohort Study.DOCX

ObjectiveWe aimed to examine the association between social participation and depressive symptoms among Chinese older people aged 65 years or above to supplement limited studies in China on this topic.
MethodsThis community-based longitudinal prospective cohort study used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, baseline in 2014 and a follow-up in 2018). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Social participation was assessed using a composite index by considering the frequency for the two types of social activity: organized social activities and informal activities. Pearson's χ2 test was used to correlate the characteristics of participants with social participation or depressive symptoms. Log-binomial regression models were used to assess the association between social participation and the risk of depressive symptoms.
ResultsThe incidence of depressive symptoms was 28.8% among 2,200 participants in 2018 after a 4-year follow-up. Participants with no social participation (32.6%), organized social activities (30.6%), or informal social activities (31.2%) were more likely to have depressive symptoms. After the adjustment of demographic factors, socioeconomic status, lifestyle habits, and health status, in comparison with older people who often engaged in social participation, organized social activities, and informal social activities, the risk of depressive symptoms was 45% [adjusted risk ratio (aRR): 1.45, 95% CI: 1.16–1.82], 42% (aRR: 1.45, 95% CI: 1.02–2.00), and 29% (aRR: 1.29, 95% CI: 1.02–1.99) higher among older people with no social participation and who never engaged in organized social activities and informal social activities, respectively.
ConclusionsThis study showed that the lack of social participation, including organized social activities and informal social activities, was associated with a higher risk of depressive symptoms after 4 years among older adults in China. Our findings shed lights into the feasibility of promoting social participation to reduce the risk of depressive symptoms and promote longevity and healthy aging among older adults.

【研究目的】本研究旨在探讨65岁及以上中国老年人群社会参与与抑郁症状之间的关联，以弥补国内该主题相关研究的不足。
【研究方法】本项基于社区的纵向前瞻性队列研究采用《中国老年健康与长寿追踪调查》（Chinese Longitudinal Healthy Longevity Survey, CLHLS）的数据，该调查基线调查于2014年开展，随访数据采集于2018年。抑郁症状采用10项流调中心抑郁量表（10-item Center for Epidemiologic Studies Depression Scale）进行评估。社会参与则通过综合指数进行衡量，该指数纳入了两类社交活动的参与频率：组织化社交活动与非正式社交活动。采用皮尔逊卡方检验分析研究对象的人口学特征与社会参与或抑郁症状之间的相关性。采用对数二项回归模型评估社会参与与抑郁症状发生风险之间的关联。
【研究结果】经过4年随访，2018年纳入的2200名研究对象中，抑郁症状发生率为28.8%。完全不参与社会参与的研究对象抑郁症状发生率为32.6%，仅参与组织化社交活动者为30.6%，仅参与非正式社交活动者为31.2%，上述人群出现抑郁症状的风险均更高。在校正人口学因素、社会经济地位、生活方式习惯与健康状况后，与经常参与社会参与、组织化社交活动及非正式社交活动的老年人群相比，完全不参与社会参与、从未参与组织化社交活动以及从未参与非正式社交活动的老年人群，其抑郁症状发生风险分别升高45%[校正风险比（adjusted risk ratio, aRR）：1.45，95%置信区间（95% CI）：1.16–1.82]、42%（aRR：1.45，95% CI：1.02–2.00）以及29%（aRR：1.29，95% CI：1.02–1.99）。
【研究结论】本研究表明，在中国老年人群中，缺乏社会参与（包括组织化社交活动与非正式社交活动）与4年后抑郁症状发生风险升高存在显著关联。本研究结果揭示了通过推动社会参与以降低老年人群抑郁症状发生风险、促进长寿与健康老龄化的可行性。