Anstey Kaarin J, von Sanden Chwee, Sargent-Cox Kerry, Luszcz Mary A
Ageing Research Unit, Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia.
Am J Geriatr Psychiatry. 2007 Jun;15(6):497-505. doi: 10.1097/JGP.0b013e31802e21d8.
The authors report the population prevalence of depression in older adults living in the community and in residential care. Demographic, medical, health behavior, functional and cognitive measures, and transition to residential care are evaluated as risk factors for depression over eight years.
Depression prevalence estimates were obtained from the initial electoral role sample of the Australian Longitudinal Study of Ageing that included persons living in residential care. A subsample (N = 1,116) based on follow-up data were included in longitudinal multilevel analyses that evaluated between-person and within-person predictors associated with scores from the Center for Epidemiology-Depression Scale.
At wave 1, 14.4% of community-dwelling and 32.0% of residential care-dwelling participants were depressed (15.2% of total cases). Increase in depression was associated with antidepressant status, sex, education, and marital status, but not history of hypertension, stroke, diabetes, heart disease, or smoking. Time-varying predictors, including residential care, activities of daily living, instrumental activities of daily living, self-rated health, and Mini-Mental State Examination, predicted depressive symptoms both between and within persons.
Depression is strongly linked with factors indicating increased dependency. Risk assessment and targeting of intervention strategies to prevent depression in late life should incorporate changes in functional capacity, mental status, and need for residential care.
作者报告了居住在社区和接受机构护理的老年人中抑郁症的总体患病率。在八年时间里，对人口统计学、医学、健康行为、功能和认知指标以及向机构护理的转变情况进行评估，以确定其作为抑郁症风险因素的情况。
抑郁症患病率估计值来自澳大利亚老龄化纵向研究最初的选民样本，其中包括接受机构护理的人员。基于随访数据的一个子样本（N = 1116）被纳入纵向多层次分析，该分析评估了与流行病学中心抑郁量表得分相关的个体间和个体内预测因素。
在第1波时，社区居住参与者中有14.4%、机构护理居住参与者中有32.0%患有抑郁症（占总病例的15.2%）。抑郁症的增加与抗抑郁药使用情况、性别、教育程度和婚姻状况有关，但与高血压、中风、糖尿病、心脏病病史或吸烟无关。随时间变化的预测因素，包括机构护理、日常生活活动、工具性日常生活活动、自评健康和简易精神状态检查，在个体间和个体内均能预测抑郁症状。
抑郁症与表明依赖性增加的因素密切相关。晚年抑郁症预防的风险评估和干预策略的针对性应纳入功能能力、精神状态和机构护理需求的变化情况。
