Isaac Vivian, Stewart Robert, Artero Sylvaine, Ancelin Marie-Laure, Ritchie Karen
King's College London, Institute of Psychiatry, Section of Epidemiology, London, UK.
Am J Geriatr Psychiatry. 2009 Aug;17(8):688-96. doi: 10.1097/JGP.0b013e3181a88441.
To investigate: i) the association between level of social activity and late-life depressive symptoms and ii) the association between level of social activity and improvement in depressive symptoms over a 2-year period among people scoring above case level.
A secondary analysis of data from a prospective community-based study.
Montpellier district, France.
Community residents aged 65 and older (N = 1,849), 85.4% of whom were reassessed after a 2-year interval.
Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale at baseline and follow-up, and the standard 16 + cutoff was applied to define case-level symptomatology. The primary independent variable assessed at baseline was three levels of social activity defined from a 33-point scale. Other covariates included age, gender, marital status, education, alcohol consumption, chronic illness, cognitive impairment, disability, life events, and antidepressant use at baseline and follow-up.
In the sample at baseline (N = 1,849), higher social activity was negatively associated with case-level depressive symptomatology after adjustment for potential confounders (odds ratio across three groups 0.7, 95% confidence interval 0.6-0.8). In a prospective analysis of participants above case level at baseline (N = 463), high-social activity at baseline was the only variable associated with improvement in depressive symptoms and remained significant after adjustment for all other factors (odds ratio=1.6; 95% confidence interval = 1.2-2.2).
In a large community sample, higher social activity was associated with a lower risk of late-life depressive symptoms at baseline and, in those with case-level baseline symptoms, was the principal factor predicting improvement over 2-year follow-up.
调查：i）社交活动水平与晚年抑郁症状之间的关联；ii）在得分高于病例水平的人群中，社交活动水平与两年期间抑郁症状改善之间的关联。
对一项基于社区的前瞻性研究数据进行二次分析。
法国蒙彼利埃地区。
65岁及以上的社区居民（N = 1849），其中85.4%在两年间隔后接受重新评估。
在基线和随访时使用流行病学研究中心抑郁量表评估抑郁症状，并应用标准的16分及以上临界值来定义病例水平的症状。在基线时评估的主要自变量是根据33分制定义的三个社交活动水平。其他协变量包括年龄、性别、婚姻状况、教育程度、饮酒量、慢性病、认知障碍、残疾、生活事件以及基线和随访时的抗抑郁药使用情况。
在基线样本（N = 1849）中，在对潜在混杂因素进行调整后，较高的社交活动与病例水平的抑郁症状呈负相关（三组的比值比为0.7，95%置信区间为0.6 - 0.8）。在对基线时高于病例水平的参与者（N = 463）进行的前瞻性分析中，基线时的高社交活动是与抑郁症状改善相关的唯一变量，在对所有其他因素进行调整后仍具有显著性（比值比 = 1.6；95%置信区间 = 1.2 - 2.2）。
在一个大型社区样本中，较高的社交活动与基线时晚年抑郁症状的较低风险相关，并且在基线有病例水平症状的人群中，是预测两年随访期间症状改善的主要因素。
