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, , 3 . . . 2020 6
. 2011, 2014, 2017 , 65 2011 10,533 , 2014 10.027 , 2017 10,082 . Chi-square . 2011 , 2014 , 2017 . . 7 . , , , , . , , , , , , , , . .
.
.
I.
1.
2019 65
14.9% , 2025 20.0%
( , 2019). (United Nation, UN)
2018 ‘ ’ ,
‘ ’
( , 2019).
( , 2017).
(World Health Organization, WHO)
3 , 2030 1
(WHO, 2004). , 2015
68 , 2011 60 2
13.0% , 65
(Carol et al, 2009) . , , , ( , 2005). , ( , 2018), ( , 2018; , 2006). · . . . , , , , , ( , 2015). (2018) , . . , .
, ( , 2017, , 2011, , , 2002), , , , ( , 2013), ( , 2011), , , ( , 2017; , 2011; , 2005), , , ( , 2018; , 2017; , 2015, , 2011) . ( , 2017) ( , 2018; , 2014; , 2014, , 2014) . , , , , , ( , 2011; , 2012). , , , ( , 2017; , 2018), ( , 2018). ( , 2018; , 2017; , 2017; , 2014; , 2012) ( , 2013)
본 연구에서는 2011 2017 ,
,
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< > 65 . , , , . , , , . , .II.
1.
, ( , 2013). (Pfeiffer, 2005). DSM-IV(Diagnostic and Statistical Manual of Mental disorders 4th Edition,) , , , , , , , 5 2 (WHO, 2015). , , , , , ( , 2006). (2002) , , , . ,
( , 2000). ( , 2000). (Zastrow et al, 2004). , , ( , , 2005), , , ( , 2011; , 2013). , , , , , , , (Baltes, Mayer, 1999; , , 2002; , , 2015). (2010) , . , , , ( , 2007; , 2012; , 2012; , 2006, Schneider, Olin, 1995).
2.
. . , ( , 2013; , 2013; , 2011). ( , , 2002). (2007) , ( , 2012). , ( , 2004 ; , 2007), . ( , 2004). , , ( , 2003). ( , 2008). ,, ( , , , 2014). ( , , , 2014). , , ( , , 2015). , ( , , 2012). ( , 2005), , ( , 2007; , 2012; , 2012). 경제적 스트레스가 우울 수준을 높일 수 있다는 연구결과 오인근( , 2012) 는 심리적으로 느끼는 경제적 스트레스도 우울을 증가시키는 요인임을 알 수 있다 즉 노인의 객관적인 경제 수준뿐만 아니라 주관적으로 지각하는. , 경제적 스트레스도 우울과 밀접한 관련이 있는 것이다 오인근( , 2017). .
( , 2002). (2008) , ( , 2000). ADL, IADL ( , 2007; , 2006). ADL IADL . (2018) , , · . , , ( , 2011). , , , , ( , 2012). . , , , , , , , ,
( , 2010). (2000) . , , . ( , 2010). ( , 2000; , 2003), ( , 2008). , / / , / , / / . , , / / , / / ( , 2017).
III.
1.
65 , , , , < 1>.2.
. ( , 2017). 2007 5 2008 3 ( , 2017). 2011 , 2014 , 2017 . 2011 65 2008 2008 ( , 2011). 3 2011 . 2014 16 · 65 . , , , 16 · , , , 3 2 . 2014 879 65 10,299 ( , 2014). 2017 17 · 1 , 2014 . 2017 879 65 10,299 ( , 2017).2011 10,997 , 464 . 2014 10,451 , 464 . 2017 10,299 . 217 . 65 3 , 2011 10,533 , 2014 10,027 , 2017 10,082 .
3.
.
65 .
4 Yesavage (1993)
(Geriatric Depression Scale,
GDS) (The Short Form of Geriatric
Depression Scale, SGDS) . 15
, ‘ ’ 1 , ‘ ’ 0 15
5 (1, 5, 7, 11, 13) . 0-15
, 8
* . *Q1 ? Q2 ? Q3 ? Q4 ? *Q5 ? Q6 ? *Q7 ? Q8 ? Q9 ? Q10 ? *Q11 ? Q12 ? *Q13 ? Q14 ? Q15 ? 1.
