目的:描述台灣地區老年人抽菸行為改變情形,以及四年後憂鬱傾向狀態,並探討抽菸行為改變情形與憂鬱傾向之相關性。 方法:本研究以間隔四年的縱貫式世代研究設計,以1999年與2003年國民健康局「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,以1999年65歲以上並且在2003年有參與調查者為研究對象,刪除未滿65歲以及變項中有遺漏值與不詳者,總樣本數共計1916人,自變項為抽菸行為改變情形,分為戒菸者、不抽菸者、開始抽菸者與持續抽菸者。依變項為2003年憂鬱傾向的有無,以CES-D10題簡短版測量。以二元邏輯斯迴歸進行統計分析,並控制性別、年齡、教育程度、婚姻狀況、健康的自我評量、身體疼痛強度、有無喝酒、1999年憂鬱傾向等控制變項。 結果:台灣地區老年人抽菸行為變化情形比例分佈,以持續不抽菸組最高,其次為持續抽菸組,以戒菸組為第三高,以開始抽菸組比例最低。憂鬱傾向情形以1999年與2003年皆無憂鬱傾向的比例最高,其次為1999年無憂鬱傾向而2003年有憂鬱傾向,1999年有憂鬱傾向2003年無憂鬱傾向的比例為第三高,以1999年與2003年皆有憂鬱傾向的比例最低。而抽菸行為改變情形與憂鬱傾向的相關性,發現持續抽菸為憂鬱傾向的危險因子,開始抽菸、戒菸的老年人四年後憂鬱傾向發生風險與不抽菸組無異。控制變項以自評健康為不太好或很不好、身體疼痛強度為輕微或中度以上的疼痛與不舒服、1999年有憂鬱傾向等與預測憂鬱傾向的發生有正相關,而教育程度為大學以上則與憂鬱傾向有負相關。 結論:本研究發現持續抽菸的老年人憂鬱傾向的風險較不抽菸者高,並且心理健康較差。建議協助抽菸的老年人解決心理問題,並持續關心抽菸者的憂鬱傾向,同時鼓勵抽菸的老年人戒菸,可降低未來發生憂鬱傾向的風險,以維護老年人老化過程的心理健康。
The purposes of this study are: 1. To describe the prevalence of smoking and depression in Taiwan’s elderly population, and 2.To examine the correlation between change in smoking behavior and depression. Data for this longitudinal cohort study came from 1999 and 2003 waves of the Survey of Health and Living Status of the Elderly in Taiwan. Those who aged 65 and older and who participated in 1999 and 2003 waves of the survey were included in the analyses. Total sample size is 1916. Subjects were categorized as quitters, non-smokers, new smokers, and continuing smokers, based on their responses to smoking behavior in 1999 and 2003. Depression was measured by short version of the CES-D. The final sample is 1916. Logistic regression models were used for analyses. All models controlled for age, gender, educational levels, marital status, self-rated health, pain intensity, history of drinking, depression status in baseline. Those who continued to smoke, those with worst or poor self-rated health, those with more than minimal or moderate pain, those with higher level of education, and those who were depressed at baseline are associated with higher risk of depression. Older adults should be encouraged to quit smoking in order to reduce their risk of developing depression in the future.