Association between Health Literacy and Depressive Symptoms among Middle-aged and Elderly People in Taiwan

Abstract

<p>目的：為了解台灣中老年族群健康識能與憂鬱症狀的關聯，本研究以收案具國家代表性的中老年族群資料庫進行分析。研究將納入各項可能與老年憂鬱相關的因子，以檢驗健康識能是否為與中老年族群憂鬱症狀相關的獨立因子。</p> <p>方法：本研究利用2015年衛生福利部國民健康署的「台灣地區中老年身心社會生活狀況長期追蹤調查」資料庫進行分析，共收案5,304人。本研究以卡方檢定、獨立t檢定分析各變項與憂鬱風險的單變項關聯，以多元線性迴歸分析自變項與憂鬱分數的關聯，並採用逐步迴歸分析加入健康識能進行分析，另以羅吉斯迴歸分析主要自變項與憂鬱風險的關聯。</p> <p>結果：低憂鬱風險(CES-D<10)族群健康識能平均為40.1分，而高憂鬱風險(CES-D≥10)族群健康識能平均為23.9分，兩者具有顯著差異(p<0.05)。線性迴歸分析結果顯示健康識能分數愈高(β=-0.13)，則憂鬱傾向愈低。健康識能較佳、分數高於平均值（即38分及以上）者，相較於健康識能較差、分數低於平均值（即37分及以下）者，能夠降低48.5%憂鬱風險(OR 0.52, 95% CI 0.40-0.66)。<p>結論：健康識能較高的中老年民眾罹患憂鬱風險較低。增進健康識能可能是未來中老年族群心理健康研究的一個方向。</p> <p> </p><p>Purpose: To understand the relationship between health literacy and depressive symptoms in the middle-aged and older population in Taiwan, the study analyzed nationally representative data and directed its attention to various factors related to depression in middle-aged and elderly people to examine whether health literacy can be an independent factor correlated with depressive symptoms in this population.</p> <p>Methods: The study analyzed the data from the 2015 Taiwan Longitudinal Survey on Aging conducted by National Health Administration of the Ministry of Health and Welfare. A total of 5,304 cases were enrolled. The chi-square test and the independent t-test were used to analyze the univariate association between variables and depression risk. Multiple linear regression was performed to analyze the relationship between independent variables and depression scores, with health literacy added in the stepwise regression analysis. In addition, logistic regression was applied to examine the relationship between the main independent variables and depression risk.</p> <p>Results: The average health literacy score of the low-depression risk group (CES-D<10) was 40.1, while that of the high-risk group (CES-D≥10) was 23.9, indicating a statistically significant difference (p<0.05). The results of stepwise regression analysis showed that the higher the score of health literacy (β=-0.13), the lower the risk of depression. Cases with good health literacy and scoring above the average (38 or higher) were able to reduce the risk of depression by 48.5% (OR 0.52, 95% CI 0.40-0.66), compared with those with poor health literacy and scoring below the average (37 or lower).</p> <p>Conclusion: Middle-aged and older people with higher health literacy are at a lower risk of depression. Improving health literacy therefore merits further studies for its contribution to mental health.</p> <p> </p>