Montagnier Delphine, Barberger-Gateau Pascale, Jacqmin-Gadda Hélène, Dartigues Jean-François, Rainfray Muriel, Pérès Karine, Lechevallier-Michel Nathalie, Fourrier-Réglat Annie
Department of Geriatrics, CHU Bordeaux, Hôpital Xavier Arnozan, Pessac, France.
J Am Geriatr Soc. 2006 Dec;54(12):1839-45. doi: 10.1111/j.1532-5415.2006.00969.x.
To describe the evolution of prevalence of depressive symptoms and antidepressant use between 1988 and 1999 in a large representative sample of older community-dwelling French people.
Prospective cohort designed in 1988/89 to study cerebral and functional aging.
Urban and rural communities in southwestern France.
Three thousand six hundred thirty-seven adults aged 65 and older living in noninstitutional settings at baseline.
Participants were interviewed 3, 5, 8, and 10 years after the initial data collection. Depressive symptomatology was evaluated using a French version of the Center for Epidemiological Studies Depression Scale. Longitudinal analysis of the prevalence of depressive symptomatology was performed using a logistic mixed model adjusted for antidepressant use, sex, age, education level, living conditions, psychiatric antecedents, drug consumption, and diagnosis of dementia.
Over the 10 years of follow-up, the prevalence of depressive symptomatology decreased from 13.8% to 8.3%. This decrease was statistically significant even after adjustment (odds ratio = 0.88 per increased year, 95% confidence interval = 0.85-0.90) and was more pronounced in subjects having reported previous depression at baseline. During the same period, antidepressant use rose from 5.2% to 11.9%, mainly due to increased use of selective serotonin reuptake inhibitors. Furthermore, the proportion of subjects who had depressive symptoms and did not use antidepressants decreased from 11.8% to 6.2%.
This study suggests better management of late-life depression in the last decade and illustrates the heterogeneity of depression disorder in late life.
描述1988年至1999年间,在一个具有广泛代表性的法国社区老年人群样本中,抑郁症状患病率及抗抑郁药物使用情况的演变。
1988/1989年设计的前瞻性队列研究,旨在研究大脑和功能衰老。
法国西南部的城乡社区。
3637名65岁及以上的成年人,基线时居住在非机构环境中。
在初始数据收集后的3年、5年、8年和10年对参与者进行访谈。使用法国版的流行病学研究中心抑郁量表评估抑郁症状。采用逻辑混合模型对抑郁症状患病率进行纵向分析,并对使用抗抑郁药物、性别、年龄、教育水平、生活条件、精神病史、药物消费和痴呆诊断进行调整。
在10年的随访中,抑郁症状的患病率从13.8%降至8.3%。即使经过调整,这种下降在统计学上仍具有显著性(每增加一年的优势比=0.88,95%置信区间=0.85-0.90),并且在基线时报告有过抑郁症的受试者中更为明显。在同一时期,抗抑郁药物的使用从5.2%上升至11.9%,主要原因是选择性5-羟色胺再摄取抑制剂的使用增加。此外,有抑郁症状但未使用抗抑郁药物的受试者比例从11.8%降至6.2%。
本研究表明在过去十年中对老年抑郁症的管理有所改善,并说明了老年抑郁症的异质性。