中国中老年人抑郁症状轨迹与偏头痛的关联性研究

A Study on the Association between the Trajectories of Depressive Symptoms and Migraine in Middle-aged and Older Adults in China

摘要:

目的：识别我国中老年人抑郁症状变化轨迹，并探讨其与偏头痛样症状的关系，为本土指南制订和偏头痛管理提供参考。方法：本研究基于2011—2018年中国健康与养老追踪调查（CHARLS）4期数据，采用组轨迹模型识别研究对象随访期间抑郁症状变化轨迹。通过多因素Logistic回归模型分析抑郁症状轨迹类型与偏头痛样症状的关联，并通过离散时间cloglog模型做敏感性分析。结果：共纳入13 012名中老年人，抑郁症状轨迹分为重度稳定组767名（5.9%）、重度缓解组1 294名（9.9%）、中度加重组1 346名（10.3%）、中度稳定组5 240名（40.3%）和轻度稳定组4 365名（33.6%）。在调整年龄、性别等纳入的全部协变量后，多因素Logistic回归分析结果显示，与轻度稳定组相比，中度稳定组（OR=1.965，95% CI ：1.579~ 2.447），中度加重组（OR=3.242，95% CI ：2.506~4.196），重度缓解组（OR=2.931，95%CI：2.246~3.382）和重度稳定组（OR=3.992，95% CI ：2.972~5.362）的中老年人偏头痛样症状的发生风险显著升高。敏感性分析结果与Logistic回归一致。结论：随着时间的推移，遵循中度稳定组、中度加重组、重度缓解组和重度稳定组抑郁症状轨迹中老年人的偏头痛样症状风险增加，抑郁症状的严重程度与动态变化是偏头痛样症状的独立风险因素，早期识别与监测抑郁轨迹或为偏头痛一级预防的潜在切入点。

Abstract:

Abstract Objective: To identify the trajectories of depressive symptoms among middle-aged and older adults in China and to explore their association with the risk of migraine-like symptoms, thereby providing guidance for the development of local guidelines and the management of migraine. Methods: This study utilised data from the four waves (2011–2018) of the China Health and Retirement Longitudinal Study (CHARLS). A cohort trajectory model was employed to identify the trajectories of depressive symptoms among study participants during the follow-up period. Multivariate logistic regression models were used to analyse the association between depressive symptom trajectories and migraine-like symptoms, with sensitivity analyses conducted using discrete-time cloglog models. Results: A total of 13,012 middle-aged and older adults were included. Depression symptom trajectories were categorised into the severe stable group (767 participants, 5.9%), the severe remission group (1,294 participants, 9.9%), the moderate to severe group (1,346 participants, 10.3%), the moderately stable group (5,240 participants, 40.3%) and the mild stable group (4,365 participants, 33.6%). After adjusting for all included covariates such as age and gender, the results of the multivariate logistic regression analysis showed that, compared with the mild stable group, the moderately stable group (OR = 1.965, 95% CI: 1.579–2.447), the moderate to severe group (OR = 3.242, 95% CI: 2.506–4.196), the severe remission Group (OR = 2.931, 95% CI: 2.246–3.382) and the severe stable group (OR = 3.992, 95% CI: 2.972–5.362) had a significantly increased risk of migraine-like symptoms onset. The results of the sensitivity analysis were consistent with those of the logistic regression. Conclusion: Over time, the risk of migraine-like symptoms increases among middle-aged and older adults following trajectories of moderately stable group, moderate to severe group, severe Remission group and severe stable group in depressive symptoms.