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.	刘厚莲. 十四五时期老龄健康重点关注的问题. 人口与健康, 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.	曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 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.	俞连芳, 丁彩华, 马云云. 老年慢性心力衰竭患者述情障碍对其正性负性情绪的影响. 浙江临床医学, 2019, 21(6): 817-819.
10.	徐凤麟, 孙建萍, 吴红霞, 等. 太原市养老机构老年人述情障碍现状及影响因素分析. 中华护理杂志, 2018, 53(8): 990-995.
11.	段思明, 邓孟兰, 高小庆, 等. 社区老年人述情障碍和孤独感及其相关性. 中国老年学杂志, 2020, 40(9): 1965-1968.
12.	蒋秋焕, 张红梅, 王梦, 等. 老年脑卒中患者述情障碍现状及影响因素分析. 中华现代护理杂志, 2020, 26(21): 2899-2903.
13.	库敏, 周巧学, 周建荣, 等. 社区空巢老人述情障碍现状及其影响因素分析. 解放军护理杂志, 2020, 37(4): 19-22.
14.	孟爽, 秦琼, 唐启群. 养老机构的特征性因素对老年人述情障碍的影响. 护理研究, 2020, 34(3): 388-391.
15.	孟微, 马新利, 黄紫琪. 社区空巢老人家庭关怀度与述情障碍相关性研究. 中华全科医学, 2020, 18(4): 612-614.
16.	田军香, 王雅星, 赵红伟, 等. 养老机构老年人老化态度、述情障碍现状及相关性分析. 职业与健康, 2020, 36(8): 1066-1070.
17.	薛晶晶, 田朝霞. 老年糖尿病患者述情障碍现状及影响因素分析. 现代预防医学, 2020, 47(2): 305-309.
18.	宋若冰, 梁春光, 李思思, 等. 社区老年人述情障碍及其影响因素. 中国老年学杂志, 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.	徐凤麟, 孙建萍. 老年慢性病患者述情障碍的研究进展. 中华护理杂志, 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.	陈纹, 苗冰, 唐秋萍, 等. 边缘性人格障碍倾向者的述情障碍及与抑郁的关系. 中国临床心理学杂志, 2016, 24(1): 116-119.
26.	张瑞星, 李国荣, 史诺. 老年躯体形式障碍患者述情障碍特征. 中国老年学杂志, 2015, (16): 4660-4661.
27.	邵晨兰, 覃波, 赵卫卫. 德阳市养老机构老人心理健康状况及影响因素. 中国老年学杂志, 2019, 39(11): 2807-2809.
28.	Höglander 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.	李秋环, 赵雯雯, 田汝香, 等. 中青年癌症患者住院期间反刍性沉思现状及影响因素的调查研究. 中华护理杂志, 2019, 54(7): 1038-1043.
32.	答会明. 中国老年人主观幸福感研究 10 年-回顾与展望. 中国老年学杂志, 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. 刘厚莲. 十四五时期老龄健康重点关注的问题. 人口与健康, 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. 曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 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. 俞连芳, 丁彩华, 马云云. 老年慢性心力衰竭患者述情障碍对其正性负性情绪的影响. 浙江临床医学, 2019, 21(6): 817-819.
10. 徐凤麟, 孙建萍, 吴红霞, 等. 太原市养老机构老年人述情障碍现状及影响因素分析. 中华护理杂志, 2018, 53(8): 990-995.
11. 段思明, 邓孟兰, 高小庆, 等. 社区老年人述情障碍和孤独感及其相关性. 中国老年学杂志, 2020, 40(9): 1965-1968.
12. 蒋秋焕, 张红梅, 王梦, 等. 老年脑卒中患者述情障碍现状及影响因素分析. 中华现代护理杂志, 2020, 26(21): 2899-2903.
13. 库敏, 周巧学, 周建荣, 等. 社区空巢老人述情障碍现状及其影响因素分析. 解放军护理杂志, 2020, 37(4): 19-22.
14. 孟爽, 秦琼, 唐启群. 养老机构的特征性因素对老年人述情障碍的影响. 护理研究, 2020, 34(3): 388-391.
15. 孟微, 马新利, 黄紫琪. 社区空巢老人家庭关怀度与述情障碍相关性研究. 中华全科医学, 2020, 18(4): 612-614.
16. 田军香, 王雅星, 赵红伟, 等. 养老机构老年人老化态度、述情障碍现状及相关性分析. 职业与健康, 2020, 36(8): 1066-1070.
17. 薛晶晶, 田朝霞. 老年糖尿病患者述情障碍现状及影响因素分析. 现代预防医学, 2020, 47(2): 305-309.
18. 宋若冰, 梁春光, 李思思, 等. 社区老年人述情障碍及其影响因素. 中国老年学杂志, 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. 徐凤麟, 孙建萍. 老年慢性病患者述情障碍的研究进展. 中华护理杂志, 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. 陈纹, 苗冰, 唐秋萍, 等. 边缘性人格障碍倾向者的述情障碍及与抑郁的关系. 中国临床心理学杂志, 2016, 24(1): 116-119.
26. 张瑞星, 李国荣, 史诺. 老年躯体形式障碍患者述情障碍特征. 中国老年学杂志, 2015, (16): 4660-4661.
27. 邵晨兰, 覃波, 赵卫卫. 德阳市养老机构老人心理健康状况及影响因素. 中国老年学杂志, 2019, 39(11): 2807-2809.
28. Höglander 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. 李秋环, 赵雯雯, 田汝香, 等. 中青年癌症患者住院期间反刍性沉思现状及影响因素的调查研究. 中华护理杂志, 2019, 54(7): 1038-1043.
32. 答会明. 中国老年人主观幸福感研究 10 年-回顾与展望. 中国老年学杂志, 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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