. 2011, 2014, 2017 4 . ( , , ) ( , , , , , , ), ( , ), ( , ), ( ) < 2>. 1) 5 ‘65-69 ’, ‘70-74 ’, ‘75-79 ’, ‘80-84 ’,‘85 ’ . ‘ ’ ‘ ’ . ‘ ( )’ ‘ , , ’ 2 ( , , , 2014) ‘ ( )’,‘ ’‘ ’ , ‘ ’ ‘ ’, ‘ ’, ‘ ’, ‘ ’ . ‘ ’,‘ ’,‘ ’,‘ ’,‘ ’, · ‘ ’ ‘ ’ ‘ ’ . ‘ ’, ‘ ’, ‘ ’, ‘ ( , , , )’ ‘ ’, ‘ ’ . ‘ ( )’,‘ ( )’,‘ ’,
‘ ’, ‘ ’, ‘ ’ , ‘ ’, ‘ ’, ‘ ’, ‘ ’ . 2) (2011) ‘500 ’, ‘500-2,000 ’, ‘2,000 ’ . ( , 2018; , 2017; , , 2014) , 1) , ‘ ’,‘ ’,‘ ’,‘ ’ 4 . ‘ ’ ‘ ’, ‘ ’ ‘ .’ ‘ ’ 2 . ‘ ’, ‘ ’, ‘ ’, ‘ ’, ‘ ’ 5 ‘ ’, ‘ ’, ‘ ’ ‘ ’ ‘ ’ 2 .
. ( , , 2018; , 2018) ‘ ’, ‘1-2 ’, ‘3 ’ 3 . ‘ ‘ ’, ‘ ’, ‘ ’, ‘ ’, ‘ ’ 5 ‘ ’, ‘ ’ ‘ ’ ‘ ’ ‘ ’ 2 . 4) ‘ ’, ‘ ’ ( , , , 2015; , , 2014) ’, ‘ ’ , ( , 2018) 1 ‘ ’,‘ ’ , 1 ‘ 1 ’ ‘ ’ ,‘ 1 -12 ’,‘ 1 ’,‘ 1-3 ’,‘ 1 ’,‘ 2-3 ’,‘ 4-6 ’,‘ ’ 1 ‘ ’ . 5) , ‘ ’, ‘ ’, ‘ ’, ‘ ’, ‘ ’ 5 ‘ ’, ‘ ’, ‘ ’ ‘ ’ ‘ ’ 2 .
1. 2. 1. 65-69 4. 80-84 2. 70-74 5. 85 3. 75-79 1. 2. 1. ( ) 2. 3. ( , , , ) 1. 2. 1. ≤ 3. 2. 4. ≥ 1. 2. 1. 3. 2. 4. 1. 2. 1. 2. 1. 0 2. 1-2 3. 3 1. 2. 1. 2. 1. 2. 1. 2. 표 2 연구에 사용된 변수.
4.
2011, 2014, 2017 SAS 9.4 version(SAS
Institute Inc., Cary, NC, USA), SPSS 21.0 (IBM Corp., Armonk, NY, USA)
, p 0.05 . . , , , . , , , Chi-square . , 2011 , 2014 ,
2017 (Pooled cross-sectional data) ,
3 (Dummy variable)
(binary logistic regression) .
.
(Odds Ratio, OR) 95% (Confidence Interval, CI) .
5.
(IRB)
( :Y-2020-0053) ,
.
IV.
1.
< 3> . 65 2011 26.5%, 2014 32.0%, 2017 21.6% , 2011 2014 2017 . 2011 56.8%, ‘70-74 ’ 30.6%, ‘ ( )’ 67.6%, ‘ ’ 67.0% . ‘ ’ 65.3%, 80.2%, 66.2% . 27.9%, ‘ ’ 55.1% . ‘3 ’ 45.7%, 65.8%, 87.4%, 66.2%, 91.7% . 2014 58.7%, ‘70-74 ’ 30.5%, ‘ ( )’ 63.0%, ‘ ’ 66.2% . 65.3%, 76.5%, 67.5% . 27.9%, ‘ ’ 55.1% . ‘3 ’ 45.7%, 65.8%, 87.4%, 66.2%, 91.7% .2017 59.9%, ‘70-74 ’ 26.5%, ‘ ( )’ 62.5%, ‘ ’ 61.9% . ‘ ’ 60.8%, 74.7%, 68.2% . 30.7%, ‘ ’ 65.4% . ‘3 ’ 52.8%, 64.3%, 90.6%, 75.1%, ‘ ’ 91.7% . 3 , , < 2>, < 3>, < 4>, < 5> . 2014 32.0% 2017 21.6 , 75 , , . .
