Department of Community and Preventive Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Int J Geriatr Psychiatry. 2013 Jul;28(7):718-27. doi: 10.1002/gps.3878. Epub 2012 Sep 7.
To evaluate the association between multisystem physiological dysfunction and depressive symptom severity in the US older adults.
We examined 2405 adults of age 60 years and older by using the data from the 2005-2008 National Health and Nutrition Examination Survey. We constructed a summary score of "physiological dysfunction," encompassing cardiovascular function, glucose regulation, liver function, and renal function. Overall depressive symptoms were obtained from the 9-item Patient Health Questionnaire depression scale, and factor analysis was used to derive affective and somatic symptom scores. We employed multiple linear regression models to estimate associations between physiological dysfunction scores and affective, somatic, and overall depressive symptoms, while adjusting for demographic, socioeconomic factors, and other potentially confounding factors.
Greater multisystem physiological dysfunction scores were associated with an increased severity of overall, affective, and somatic depressive symptoms. These associations persisted after adjusting for all covariates: beta = 0.23 (95% confidence interval (CI) = 0.13, 0.32); beta = 0.08 (95% CI = 0.04, 0.11); beta = 0.12 (95% CI = 0.06, 0.18), respectively.
Our results suggest that the multisystem physiological dysfunction is associated with late-life depressive symptoms. Additional longitudinal studies of links between allostatic load, psychosocial stress events throughout the life course, and late-life depressive symptoms may shed further light on this association.
评估美国老年人多系统生理功能障碍与抑郁症状严重程度之间的关系。
我们利用 2005-2008 年全国健康与营养调查的数据,对 2405 名年龄在 60 岁及以上的成年人进行了检查。我们构建了一个“生理功能障碍”综合评分,包括心血管功能、血糖调节、肝功能和肾功能。总体抑郁症状采用 9 项患者健康问卷抑郁量表获得,采用因子分析得出情感和躯体症状评分。我们采用多元线性回归模型来估计生理功能障碍评分与情感、躯体和总体抑郁症状之间的关联,同时调整了人口统计学、社会经济因素和其他潜在的混杂因素。
多系统生理功能障碍评分越高,总体、情感和躯体抑郁症状的严重程度越高。这些关联在调整了所有协变量后仍然存在:β=0.23(95%置信区间(CI)=0.13,0.32);β=0.08(95%CI=0.04,0.11);β=0.12(95%CI=0.06,0.18)。
我们的结果表明,多系统生理功能障碍与晚年抑郁症状有关。进一步研究适应负荷、整个生命历程中的心理社会应激事件与晚年抑郁症状之间的联系,可能会进一步阐明这种关联。