Andrew Melissa K, Rockwood Kenneth
Division of Geriatric Medicine, Dalhousie University.
Can J Aging. 2007 Spring;26(1):33-8. doi: 10.3138/8774-758w-702q-2531.
We investigated whether frailty, defined as the accumulation of multiple, interacting illnesses, impairments and disabilities, is associated with psychiatric illness in older adults. Five-thousand-six-hundred-and-seventy-six community dwellers without dementia were identified within the Canadian Study of Health and Aging, and self-reported psychiatric illness was compared by levels of frailty (defined by an index of deficits that excluded mental illnesses). People with psychiatric illness (12.6% of those surveyed, who chiefly reported depression) had a higher mean frailty index value than those who did not. Older age was not associated with higher odds of psychiatric illness. Taking sex, frailty, and education into account, the odds of psychiatric illness decreased with each increasing year of age (OR 0.95; 95% CI, 0.94-0.97). Frailty was associated with psychiatric illness; for each additional deficit-defining frailty, odds of psychiatric illness increased (OR 1.23; 95% CI, 1.19-1.26). Similarly, psychiatric illness was associated with much higher odds of being among the most frail. These findings lend support to a multidimensional conceptualization of frailty. Our data also suggest that health care professionals who work with older adults with psychiatric illness should expect frailty to be common, and that those working with frail seniors should consider the possible co-existence of depression and psychiatric illness.
我们调查了虚弱（定义为多种相互作用的疾病、损伤和残疾的累积）是否与老年人的精神疾病有关。在加拿大健康与老龄化研究中，识别出5676名无痴呆的社区居民，并根据虚弱程度（由排除精神疾病的缺陷指数定义）比较自我报告的精神疾病情况。患有精神疾病的人（占被调查者的12.6%，主要报告为抑郁症）的平均虚弱指数值高于未患精神疾病的人。年龄较大与患精神疾病的较高几率无关。考虑到性别、虚弱程度和教育程度，精神疾病的几率随年龄每增加一岁而降低（比值比0.95；95%置信区间，0.94 - 0.97）。虚弱与精神疾病有关；每增加一个定义虚弱的缺陷，患精神疾病的几率就增加（比值比1.23；95%置信区间，1.19 - 1.26）。同样，精神疾病与处于最虚弱状态的高得多的几率有关。这些发现支持了对虚弱的多维概念化。我们的数据还表明，与患有精神疾病的老年人打交道的医护人员应该预计虚弱情况很常见，而与虚弱老年人打交道的人员应该考虑抑郁症和精神疾病可能并存的情况。