2011 (n=10,533) 2014 (n=10,027) 2017 (n=10,082) N % N % N % 7,739 73.5 6,819 68.0 7,906 78.4 2,794 26.5 3,208 32.0 2,176 21.6 4,546 43.2 4,137 41.3 4,046 40.1 5,987 56.8 5,890 58.7 6,036 59.9 65-69 3,149 29.9 2,703 27.0 2,628 26.1 70-74 3,224 30.6 3,057 30.5 2,673 26.5 75-79 2,389 22.7 2,425 24.2 2,582 25.6 80-84 1,160 11.0 1,280 12.8 1,551 15.4 85 612 5.8 562 5.6 648 6.4 7,141 67.8 6,659 66.4 6,611 65.6 3,392 32.2 3,368 33.6 3,471 34.4 7,116 67.6 6,314 63.0 6,297 62.5 3,176 30.2 3,395 33.9 3,342 33.1 241 2.3 318 3.2 443 4.4 6,875 65.3 6,522 65.0 6,129 60.8 3,658 34.7 3,505 35.0 3,953 39.2 ≤ 7,062 67.0 6,637 66.2 6,236 61.9 1,419 13.5 1,289 12.9 1,602 15.9 1,318 12.5 1,457 14.5 1,588 15.7 ≥ 734 7.0 644 6.4 656 6.5 2,084 19.8 2,352 23.5 2,551 25.3 8,449 80.2 7,675 76.5 7,531 74.7 3.
( ) 3. 2011 (n=10,533) 2014 (n=10,027) 2017 (n=10,082) N % N % N % 2,384 22.6 2,404 24.0 1,312 13.0 2,661 25.3 2,550 25.4 2,679 26.6 2,863 27.2 2,560 25.5 3,098 30.7 2,626 24.9 2,513 25.1 2,993 29.7 3,565 33.8 3,254 32.5 3,203 31.8 6,968 66.2 6,773 67.5 6,879 68.2 5,805 55.1 4,933 49.2 6,592 65.4 4,728 44.9 5,094 50.8 3,490 34.6 0 1,138 10.8 1,005 10.0 965 9.6 1-2 4,576 43.4 4,249 42.4 3,791 37.6 3 4,819 45.7 4,773 47.6 5,326 52.8 3,599 34.2 3,193 31.8 3,598 35.7 6,934 65.8 6,834 68.2 6,484 64.3 1,323 12.6 1,151 11.5 949 9.4 9,210 87.4 8,876 88.5 9,133 90.6 3,563 33.8 2,743 27.4 2,513 24.9 6,970 66.2 7,284 72.6 7,569 75.1
2.
4.
2.
2011 , 2014 , 2017 , , < 4>. 2014 25.4% , 2014 36.6% , . 3 ,‘85 ’ 2011 37.4%, 2014 46.1%, 2017 33.8% (p<.000). 2011 (p=0.364), 2014 (p=0.266), 2017 (p=0.012) 3 . ( ) 2014 26.5% , 2014 41.4% , ( , , , ) 2011 44.4% . 3 , ‘ ’ 2011 31.2%, 2014 38.0%, 2017 26.3% (p<.000). 3 , 2011 42.5%, 2014 46.1%, 2017 38.9% , (p<.000). , , (p<.000).2014 46.7% . 3 , (p<.000). ‘3 ’ 2011 37.6%, 2014 43.4%, 2017 29.5% . , (p<.000). 2011 (p=0.381), 2014 (p=0.392), 2017 (p=0.689) 3 .
