抑郁症状与步速之间的双向关联：来自英国老龄化纵向研究（ELSA）的证据。
The bidirectional association between depressive symptoms and gait speed: evidence from the English Longitudinal Study of Ageing (ELSA).
机构信息
Department of Epidemiology and Public Health, University College London, London, United Kingdom.
出版信息
PLoS One. 2013 Jul 9;8(7):e68632. doi: 10.1371/journal.pone.0068632. Print 2013.
BACKGROUND
Depressive symptoms and physical performance are inversely associated, but it is unclear whether their association is bidirectional. We examined whether the association between depressive symptoms and physical performance measured using gait speed is bidirectional.
METHODS
We used a national sample of 4,581 community-dwelling people aged 60 years and older from the English Longitudinal Study of Ageing (from 2002-03 to 2008-09). We fitted Generalized Estimating Equation (GEE) regression models to analyse repeated measurements of gait speed (m/sec) and elevated depressive symptoms (defined as a score of ≥4 on the eight-item Center for Epidemiological Studies-Depression scale).
RESULTS
Slower gait speed was associated with elevated depressive symptoms both concurrently and two years later. After adjustment for previous depressive symptoms and sociodemographic, clinical, lifestyle, psychosocial, and cognitive factors the concurrent association was partially explained (Odds Ratio [OR] 0.42, 95% confidence interval [CI], 0.30 to 0.59, per 1m/sec increase in gait speed) and the two-year lagged association fully (OR 0.75, 95% CI, 0.56 to 1.00). Elevated depressive symptoms were associated with slower gait speed. Full adjustment for covariates (including previous gait speed) partially explained both the concurrent (β regression coefficient [β] -0.038, 95% CI, -0.050 to -0.026, for participants with elevated depressive symptoms compared with those with no or one symptom) and the two-year lagged associations (β -0.017, 95% CI, -0.030 to -0.005). Subthreshold depressive symptoms (defined as a score of two or three on the eight-item Center for Epidemiological Studies-Depression scale) were also associated with slower gait speed. Full adjustment for covariates partially explained both the concurrent (β -0.029, 95% CI, -0.039 to -0.019, for participants with subthreshold symptoms compared with those with no or one symptom) and the two-year lagged associations (β -0.011, 95% CI, -0.021 to -0.001).
CONCLUSIONS
The inverse association between gait speed and depressive symptoms appears to be bidirectional.
背景
抑郁症状与身体表现呈负相关，但尚不清楚这种关联是否具有双向性。我们研究了使用步态速度测量的抑郁症状与身体表现之间的关联是否具有双向性。
方法
我们使用来自英国老龄化纵向研究（2002-03 年至 2008-09 年）的 4581 名 60 岁及以上的社区居民的全国性样本。我们使用广义估计方程（GEE）回归模型来分析步态速度（米/秒）和抑郁症状升高（使用八项流行病学研究中心抑郁量表评分≥4 定义）的重复测量值。
结果
较慢的步态速度与同时发生和两年后的抑郁症状升高均有关。在校正了先前的抑郁症状以及社会人口学、临床、生活方式、心理社会和认知因素后，同期关联部分得到了解释（每增加 1 米/秒的步态速度，优势比 [OR] 0.42，95%置信区间 [CI]，0.30 至 0.59），两年的滞后关联完全得到了解释（OR 0.75，95% CI，0.56 至 1.00）。抑郁症状升高与步态速度较慢有关。同时调整协变量（包括先前的步态速度）部分解释了同期（β回归系数[β]-0.038，95%CI，-0.050 至-0.026，与无或仅有一个症状的参与者相比，抑郁症状升高的参与者）和两年滞后的关联（β-0.017，95%CI，-0.030 至-0.005）。亚阈值抑郁症状（使用八项流行病学研究中心抑郁量表评分 2 或 3 定义）也与步态速度较慢有关。同时调整协变量部分解释了同期（β-0.029，95%CI，-0.039 至-0.019，与无或仅有一个症状的参与者相比，亚阈值症状的参与者）和两年滞后的关联（β-0.011，95%CI，-0.021 至-0.001）。
结论
步态速度与抑郁症状之间的负向关联似乎具有双向性。
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