Istanbul Metropolitan Municipality Department of Health Services, Kayisdagi nursing home, Kayisdagi street No: 65 Kucukbakkalkoy, Kadikoy/Istanbul, Turkey.
J Nutr Health Aging. 2010 Jun;14(6):483-7. doi: 10.1007/s12603-010-0035-8.
Depression is frequently overlooked in older adults. Detection of depressive symptoms (DS) is important in primary care. This study aimed to detect the rate, risk factors and effects of DS in a disadvantaged older population.
Descriptive study.
Community based rehabilitation centers and Sehzadebasi medical center of Istanbul Metropolitan Municipality (IMM).
1163 Consecutive patients at least 60 years old, and applied to IMM; mostly poor and/or without health insurance.
Detailed history and geriatric scales were obtained. Depressive symptoms (DS) were defined as 14 or more points in 30 item Geriatric Depression Scale. Relations of DS and ordinal variables were tested by Chi-square; DS and numeric variables by T-test. Multiple regressions followed.
Younger old and women subjects were in majority. The rate of DS was 52%, while 9.1% have depression diagnosis in their history. After multiple regressions, lack of health insurance was found to be the strongest independent risk factor for DS (p < 0.0001). Other variables that remained significant were: Limited mobility, lower Instrumental Activities of Daily Living and Tinetti Balance scores, onset insomnia, nightly awakenings and reported dizziness (p values = 0.008; 0.021; 0.005; 0.022; 0.04 and 0.03 respectively).
These results indicate the need for comprehensive geriatric assessment in primary care to detect DS, in addition to negative effect of DS on sleep and independency. Health insurance coverage of the senior citizens also is an important challenge.
老年人中经常会忽视抑郁症状。在初级保健中，检测抑郁症状（DS）很重要。本研究旨在检测弱势老年人群中 DS 的发生率、危险因素和影响。
描述性研究。
伊斯坦布尔大都会市（IMM）社区康复中心和 Sehzadebasi 医疗中心。
1163 名连续就诊的年龄至少 60 岁的患者，他们申请了 IMM；大多数患者贫困且/或没有医疗保险。
详细的病史和老年科量表。使用 30 项老年抑郁量表，DS 定义为 14 个或更多点。通过卡方检验测试 DS 与有序变量之间的关系；通过 T 检验测试 DS 与数值变量之间的关系。然后进行多元回归。
年轻和女性患者居多。DS 的发生率为 52%，而 9.1%的患者在其病史中有抑郁诊断。经过多元回归，发现没有医疗保险是 DS 的最强独立危险因素（p < 0.0001）。其他仍然显著的变量包括：行动不便、较低的工具性日常生活活动和 Tinetti 平衡评分、起始性失眠、夜间醒来和头晕（p 值分别为 0.008；0.021；0.005；0.022；0.04 和 0.03）。
这些结果表明，除了 DS 对睡眠和独立性的负面影响外，初级保健中还需要进行全面的老年评估以检测 DS。老年人的医疗保险覆盖也是一个重要的挑战。