2011 2014 2017
total p-value total p-value total p-value
N % Y % N % Y % N % Y % 3,603 79.3 943 20.7 4,546 <.000 3,086 74.6 1,051 25.4 4,137 <.000 3,337 82.5 709 17.5 4,046 <.000 4,137 69.1 1,850 30.9 5,987 3,733 63.4 2,157 36.6 5,890 4,569 75.7 1,467 24.3 6,036 65-69 2,605 82.7 544 17.3 3,149 <.000 2,069 76.5 634 23.5 2,703 <.000 2,246 85.5 382 14.5 2,628 <.000 70-74 2,410 74.8 814 25.2 3,224 2,161 70.7 896 29.3 3,057 2,189 81.9 484 18.1 2,673 75-79 1,612 67.5 777 32.5 2,389 1,524 62.8 901 37.2 2,425 1,981 76.7 601 23.3 2,582 80-84 729 62.9 430 37.1 1,159 762 53.9 518 40.5 1,280 1,061 68.4 490 31.6 1,551 85 ≥ 383 62.6 229 37.4 612 303 68.0 259 46.1 562 429 66.2 219 33.8 648 5,266 73.7 1,875 26.3 7,141 0.364 4,504 67.6 2,155 32.4 6,659 0.266 5,135 77.7 1,476 22.3 6,611 0.012 2,473 72.9 919 27.1 3,392 2,315 68.7 1,053 31.3 3,368 2,771 79.8 700 20.2 3,471 ( ) 5,571 78.3 1,545 21.7 7,116 <.000 4,643 73.5 1,671 26.5 6,314 <.000 5,213 82.8 1,084 17.2 6,297 <.000 2,035 64.1 1,141 35.9 3,176 1,989 58.6 1,406 41.4 3,395 2,392 71.6 950 28.4 3,342 134 55.6 107 44.4 241 187 58.8 131 41.2 318 301 67.9 142 32.1 443 5,118 74.4 1,758 25.6 6,876 0.002 4,497 69.0 2,025 31.0 6,522 0.005 4,915 80.2 1,214 19.8 6,129 <.000 2,621 71.7 1,036 28.3 3,657 2,322 66.2 1,183 33.8 3,505 2,991 75.7 962 24.3 3,953 ( ) 표 4.
4.
2011 2014 2017
total p-value total p-value total p-value
N % Y % N % Y % N % Y % ≤ 4,858 68.8 2,204 31.2 7,062 <.000 4,112 62.0 2,525 38.0 6,637 <.000 4,595 73.7 1,641 26.3 6,236 <.000 1,114 78.5 306 21.5 1,420 984 76.3 305 23.7 1,289 1,347 84.1 255 15.9 1,602 1,098 83.4 219 16.6 1,317 1,158 79.5 299 20.5 1,457 1,367 86.1 221 13.9 1,588 ≥ 669 91.1 65 8.9 734 565 87.7 79 12.3 644 597 91.0 59 9.0 656 1,293 62.1 791 97.9 2,084 <.000 1,374 58.4 978 41.6 2,352 <.000 1,805 70.8 746 29.2 2,551 <.000 6,446 76.3 2,003 23.7 8,449 5,445 70.9 2,230 29.1 7,675 6,101 81.0 1,430 19.0 7,531 1,370 57.5 1,014 42.5 2,384 <.000 1,295 53.9 1,109 46.1 2,404 <.000 802 61.1 510 38.9 1,312 <.000 1,901 71.4 760 28.6 2,661 1,685 66.1 865 33.9 2,550 1,989 74.2 690 25.8 2,679 2,259 78.9 604 21.1 2,863 1,826 71.3 734 28.7 2,560 2,539 82.0 559 18.0 3,098 2,209 84.2 416 15.8 2,625 2,013 80.1 500 19.9 2,513 2,576 86.1 417 13.9 2,993 2,950 82.7 615 17.3 3,565 <.000 2,557 78.6 697 21.4 3,254 <.000 2,818 88.0 385 12.0 3,203 <.000
4.
