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抑郁症状和步态速度受损是否会相互预测?社区 16 年的前瞻性研究。

Do depressive symptoms and gait speed impairment predict each other's incidence? A 16-year prospective study in the community.

机构信息

Department of Old Age Psychiatry, Altrecht, Institute for Mental Health Care, Zeist, The Netherlands.

出版信息

J Am Geriatr Soc. 2012 Sep;60(9):1673-80. doi: 10.1111/j.1532-5415.2012.04114.x. Epub 2012 Aug 20.

DOI:10.1111/j.1532-5415.2012.04114.x
PMID:22905679
Abstract

OBJECTIVES

To investigate whether gait speed predicts incident depressive symptoms and whether depressive symptoms predict incident gait speed impairment; to ascertain the presence of shared risk factors for these associations.

DESIGN

The Longitudinal Aging Study Amsterdam, a prospective cohort study with five follow-up cycles over 16 years.

SETTING

Population based.

PARTICIPANTS

One thousand nine hundred twenty-eight respondents for incident depressive symptoms (mean age 68.9 ± 8.5) and 1,855 respondents for incident gait speed impairment (mean age 68.0 ± 8.2).

MEASUREMENTS

Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale; gait speed was measured, back and forth, during a 3-m walk as quickly as possible, with a 180° turn. Multivariate analyses were performed for both sexes using Cox regression.

RESULTS

Incident depressive symptoms occurred in 24% of respondents. In univariate analyses, gait speed at baseline predicted incident depressive symptoms in men and women; after adjustment for covariates, this association persisted in men only. Examining the reverse association, 34% of respondents developed gait speed impairment. Depressive symptoms at baseline were univariately associated with incident gait speed impairment in women but not in men; this association did not persist after adjustment. The bidirectional associations did not share the same explanatory variables.

CONCLUSION

Gait speed predicts depressive symptoms in men. The geriatric giants of depressive symptoms and slowed gait speed in late life appear to result from different pathologies, both of which therefore require their own treatment strategies.

摘要

目的

研究步态速度是否可预测抑郁症状的发生,以及抑郁症状是否可预测步态速度损害的发生;确定这些关联是否存在共同的风险因素。

设计

阿姆斯特丹纵向老龄化研究,一项前瞻性队列研究,历时 16 年进行了五次随访。

地点

基于人群。

参与者

1928 名出现抑郁症状的新发病例(平均年龄 68.9±8.5)和 1855 名出现步态速度损害的新发病例(平均年龄 68.0±8.2)。

测量方法

使用流行病学研究中心抑郁量表来测量抑郁症状;在 3 米的步行距离内尽可能快地来回行走,并进行 180°转弯,来测量步态速度。对两性使用 Cox 回归进行多变量分析。

结果

24%的受访者出现了抑郁症状。在单变量分析中,基线时的步态速度可预测男性和女性的抑郁症状发生;在调整了协变量后,这种关联仅在男性中持续存在。在反向关联中,34%的受访者出现了步态速度损害。基线时的抑郁症状与女性发生步态速度损害存在单变量关联,但在男性中没有;在调整后,这种关联并不存在。双向关联不存在相同的解释变量。

结论

步态速度可预测男性的抑郁症状。老年人群中抑郁症状和晚年步态速度减慢这两个“巨人”似乎是由不同的病理引起的,因此两者都需要有自己的治疗策略。

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