Center on Aging, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-5215, USA.
J Gerontol A Biol Sci Med Sci. 2013 Mar;68(3):286-92. doi: 10.1093/gerona/gls179. Epub 2012 Sep 11.
Disability is associated with depression in older persons, yet the effect of disability burden on the likelihood of being depressed is uncertain.
A total of 754 community-living persons, aged ≥70, underwent monthly assessments in four essential activities of daily living and assessments of depression (yes/no) every 18 months for up to 108 months. Within each 18-month person-interval, participants' disability burden was operationalized as none or any, and according to severity (none, mild, or severe) and chronicity (none, nonchronic, or chronic) given the highest level of severity or chronicity experienced during a given 18-month interval, respectively. A variable combining severity and chronicity (none, nonchronic mild, nonchronic severe, chronic-mild, or chronic-severe) was also created. Using generalized estimating equations, we evaluated the association between each indicator of disability burden and subsequent depression.
Participants who had any versus no disability during the previous 18 months were 65% more likely to experience subsequent depression (OR = 1.65; 95% confidence interval [CI] 1.34, 2.02). Quantifying severity (mild disability vs. none, OR = 1.43; 95% CI: 1.15, 1.79; severe disability vs. none, OR = 2.07; 95% CI 1.56, 2.74) and chronicity (nonchronic disability vs. none, OR = 1.44; 95% CI 1.13, 1.83; chronic disability vs. none, OR = 1.96; 95% CI 1.50, 2.55) indicated increasingly stronger associations with subsequent depression, with the highest likelihood of subsequent depression (OR = 2.42; 95% CI 1.78, 3.30) observed among participants with chronic-severe disability.
Quantifying the magnitude of disability burden, particularly on the basis of severity and chronicity, provides additional information regarding the likelihood of experiencing subsequent depression among older persons.
残疾与老年人的抑郁有关，但残疾负担对抑郁发生的可能性的影响尚不确定。
共有 754 名年龄≥70 岁的社区居民，每月评估四项日常生活基本活动能力，每 18 个月评估一次抑郁情况（是/否），最长达 108 个月。在每个 18 个月的个体间隔内，根据在给定的 18 个月间隔内经历的最高严重程度或慢性程度，将参与者的残疾负担定义为无或有，并根据严重程度（无、轻度或重度）和慢性程度（无、非慢性或慢性）进行操作。还创建了一个结合严重程度和慢性程度的变量（无、非慢性轻度、非慢性重度、慢性轻度或慢性重度）。使用广义估计方程，我们评估了残疾负担的每个指标与随后抑郁之间的关系。
在过去 18 个月中有任何残疾的参与者比没有残疾的参与者随后发生抑郁的可能性高 65%（OR=1.65；95%置信区间[CI]1.34，2.02）。量化严重程度（轻度残疾与无残疾，OR=1.43；95%CI：1.15，1.79；重度残疾与无残疾，OR=2.07；95%CI 1.56，2.74）和慢性程度（非慢性残疾与无残疾，OR=1.44；95%CI 1.13，1.83；慢性残疾与无残疾，OR=1.96；95%CI 1.50，2.55）表明与随后的抑郁有更强的关联，具有慢性重度残疾的参与者随后发生抑郁的可能性最高（OR=2.42；95%CI 1.78，3.30）。
量化残疾负担的程度，特别是基于严重程度和慢性程度，为老年人随后发生抑郁的可能性提供了更多信息。
