Department of Family, Consumer, and Human Development, Utah State University, Logan, UT 84322-2905, USA.
J Gerontol B Psychol Sci Soc Sci. 2012 Mar;67(2):167-77. doi: 10.1093/geronb/gbr078. Epub 2011 Aug 6.
Gerontological research suggests that depressive symptoms show antecedent and consequent relations with late-life disability. Less is known, however, about how depressive symptoms change with the progression of disability-related processes and what factors moderate such changes.
We applied multiphase growth models to longitudinal data pooled across 4 Swedish studies of very old age (N = 779, M age = 86 years at disability onset, 64% women) to describe change in depressive symptoms prior to disability onset, at or around disability onset (the measurement wave at which assistance in personal activities of daily living was first recorded), and postdisability onset.
Results indicate that, on average, depressive symptoms slightly increase with approaching disability, increase at onset, and decline in the postdisability phase. Age, study membership, being a woman, and multimorbidity were related to depressive symptoms, but social support emerged as the most powerful predictor of level and change in depressive symptoms.
Our findings are consistent with conceptual notions implicating disability-related factors as key contributors to late-life change and suggest that contextual and psychosocial factors play a pivotal role for how well people adapt to late-life challenges.
老年学研究表明,抑郁症状与晚年残疾具有先行和后继关系。然而,人们对抑郁症状如何随着与残疾相关过程的进展而变化以及哪些因素会影响这种变化知之甚少。
我们应用多阶段增长模型对来自瑞典的四项针对高龄人群(N=779,残疾起始时的平均年龄为 86 岁,64%为女性)的纵向数据进行了汇总,以描述残疾发生前、残疾发生时或残疾发生时(首次记录日常生活活动辅助的测量波)的抑郁症状变化。
结果表明,平均而言,抑郁症状随着接近残疾而略有增加,在发病时增加,并在残疾后阶段下降。年龄、研究参与、女性和多种合并症与抑郁症状有关,但社会支持是抑郁症状水平和变化的最有力预测因素。
我们的研究结果与概念上的观点一致,即残疾相关因素是导致晚年变化的关键因素,并表明环境和心理社会因素对人们适应晚年挑战的能力起着关键作用。