Cronin-Stubbs D, de Leon C F, Beckett L A, Field T S, Glynn R J, Evans D A
Department of Medicine, Rush University College of Medicine, Chicago, IL, USA.
Arch Intern Med. 2000 Nov 13;160(20):3074-80. doi: 10.1001/archinte.160.20.3074.
Late-life depression affects physical health and impedes recovery from physical disability. But whether milder symptoms that occur frequently in the general population increase the risk of developing a disability or decrease the likelihood of recovery remains unclear.
To examine the effect of mild symptoms of depression, assessed by a reduced version (10 items, ranging from 0-10) of the Center for Epidemiological Studies-Depression Scale, on the course of physical disability, assessed by items from the Katz Activities of Daily Living Scale, the Rosow-Breslau Functional Health Scale, and the Nagi Index.
A population-based longitudinal study was conducted, with 6 follow-up interviews of 3434 community-dwelling persons aged 65 years and older in East Boston, Mass.
The likelihood of becoming disabled increased with each additional symptom of depression (for the Katz measure: odds ratio, 1.16 per symptom; 95% confidence interval, 1.13-1.19; for the Rosow-Breslau measure: odds ratio, 1.14; 95% confidence interval, 1.11-1.16; and for the Nagi measure: odds ratio, 1.17; 95% confidence interval, 1.14-1.19). As the number of depressive symptoms increased, the likelihood of recovering from a physical disability decreased (for the Katz measure: odds ratio, 0.96; 95% confidence interval, 0.93-0.99; for the Rosow-Breslau measure: odds ratio, 0.86; 95% confidence interval, 0.84-0.89; and for the Nagi measure: odds ratio, 0.89; 95% confidence interval, 0.87-0.91). This effect was not accounted for by age, sex, level of educational attainment, body mass index, or chronic health conditions.
Mild depressive symptoms in older persons (those aged > or =65 years) are associated with an increased likelihood of becoming disabled and a decreased chance of recovery, regardless of age, sex, and other factors that contribute to physical disability.
老年期抑郁症会影响身体健康，并阻碍身体残疾的康复。但普通人群中频繁出现的较轻症状是否会增加残疾风险或降低康复可能性仍不明确。
通过流行病学研究中心抑郁量表简化版（10项，评分范围为0至10）评估抑郁的轻微症状，通过Katz日常生活活动量表、Rosow - Breslau功能健康量表和Nagi指数项目评估身体残疾进程，研究两者之间的关系。
在马萨诸塞州东波士顿对3434名65岁及以上的社区居民进行了一项基于人群的纵向研究，并进行了6次随访访谈。
抑郁症状每增加一项，残疾的可能性就会增加（对于Katz量表：每症状比值比为1.16；95%置信区间为1.13 - 1.19；对于Rosow - Breslau量表：比值比为1.14；95%置信区间为1.11 - 1.16；对于Nagi量表：比值比为1.17；95%置信区间为1.14 - 1.19）。随着抑郁症状数量的增加，身体残疾康复的可能性降低（对于Katz量表：比值比为0.96；95%置信区间为0.93 - 0.99；对于Rosow - Breslau量表：比值比为0.86；95%置信区间为0.84 - 0.89；对于Nagi量表：比值比为0.89；95%置信区间为0.87 - 0.91）。这种影响不受年龄、性别、教育程度、体重指数或慢性健康状况的影响。
老年人（年龄≥65岁）的轻微抑郁症状与残疾可能性增加及康复机会减少相关，与年龄、性别和其他导致身体残疾的因素无关。
