Department of Sociology, Bowling Green State University, 217 Williams Hall, Bowling Green, OH 43403, USA.
J Gerontol B Psychol Sci Soc Sci. 2011 Sep;66(5):585-94. doi: 10.1093/geronb/gbr060. Epub 2011 Jul 11.
Prior studies have extensively examined the reciprocal relation between disability and depressive symptoms in late life, but little is known about whether informal care attenuates the reciprocal relation over time. This study examined whether disability and depressive symptoms mobilize informal care and whether informal care, once mobilized, protects older adults against the progression of disability and depressive symptoms.
The analysis was based on 6,454 community-dwelling older adults who were interviewed in one or more waves of the Health and Retirement Study between 1998 and 2006. Extending an autoregressive cross-lagged model, we constructed 3 cycles of the relations among disability, depressive symptoms, and informal care. Comparing the relations across 3 cycles informs us about the attenuating effect of informal care on the relation between disability and depressive symptoms over time.
Although older adults' disability and depressive symptoms mobilized informal care initially, worsening disability and depressive symptoms often exhausted support. Receipt of care generally increased, rather than decreased, disability and depressive symptoms, and the detrimental effects remained the same over time.
We need to better understand the linkage between disability and depressive symptoms and seek effective interventions to reduce caregiver strain and enhance care receivers' well-being.
先前的研究广泛考察了老年期残疾与抑郁症状之间的相互关系，但对于非正规照料是否会随着时间的推移减弱这种相互关系知之甚少。本研究考察了残疾和抑郁症状是否会调动非正规照料，以及非正规照料一旦被调动，是否会保护老年人免受残疾和抑郁症状的恶化。
该分析基于 1998 年至 2006 年间参加健康与退休研究（Health and Retirement Study）一次或多次访谈的 6454 名居住在社区的老年人。通过扩展自回归交叉滞后模型，我们构建了残疾、抑郁症状和非正规照料之间的 3 个循环关系。比较 3 个循环中的关系，可以了解非正规照料随时间减弱残疾和抑郁症状之间关系的效果。
尽管老年人的残疾和抑郁症状最初会调动非正规照料，但不断恶化的残疾和抑郁症状往往会耗尽支持。接受照料通常会增加残疾和抑郁症状，而不是减少，而且这种不利影响随着时间的推移保持不变。
我们需要更好地理解残疾和抑郁症状之间的联系，并寻求有效的干预措施来减轻照顾者的压力，增强照顾者的幸福感。
