Status of alexithymia among the elderly in China: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

TANG Ping ,  WANG Jialin , XIE Wanqing , SU Sihui , YANG Pengyu , NI Wanying , MA Chun

Department of Nursing, Chengdu University of Chinese Medicine, Chengdu 610075, P.R.China;

Corresponding?author：

WANG Jialin, Email: wangjialin@cdutcm.edu.cn

Keywords：

Chinese; The elderly; Alexithymia; Systematic review; Meta-analysis; Cross-sectional study

DOI：

10.7507/1672-2531.202103048

Video：

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Objective To systematically review the status of alexithymia in the Chinese elderly.Methods CNKI, VIP, CBM, WanFang Data, PubMed, EMbase, Web of Science, PsycINFO, and The Cochrane Library databases were electronically searched to collect cross-sectional studies related to the epidemiological characteristics of alexithymia among the elderly in China from inception to February 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; meta-analysis was then performed using Stata 16.0 software.Results A total of 11 cross-sectional studies involving 3 592 elderly individuals were included. The results of meta-analysis showed that the prevalence of alexithymia in the Chinese elderly was 36% (95%CI 30% to 42%), and the score of alexithymia was 58.59 (95%CI 54.60 to 62.57). Subgroup analyses indicated that the prevalence of alexithymia was 39% (95%CI 32% to 45%) in northern China, 33% (95%CI 30% to 37%) in northeast China, 36% (95%CI 31% to 41%) in eastern China, 51% (95%CI 44% to 58%) in central China, and 20% (95%CI 16% to 24%) in the southwest China. The prevalence rates of hospitalized, nursing home, and community elderly were 42% (95%CI 34% to 49%), 37% (95%CI 28% to 45%), and 29% (95%CI 20% to 38%), respectively. The scores of alexithymia were higher among the elderly males, 80 years or older, engaged in heavy physical work prior to retirement, suffering from severer chronic diseases, low education background, low monthly income, living alone, and low frequency of participation in group activities and visited by relatives.Conclusions Current evidence shows that the overall prevalence of alexithymia is high in the Chinese elderly, and varies with regions. The levels of alexithymia among gender, age, occupation prior to retirement, number of chronic diseases, educational level, monthly income, habitation manner, the frequency of participating in group activities, and being visited by relatives and friends are different.

Citation： TANG Ping, WANG Jialin, XIE Wanqing, SU Sihui, YANG Pengyu, NI Wanying, MA Chun. Status of alexithymia among the elderly in China: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2021, 21(7): 779-786. doi: 10.7507/1672-2531.202103048 Copy