2011 2014 2017
total p-value total p-value total p-value
N % Y % N % Y % N % Y % 0 1,044 91.7 94 8.3 1,138 <.000 878 87.4 127 12.6 1,005 <.000 902 93.5 63 6.5 965 <.000 1-2 3,687 80.6 890 19.4 4,577 3,238 76.2 1,011 23.8 4,249 3,250 85.7 541 14.3 3,791 3 3,008 62.4 1,810 37.6 4,818 2,703 56.6 2,070 43.4 4,773 3,754 70.5 1,572 29.5 5,326 3,342 92.9 257 7.1 3,599 <.000 2,881 90.2 312 9.8 3,193 <.000 3,423 95.1 175 4.9 3,598 <.000 4,398 63.4 2,536 36.6 6,934 3,938 57.6 2,896 42.4 6,834 4,483 69.1 2,001 30.9 6,484 959 72.5 364 27.5 1,323 0.381 770 66.9 381 33.1 1,151 0.392 749 78.9 200 21.1 949 0.689 6,780 73.6 2,430 26.4 9,210 6,049 68.2 2,827 31.8 8,876 7,157 78.4 1,976 21.6 9,133 2,949 82.8 614 17.2 3,563 <.000 2,100 76.6 643 23.4 2,743 <.000 2,130 84.8 383 15.2 2,513 <.000 4,790 68.7 2,180 31.3 6,970 4,719 64.8 2,565 35.2 7,284 5,776 76.3 1,793 23.7 7,569 7,375 76.3 2,288 23.7 9,663 <.000 6,546 70.1 2,795 29.9 9,341 <.000 7,445 80.6 1,796 19.4 9,241 <.000 364 41.9 506 58.1 871 273 39.8 413 60.2 686 461 54.8 380 45.2 841
3.
2011 , 2014 , 2017 < 5> . , , , , , , , , , , , , , . (OR=0.99) . 65-69 70-74 (OR=1.10), 75-79 (OR=1.31), 80-84 (OR=1.52), 85 (OR=1.76) , . (p=0.962). ( ) (OR=1.24), ( , , , ) (OR=1.27) . (OR=1.33) , (OR=1.28), (OR=1.40), (OR=1.88) , . (OR=1.21) . (OR=1.20),(OR=2.90) . 0 1-2 (OR=1.25), 3 (OR=1.87) . (OR=3.99) . (OR=0.74) , (OR=1.31) . (OR=2.36) .
OR 95% CI p-value ref 0.99 0.91 1.07 0.721 65-69 ref 70-74 1.10 1.01 1.20 0.0215 75-79 1.31 1.20 1.42 <.0001 80-84 1.52 1.38 1.68 <.0001 85 ≥ 1.76 1.54 2.01 <.0001 ref 1.00 0.94 1.07 0.962 ( ) ref 1.24 1.13 1.36 <.0001 1.27 1.06 1.53 0.009 ref 1.33 1.25 1.41 <.0001 ≤ 1.88 1.58 2.22 0.0003 1.40 1.16 1.67 0.0080 1.28 1.07 1.54 0.0004 ≥ ref ref 1.21 1.08 1.35 <.0001 ref 1.20 1.03 1.41 0.0232 1.48 1.27 1.73 <.0001 1.77 1.51 2.08 <.0001 표 5.
표 5. OR 95% CI p-value 0 ref 1-2 1.25 1.08 1.44 0.0024 3 1.88 1.63 2.16 <.0001 ref 3.99 3.66 4.35 <.0001 ref 0.74 0.67 0.82 <.0001 ref 1.31 1.22 1.41 <.0001 ref 2.36 2.14 2.61 <.0001 2011 ref 2014 1.26 1.18 1.35 <.0001 2017 0.79 0.73 0.85 <.0001
4.
< 6>. . , , . , 2014 . 2011 2014 (OR=1.17) , 2011 2014 (OR=1.18) . 2011 2014 (OR=1.50) 2017(OR=1.18) . 2011 2014 (OR=1.29) . < 6> .OR 95% CI p-value 2011 ref 2014 1.17 1.03 1.32 0.0122 2017 0.78 0.67 0.91 0.0013 2011 ref 2014 1.18 1.04 1.34 0.0122 2017 0.72 0.63 0.83 <.0001 2011 ref 2014 1.50 1.30 1.72 <.0001 2017 0.80 0.69 0.92 0.0023 2011 ref 2014 1.29 1.09 1.51 0.0025 2017 0.92 0.78 1.09 0.3479
Notes: OR : Odds ratio, CI : confidence interval, ref: reference
V.
1.
, , . ( , 2018; , 2017; , 2017; , 2014; , 2012) ( , 2013), ( , , 2015) 2011 , 2014 , 2017 3 7 . 2011 , 2014 , 2017 (pooled cross-section) .2.
