老年综合征与低收入新加坡糖尿病患者的抑郁情绪：对糖尿病管理和健康促进的影响。

Geriatric syndromes and depressed mood in lower-income Singaporeans with diabetes: implications for diabetes management and health promotion.

机构信息

Health Services and Outcomes Research, National Healthcare Group, Singapore.

出版信息

Ann Acad Med Singap. 2012 Feb;41(2):67-76.

Abstract

INTRODUCTION

This study aims to determine the association of geriatric syndromes and depressed mood among respondents with diabetes in a lower income community; and their association with self-management, lifestyle behaviour, and healthcare utilisation. This paper focuses primarily on the 114 respondents with diabetes aged 50+ to inform policy formulation at the community level.

MATERIALS AND METHODS

A pilot community health assessment was conducted in 4 blocks of 1- and 2-room apartments in Toa Payoh district from July to November 2009. Using a standard questionnaire, interviewers conducted face-to-face interviews with household members on chronic diseases, geriatric syndromes and health-related behaviour. Data were analysed using SPSSv15.

RESULTS

A total of 795 respondents were assessed with a response rate of 61.8%. Of 515 (64.8%) aged 50+ analysed in this study, 22.1% reported having diabetes, of whom 31.6% reported being depressed. Respondents with diabetes who reported being depressed had a higher prevalence of geriatric syndromes compared with those non-depressed; i.e. functional decline (30.6% vs 5.1%, P <0.001); falls (33.3% vs 10.3%, P = 0.003); stumbling (30.6% vs 10.3%, P = 0.007); urinary incontinence (33.3% vs 5.1%, P <0.001), progressive forgetfulness (27.8% vs 6.4%, P = 0.002) and poor eyesight (22.2% vs 6.4%, P = 0.014). They were less likely to comply with medications (86.1% vs 97.3%, P = 0.026) and performed exercise (13.9% vs 53.8%, P <0.001). More had hospital admissions (13.9% vs 7.7%); and they had more outpatient visits per person (2.4 visits vs 0.9 visits, P = 0.03) at Specialist Outpatient Clinics.

CONCLUSION

Geriatric syndromes were associated with the presence of depressed mood among persons with diabetes in the lower income group. As those with depressed mood had more unfavourable self-management and lifestyle behaviour, and utilise higher healthcare services, diabetes management must take these findings into consideration.

摘要

简介

本研究旨在确定在收入较低的社区中，老年综合征和抑郁情绪与糖尿病患者之间的关联；并确定它们与自我管理、生活方式行为和医疗保健利用之间的关联。本文主要关注年龄在 50 岁及以上的 114 名糖尿病患者，以为社区层面的政策制定提供信息。

材料和方法

2009 年 7 月至 11 月，在大巴窑区的 4 个 1 房和 2 房式公寓街区进行了试点社区健康评估。使用标准问卷，访谈员与家庭成面对面访谈，了解慢性病、老年综合征和与健康相关的行为。使用 SPSSv15 进行数据分析。

结果

共评估了 795 名受访者，应答率为 61.8%。在这项研究中分析的 515 名（64.8%）年龄在 50 岁及以上的人中，22.1%报告患有糖尿病，其中 31.6%报告患有抑郁症。与非抑郁组相比，报告患有抑郁症的糖尿病患者更常见老年综合征；即功能下降（30.6%比 5.1%，P<0.001）；跌倒（33.3%比 10.3%，P=0.003）；蹒跚（30.6%比 10.3%，P=0.007）；尿失禁（33.3%比 5.1%，P<0.001）；记忆力减退（27.8%比 6.4%，P=0.002）和视力不佳（22.2%比 6.4%，P=0.014）。他们更不可能遵守药物治疗（86.1%比 97.3%，P=0.026）和运动（13.9%比 53.8%，P<0.001）。更多的人住院（13.9%比 7.7%）；而且他们在专科门诊就诊的人均就诊次数更多（2.4 次比 0.9 次，P=0.03）。