Onder Graziano, Liperoti Rosa, Soldato Manuel, Cipriani Maria Camilla, Bernabei Roberto, Landi Francesco
Department of Gerontology, Catholic University of Sacred Heart, Rome, Italy.
J Clin Psychiatry. 2007 Sep;68(9):1392-8. doi: 10.4088/jcp.v68n0910.
Depression is a frequent condition observed among nursing home residents. However, so far, limited data are available on the impact of depression on nursing home admission. The aim of the present study was to assess the effect of depression on the risk of nursing home admission in a group of older adults receiving home care in Europe.
We conducted a longitudinal analysis using data from the Aged in Home Care (AdHOC) database, which contains information on older adults receiving home care services in 11 European countries. Subjects had been admitted to the home care programs between 2001 and 2003. Depression was diagnosed as a score >or=3 on the Minimum Data Set (MDS) Depression Rating Scale. Information on nursing home admission was collected semiannually for 1 year by trained research personnel.
The mean age of 2718 older adults entering the study was 82.4 (SD = 7.3) years, 2047 (75.3%) were women, and 331 (12.2%) were depressed. Overall, 49/331 depressed participants (14.8%) and 252/2387 nondepressed participants (10.6%) were admitted to a nursing home (p = .02). After adjusting for potential confounders, the risk of nursing home admission was significantly higher for depressed participants (hazard ratio = 1.43, 95% CI = 1.02 to 2.02). The risk of nursing home admission progressively and significantly increased as MDS Depression Rating Scale score increased (signifying more severe depression) (p = .001 for linear trend).
In older adults receiving home care in Europe, depression is associated with an increased risk for nursing home admission. This association increases with severity of depression.
抑郁症是疗养院居民中常见的一种状况。然而，迄今为止，关于抑郁症对入住疗养院的影响的数据有限。本研究的目的是评估抑郁症对欧洲一组接受居家护理的老年人入住疗养院风险的影响。
我们使用来自居家护理老年人（AdHOC）数据库的数据进行了一项纵向分析，该数据库包含11个欧洲国家接受居家护理服务的老年人的信息。研究对象于2001年至2003年期间进入居家护理项目。抑郁症通过最低数据集（MDS）抑郁评定量表得分≥3分来诊断。训练有素的研究人员每半年收集一次有关入住疗养院的信息，为期1年。
进入研究的2718名老年人的平均年龄为82.4（标准差=7.3）岁，其中2047名（75.3%）为女性，331名（12.2%）患有抑郁症。总体而言，331名抑郁参与者中有49名（14.8%）、2387名非抑郁参与者中有252名（10.6%）入住了疗养院（p = 0.02）。在对潜在混杂因素进行调整后，抑郁参与者入住疗养院的风险显著更高（风险比=1.43，95%置信区间=1.02至2.02）。随着MDS抑郁评定量表得分增加（表明抑郁更严重），入住疗养院的风险逐渐且显著增加（线性趋势p = 0.001）。
在欧洲接受居家护理的老年人中，抑郁症与入住疗养院的风险增加有关。这种关联随着抑郁症严重程度的增加而增强。
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