3 (2011, 2014, 2017 ) 65 . , , , , , , , , , , . . , , , . , (2002) . . , , . . .. , (2017) . (2020) . . . , , . (2013) . . . ( , 2013; , 2007; , , 2002) . . . (2005) . . . (2010)
, . . . (2014) . , ( , 2014, , 2012) . , . . ( , 2008; , 2000) . , , .
3.
. , . . , . , 2008 . . . , . . .VI.
, , , , , , , , . . . , , . . , . , 6 . , , , . . , 2017,
.
.
, . . 2012; 32(1): 129-143 , . : . . 2015; 68: 251-271. , . . 2003; 9(1): 112-117. , . . 2005; 25(4): 167-187. . : 7 . 2020; 45(2): 165-172. . . 2004; 16: 155-177. . [ ]. : ; 2010. , . :
. Social Welfare Policy 2015; 42(1): 55-79
, , , . ,
Health & Nursing ( ) 2008; Volume 20, Issue 2.
, , . . 2013; 61: 57-84. , , , , , . , : 2014 2017. 2017; 21(2). . , [ ]. : ; 2011. , . . 2018; 32(2): 275-287. . . 2006; 7(1): 83-92 . : . 2012; 17(4): 237-255. . . 2017; 34 1 : 131-152. . : . 2017; 30: 389-410. , , , . . 2011; 96-121. , , . . 2017; 43 3 : 13-25. . . 2010; Issue 49. .
[ ]. : ; 2002. , , . . 2013; 13(7). , , . . 2008; 28(4): 1129∼ 1145. . - , , : 2014 . 2018; 24(2). . . 2014; 12(6). . : (2014 ) [ ]. : ; 2017. , , , , , , . DSM-III-R
Geriatric Depression Scale(GDS)
. 1999; 38(1): 48-63. . [ ]. : ; 2007, . : 2014 [ ]. : ; 2018. , . , . 2012; 3(3): 1203-1211
, . : . 2015; 69: 417-447. . . 2018. . 2017-25 . 2017. . . 2008. . . 2011. . . 2014. . . 2017. , . . , 2002; vol. 13: 7- 35. . . 2018.
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ABSTRACT
The study of the factors influencing geriatric depression:
focusing on annual household income
Choi, Eun-young
Department of Hospital Management
Graduate School of Public Health
Yonsei University
(Directed by Professor Tae Hyun Kim, Ph.D)
The purpose of this study is to analyze the annual changes in the characteristics of the elderly and the relevance of factors affecting geriatric depression. Moreover, the relation between the annual household income of the elderly and the degree of geriatric depression will be investigated. This study uses National Surveys on Living Conditions and Welfare Needs of Korean Older Persons conducted by the Ministry of Health and Welfare and Korea Institute for Health and Social Affairs (KIHASA) in 2011, 2014, and 2017 for data analysis. The elderly aged over 65 is the subject of the survey. 10,533, 10,027, and 10,082 older people in
2011, 2014, and 2017 respectively are subject to the final analysis of this study. The Chi-square test was conducted for each year to find out the relevance of the factors influencing geriatric depression. The method of Binominal Logistic Regression Analysis was applied in utilizing the primitive data in 2011, 2014, and 2017 as pooled cross-sections data to examine the impact of annual household income on geriatric depression over time.
The major findings of this study summarized as follows.
The general characteristics of the elderly have changed over the past seven years. The study identified that the variables of age, annual household income, and the number of chronic diseases is the critical factors of geriatric depression. In particular, annual household income had a significant influence on the lower class. Age, marital status, religion, education level, living condition, annual household income, employment status, the number of chronic diseases, and subjective health conditions were decisive factors of influencing the depression. In association with annual household income and depression, the lower the annual household income, the more depressed the elderly. In contrast, this study confirmed that the upper-middle class is relatively more affected concerning geriatric depression in terms of reciprocal action between annual household income and the survey year.
activation of the project for creating job opportunities for the Elderly, which is directly related to their income level, should be supported continuously. The implementation of depressive symptoms prevention and the early diagnosis programs by identifying risk factors causing the depression from multiple angles is highly required for rapidly increasing elderly population to enjoy their healthy and independent life.
Keywords: geriatric depression, National Survey on Living Conditions and Welfare Needs of Korean Older Persons, annual household income, pooled cross-sections