1.	劉厚蓮. 十四五時期老齡健康重點關注的問題. 人口與健康, 2020, 8: 37-40.
2.	Sifneos PE. The prevalence of 'alexithymic' characteristics in psychosomatic patients. Psychother Psychosom, 1973, 22(2): 255-262.
3.	Baiardini I, Abbà S, Ballauri M, et al. Alexithymia and chronic diseases: the state of the art. G Ital Med Lav Ergon, 2011, 33(1 Suppl A): A47-52.
4.	Santorelli GD, Ready RE. Alexithymia and executive function in younger and older adults. Clin Neuropsychol, 2015, 29(7): 938-955.
5.	Terock J, Janowitz D, Spitzer C, et al. Alexithymia and self-directedness as predictors of psychopathology and psychotherapeutic treatment outcome. Compr Psychiatry, 2015, 62: 34-41.
6.	曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
7.	Prins J, Blanker MH, Bohnen AM, et al. Prevalence of erectile dysfunction: a systematic review of population-based studies. Int J Impot Res, 2002, 14(6): 422-432.
8.	Han D, Zhang Y, Li B, et al. Alexithymia in Chinese chronic obstructive pulmonary disease (COPD) patients: the prevalence and related factors of alexithymia. Psychiatry Res, 2012, 198(2): 274-278.
9.	俞連芳, 丁彩華, 馬云云. 老年慢性心力衰竭患者述情障礙對其正性負性情緒的影響. 浙江臨床醫學, 2019, 21(6): 817-819.
10.	徐鳳麟, 孫建萍, 吳紅霞, 等. 太原市養老機構老年人述情障礙現狀及影響因素分析. 中華護理雜志, 2018, 53(8): 990-995.
11.	段思明, 鄧孟蘭, 高小慶, 等. 社區老年人述情障礙和孤獨感及其相關性. 中國老年學雜志, 2020, 40(9): 1965-1968.
12.	蔣秋煥, 張紅梅, 王夢, 等. 老年腦卒中患者述情障礙現狀及影響因素分析. 中華現代護理雜志, 2020, 26(21): 2899-2903.
13.	庫敏, 周巧學, 周建榮, 等. 社區空巢老人述情障礙現狀及其影響因素分析. 解放軍護理雜志, 2020, 37(4): 19-22.
14.	孟爽, 秦瓊, 唐啟群. 養老機構的特征性因素對老年人述情障礙的影響. 護理研究, 2020, 34(3): 388-391.
15.	孟微, 馬新利, 黃紫琪. 社區空巢老人家庭關懷度與述情障礙相關性研究. 中華全科醫學, 2020, 18(4): 612-614.
16.	田軍香, 王雅星, 趙紅偉, 等. 養老機構老年人老化態度、述情障礙現狀及相關性分析. 職業與健康, 2020, 36(8): 1066-1070.
17.	薛晶晶, 田朝霞. 老年糖尿病患者述情障礙現狀及影響因素分析. 現代預防醫學, 2020, 47(2): 305-309.
18.	宋若冰, 梁春光, 李思思, 等. 社區老年人述情障礙及其影響因素. 中國老年學雜志, 2020, 40(22): 4899-4901.
19.	Belvederi Murri M, Mamberto S, Briatore L, et al. The interplay between diabetes, depression and affective temperaments: A structural equation model. J Affect Disord, 2017, 219: 64-71.
20.	Naicker K, Johnson JA, Skogen JC, et al. Type 2 diabetes and comorbid symptoms of depression and anxiety: longitudinal associations with mortality risk. Diabetes Care, 2017, 40(3): 352-358.
21.	Tartaglini MF, Dillon C, Hermida PD, et al. Prevalence of geriatric depression and alexithymia and their association with sociodemographic characteristics in a sample of elderly persons living in Buenos Aires, Argentina. Rev Brasil Geriat Gerontol, 2017, 20(4): 516-524.
22.	徐鳳麟, 孫建萍. 老年慢性病患者述情障礙的研究進展. 中華護理雜志, 2018, 53(1): 105-109.
23.	Mattila AK, Salminen JK, Nummi T, et al. Age is strongly associated with alexithymia in the general population. J Psychosom Res, 2006, 61(5): 629-635.
24.	Hawkins LG, Mullet N, Tuliao AP, et al. Alexithymia, prior trauma, alcohol use, and sexual aggression perpetration: a cross-cultural comparison of a moderated mediation model. Sex Abuse, 2021, 33(4): 455-474.
25.	陳紋, 苗冰, 唐秋萍, 等. 邊緣性人格障礙傾向者的述情障礙及與抑郁的關系. 中國臨床心理學雜志, 2016, 24(1): 116-119.
26.	張瑞星, 李國榮, 史諾. 老年軀體形式障礙患者述情障礙特征. 中國老年學雜志, 2015, (16): 4660-4661.
27.	邵晨蘭, 覃波, 趙衛衛. 德陽市養老機構老人心理健康狀況及影響因素. 中國老年學雜志, 2019, 39(11): 2807-2809.
28.	H?glander J, Sundler AJ, Spreeuwenberg P, et al. Emotional communication with older people: a cross-sectional study of home care. Nurs Health Sci, 2019, 21(3): 382-389.
29.	Raczkiewicz D, Saran T, Sarecka-Hujar B, et al. Work conditions in agriculture as risk factors of spinal pain in postmenopausal women. Int J Occup Saf Ergon, 2019, 25(2): 250-256.
30.	Hiirola A, Pirkola S, Karukivi M, et al. An evaluation of the absolute and relative stability of alexithymia over 11years in a Finnish general population. J Psychosom Res, 2017, 95: 81-87.
31.	李秋環, 趙雯雯, 田汝香, 等. 中青年癌癥患者住院期間反芻性沉思現狀及影響因素的調查研究. 中華護理雜志, 2019, 54(7): 1038-1043.
32.	答會明. 中國老年人主觀幸福感研究 10 年-回顧與展望. 中國老年學雜志, 2019, 39(9): 2288-2294.
33.	Wang G, Hu M, Xiao SY, et al. Loneliness and depression among rural empty-nest elderly adults in Liuyang, China: a cross-sectional study. BMJ Open, 2017, 7(10): e016091.

