关键词: 焦虑, 老年人, 农村, 城市, 差异性, 影响因素分析

Abstract: Background　Anxiety is a common psychological problem that hinders the healthy aging process of the elderly. At present，most studies on the mental health of the elderly are focused on the urban or rural elderly in local areas，and there are limited comparative studies on the anxiety level of the nationwide elderly and the difference between urban and rural areas. Objective　To investigate the incidence of anxiety among the elderly nationwide，analyze and compare the detection rate and influencing factors of anxiety symptoms between rural and urban elderly，in order to provide a basis for mental health intervention for the elderly. Methods　In February 2021，data from the 2018 Chinese Longitudinal Healthy Longevity Survey conducted by the Peking University Center for Healthy Aging and Development was adopted. A total of 14 417 survey subjects who were aged≥60 years，received an anxiety survey and had complete values of related variables were selected as the research subjects. Anxiety was evaluated by 7-item Generalized Anxiety Disorder Scale（GAD-7），which is stratified by place of residence（urban/rural），and different characteristics（demographic characteristics，socioeconomic status，health status，life satisfaction，lifestyle and medical services accessibility）were compared. Unconditional Logistic regression was used to analyze related factors. Results　Among 14 417 elderly people，1 751 people had anxiety symptoms，and the overall detection rate was 12.15%，including 1 400 people with mild anxiety（79.95%），256 people with moderate anxiety（14.62%），and 95 people with severe anxiety（5.43%）. The incidence of anxiety symptoms in rural elderly〔13.05%（1 459/11 183）〕was higher than that in urban elderly〔9.03%（292/3 234）〕（χ2=37.946，P<0.001），and the severity of anxiety was higher in rural compared with urban elderly people（Z=-2.312，P=0.021）. The results of multivariate analysis showed that western region，bad self-reported financial conditions，with ordinary or bad self-reported health status，with bad self-reported life satisfaction，no smoking were independent risk factors affecting the occurrence of anxiety in urban elderly（P<0.05），and having sleep time of 7~8 hours was a protective factor（P<0.001）for the occurrence of anxiety in urban elderly. Female，central region，with ordinary or bad self-reported financial conditions，with ordinary or bad self-reported health status，with ordinary or bad self-reported life satisfaction，serious illness cannot be treated in time，salty diet were risk factors affecting the occurrence of anxiety in rural elderly（P<0.05），and having sleeping time of 7~8 hours or more than 8 hours was protective factor（P<0.001）for the occurrence of anxiety in rural elderly. Conclusion　The detection rate of anxiety symptoms in the Chinese elderly is relatively high and the detection rate of anxiety symptoms in rural elderly is higher than that in urban elderly. The factors associated with anxiety symptoms in urban and rural elderly people were partially different. So urban-rural differences should be considered when delivering preventive interventions or improving management interventions for such people.

Key words: Anxiety, Aged, Rural, Urban, Differences, Root cause analysis