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老年人抑郁症状与残疾之间的纵向关系:一项基于人群的研究。

The longitudinal relationship between depressive symptoms and disability for older adults: a population-based study.

机构信息

Department of Health Care Management, University of Kang Ning, Tainan, Taiwan.

出版信息

J Gerontol A Biol Sci Med Sci. 2012 Oct;67(10):1059-67. doi: 10.1093/gerona/gls074. Epub 2012 Mar 27.

Abstract

BACKGROUND

Although depressive symptoms in older adults are common, their relationship with disability and the influence of disability on the development of depressive symptoms over time is not well understood. This longitudinal study investigates the change trajectories of both depressive symptoms and disability, as well as their associations over time.

METHODS

Participants included 442 community-dwelling older adults living in Taiwan, aged 65 years or older, who completed six waves of survey interviews. Depression was scored with the Short Psychiatric Evaluation Schedule and disability with the instrumental and physical activities of daily living measure during each consecutive data collection wave. The autoregressive latent trajectory model and parallel latent growth curve modeling were adopted for analysis of the data.

RESULTS

The autoregressive latent trajectory model highlights that previous depressive symptoms (and disability) significantly contributed to the advancement of more severe depressive symptoms (and disability). This model also indicates that disability significantly contributed to the onset of depressive symptoms and vice versa. The parallel latent growth curve modeling highlights that the disability intercept had significant effects on the depressive symptoms intercept, as did the depressive symptoms on disability. Furthermore, the disability slope had significant effects on the slope of the depressive symptoms.

CONCLUSIONS

These findings demonstrate that disability is a stronger predictor of depressive symptoms than depressive symptoms are of disability. In addition, the prior existence of a health condition will lead to further deterioration of health conditions and that they often coexist.

摘要

背景

尽管老年人中抑郁症状很常见,但他们的抑郁症状与残疾之间的关系以及残疾对抑郁症状随时间发展的影响尚不清楚。本纵向研究调查了抑郁症状和残疾的变化轨迹,以及它们随时间的关联。

方法

参与者包括居住在台湾的 442 名 65 岁或以上的社区老年人,他们完成了六轮调查访谈。在每次连续的数据收集期间,使用简短精神病评定量表和工具性及躯体日常生活活动度量表来评定抑郁和残疾。采用自回归潜轨迹模型和并行潜增长曲线模型分析数据。

结果

自回归潜轨迹模型强调,先前的抑郁症状(和残疾)显著促进了更严重的抑郁症状(和残疾)的发展。该模型还表明,残疾显著导致抑郁症状的发生,反之亦然。并行潜增长曲线模型强调残疾截距对抑郁症状截距有显著影响,抑郁症状对残疾也有显著影响。此外,残疾斜率对抑郁症状斜率有显著影响。

结论

这些发现表明,残疾是抑郁症状的一个更强的预测因子,而不是抑郁症状是残疾的预测因子。此外,先前存在的健康状况会导致健康状况进一步恶化,而且它们经常共存。

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