Bruce M L, McNamara R
Department of Epidemiology and Public Health, Yale University.
J Am Geriatr Soc. 1992 Jun;40(6):561-6. doi: 10.1111/j.1532-5415.1992.tb02103.x.
To compare the prevalence of specific psychiatric disorders in the homebound elderly to other elders, controlling for demographic, physical health, and socio-economic factors.
Survey.
Epidemiologic Catchment Area (ECA) project in New Haven, CT.
2,553 non-institutionalized elders representing the total elderly population of the greater New Haven area.
None
Homebound status determined by self-report; psychiatric status according to DSM III by the Diagnostic Interview Schedule (DIS); cognitive status by Mini-Mental Status Examination.
Cognitive impairment (21.8% vs 11.0%, P less than 0.001), depression (2.3% vs 0.7%, P less than 0.01), dysthymia (3.9% vs 1.7%, P less than 0.01), and anxiety disorders (2.2% vs 0.4%, P less than 0.001) were each at least twice as prevalent among elders confined to a bed or chair as among non-homebound elders. Most of this increase was consistent with the poorer physical health status of the homebound; after controlling for health status, only dysthymia (Odds ratio = 2.1, P less than 0.01) was significantly more prevalent among elders confined to a bed or chair.
The higher prevalence of disorders among the homebound support recommendations that psychiatric assessments become routine in primary care examinations of homebound elders and that the availability of preventive and therapeutic psychiatric services to the homebound increase.
比较居家老年人与其他老年人中特定精神障碍的患病率，同时控制人口统计学、身体健康和社会经济因素。
调查。
康涅狄格州纽黑文市的流行病学集水区（ECA）项目。
2553名非机构化老年人，代表大纽黑文地区的老年人口总数。
无
通过自我报告确定居家状态；根据《精神疾病诊断与统计手册》第三版，采用诊断访谈表（DIS）确定精神状态；通过简易精神状态检查表确定认知状态。
认知障碍（21.8%对11.0%，P<0.001）、抑郁症（2.3%对0.7%，P<0.01）、心境恶劣（3.9%对1.7%，P<0.01）和焦虑症（2.2%对0.4%，P<0.001）在卧床或坐轮椅的老年人中的患病率均至少是非居家老年人的两倍。这种增加大多与居家老年人较差的身体健康状况一致；在控制健康状况后，只有心境恶劣（优势比=2.1，P<0.01）在卧床或坐轮椅的老年人中患病率显著更高。
居家老年人中精神障碍患病率较高，这支持了在对居家老年人进行初级保健检查时将精神评估作为常规项目的建议，以及增加为居家老年人提供预防性和治疗性精神服务的建议。