1. 劉厚蓮. 十四五時期老齡健康重點關注的問題. 人口與健康, 2020, 8: 37-40.
2. Sifneos PE. The prevalence of 'alexithymic' characteristics in psychosomatic patients. Psychother Psychosom, 1973, 22(2): 255-262.
3. Baiardini I, Abbà S, Ballauri M, et al. Alexithymia and chronic diseases: the state of the art. G Ital Med Lav Ergon, 2011, 33(1 Suppl A): A47-52.
4. Santorelli GD, Ready RE. Alexithymia and executive function in younger and older adults. Clin Neuropsychol, 2015, 29(7): 938-955.
5. Terock J, Janowitz D, Spitzer C, et al. Alexithymia and self-directedness as predictors of psychopathology and psychotherapeutic treatment outcome. Compr Psychiatry, 2015, 62: 34-41.
6. 曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
7. Prins J, Blanker MH, Bohnen AM, et al. Prevalence of erectile dysfunction: a systematic review of population-based studies. Int J Impot Res, 2002, 14(6): 422-432.
8. Han D, Zhang Y, Li B, et al. Alexithymia in Chinese chronic obstructive pulmonary disease (COPD) patients: the prevalence and related factors of alexithymia. Psychiatry Res, 2012, 198(2): 274-278.
9. 俞連芳, 丁彩華, 馬云云. 老年慢性心力衰竭患者述情障礙對其正性負性情緒的影響. 浙江臨床醫學, 2019, 21(6): 817-819.
10. 徐鳳麟, 孫建萍, 吳紅霞, 等. 太原市養老機構老年人述情障礙現狀及影響因素分析. 中華護理雜志, 2018, 53(8): 990-995.
11. 段思明, 鄧孟蘭, 高小慶, 等. 社區老年人述情障礙和孤獨感及其相關性. 中國老年學雜志, 2020, 40(9): 1965-1968.
12. 蔣秋煥, 張紅梅, 王夢, 等. 老年腦卒中患者述情障礙現狀及影響因素分析. 中華現代護理雜志, 2020, 26(21): 2899-2903.
13. 庫敏, 周巧學, 周建榮, 等. 社區空巢老人述情障礙現狀及其影響因素分析. 解放軍護理雜志, 2020, 37(4): 19-22.
14. 孟爽, 秦瓊, 唐啟群. 養老機構的特征性因素對老年人述情障礙的影響. 護理研究, 2020, 34(3): 388-391.
15. 孟微, 馬新利, 黃紫琪. 社區空巢老人家庭關懷度與述情障礙相關性研究. 中華全科醫學, 2020, 18(4): 612-614.
16. 田軍香, 王雅星, 趙紅偉, 等. 養老機構老年人老化態度、述情障礙現狀及相關性分析. 職業與健康, 2020, 36(8): 1066-1070.
17. 薛晶晶, 田朝霞. 老年糖尿病患者述情障礙現狀及影響因素分析. 現代預防醫學, 2020, 47(2): 305-309.
18. 宋若冰, 梁春光, 李思思, 等. 社區老年人述情障礙及其影響因素. 中國老年學雜志, 2020, 40(22): 4899-4901.
19. Belvederi Murri M, Mamberto S, Briatore L, et al. The interplay between diabetes, depression and affective temperaments: A structural equation model. J Affect Disord, 2017, 219: 64-71.
20. Naicker K, Johnson JA, Skogen JC, et al. Type 2 diabetes and comorbid symptoms of depression and anxiety: longitudinal associations with mortality risk. Diabetes Care, 2017, 40(3): 352-358.
21. Tartaglini MF, Dillon C, Hermida PD, et al. Prevalence of geriatric depression and alexithymia and their association with sociodemographic characteristics in a sample of elderly persons living in Buenos Aires, Argentina. Rev Brasil Geriat Gerontol, 2017, 20(4): 516-524.
22. 徐鳳麟, 孫建萍. 老年慢性病患者述情障礙的研究進展. 中華護理雜志, 2018, 53(1): 105-109.
23. Mattila AK, Salminen JK, Nummi T, et al. Age is strongly associated with alexithymia in the general population. J Psychosom Res, 2006, 61(5): 629-635.
24. Hawkins LG, Mullet N, Tuliao AP, et al. Alexithymia, prior trauma, alcohol use, and sexual aggression perpetration: a cross-cultural comparison of a moderated mediation model. Sex Abuse, 2021, 33(4): 455-474.
25. 陳紋, 苗冰, 唐秋萍, 等. 邊緣性人格障礙傾向者的述情障礙及與抑郁的關系. 中國臨床心理學雜志, 2016, 24(1): 116-119.
26. 張瑞星, 李國榮, 史諾. 老年軀體形式障礙患者述情障礙特征. 中國老年學雜志, 2015, (16): 4660-4661.
27. 邵晨蘭, 覃波, 趙衛衛. 德陽市養老機構老人心理健康狀況及影響因素. 中國老年學雜志, 2019, 39(11): 2807-2809.
28. H?glander J, Sundler AJ, Spreeuwenberg P, et al. Emotional communication with older people: a cross-sectional study of home care. Nurs Health Sci, 2019, 21(3): 382-389.
29. Raczkiewicz D, Saran T, Sarecka-Hujar B, et al. Work conditions in agriculture as risk factors of spinal pain in postmenopausal women. Int J Occup Saf Ergon, 2019, 25(2): 250-256.
30. Hiirola A, Pirkola S, Karukivi M, et al. An evaluation of the absolute and relative stability of alexithymia over 11years in a Finnish general population. J Psychosom Res, 2017, 95: 81-87.
31. 李秋環, 趙雯雯, 田汝香, 等. 中青年癌癥患者住院期間反芻性沉思現狀及影響因素的調查研究. 中華護理雜志, 2019, 54(7): 1038-1043.
32. 答會明. 中國老年人主觀幸福感研究 10 年-回顧與展望. 中國老年學雜志, 2019, 39(9): 2288-2294.
33. Wang G, Hu M, Xiao SY, et al. Loneliness and depression among rural empty-nest elderly adults in Liuyang, China: a cross-sectional study. BMJ Open, 2017, 7(10): e016091.

Chinese Journal of Evidence-Based Medicine

Status of alexithymia among the elderly in China: a meta-analysis

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