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一生中累积逆境对老年人抑郁症状和生活质量变化及持续性的影响。

The effect of lifetime cumulative adversity on change and chronicity in depressive symptoms and quality of life in older adults.

机构信息

Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel.

出版信息

Int Psychogeriatr. 2012 Dec;24(12):1988-97. doi: 10.1017/S1041610212001123. Epub 2012 Jul 3.

DOI:10.1017/S1041610212001123
PMID:22874666
Abstract

BACKGROUND

Lifetime cumulative adversity (LCA) has a detrimental effect on mental health. However, it is less clear whether it also increases the risk for mental health deterioration across time, and whether it is related to a continuous impairment in mental health among older adults. The current study aimed to examine whether LCA is related to deterioration and to continuous vulnerability in depressive symptoms and quality of life.

METHOD

Nine thousand one hundred fifty four older adults (mean age = 63 at Wave 1) who participated in the first three waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) reported exposure to negative life events, depressive symptoms, and quality of life.

RESULTS

Respondents with more LCA were at greater risk of high level of depressive symptoms and low level of quality of life. Those with more adversity were at greater risk of reporting an increase in depressive symptoms and a decrease in quality of life between waves. LCA was also related to continuous high level of depressive symptoms and low level of quality of life. The effect of LCA was stronger for depressive symptoms than for quality of life.

CONCLUSIONS

LCA is associated with decline, as well as with continuous impairment, in major markers of mental health at the second half of life. The overall modest effects imply that resilience to LCA is widespread among older adults. Still, prevention and intervention programs should target old people with cumulative adversity, as they are in risk for deterioration and chronic vulnerability in important components of mental health.

摘要

背景

终生累积逆境(LCA)对心理健康有不利影响。然而,目前尚不清楚它是否也会增加随时间推移心理健康恶化的风险,以及它是否与老年人的心理健康持续受损有关。本研究旨在探讨 LCA 是否与抑郁症状和生活质量的恶化和持续脆弱性有关。

方法

9154 名参加欧洲健康、老龄化和退休调查(SHARE)前三个波次的老年人(第 1 波平均年龄为 63 岁)报告了负性生活事件、抑郁症状和生活质量的暴露情况。

结果

LCA 较多的受访者患高水平抑郁症状和低生活质量的风险更高。逆境较多的人在各波次之间报告抑郁症状加重和生活质量下降的风险更高。LCA 也与持续高水平的抑郁症状和低水平的生活质量有关。LCA 对抑郁症状的影响强于对生活质量的影响。

结论

LCA 与生命后半段主要心理健康标志物的下降以及持续受损有关。整体而言,影响程度较小表明,老年人普遍具有对 LCA 的适应能力。不过,预防和干预计划应该针对累积逆境的老年人,因为他们面临着心理健康重要组成部分恶化和慢性脆弱的风险。

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