Becofsky Katie, Baruth Meghan, Wilcox Sara
Department of Exercise Science, University of South Carolina, Public Health Research Center, 921 Assembly Street, Columbia, SC 29208, USA.
Arthritis. 2013;2013:525761. doi: 10.1155/2013/525761. Epub 2013 Sep 5.
This study investigated how physical functioning and perceived disability are related to depressive symptoms in adults with arthritis (n = 401). Participants self-reported depressive symptoms and disability. Objective measures of physical functioning included the 30-second chair stand test, 6-minute walk test, gait speed, balance, grip strength, and the seated reach test. Separate quantile regression models tested associations between each functional measure and depressive symptoms, controlling for age, gender, race, BMI, self-reported health status, and arthritis medication use. The association between perceived disability and depressive symptoms was also tested. Participants averaged 56.3 ± 10.7 years; 85.8% were women; 64.3% were white. Lower distance in the 6-minute walk test, fewer chair stands, slower gait speed, and greater perceived disability were associated with greater depressive symptoms in unadjusted models (Ps < 0.05). Fewer chair stands and greater perceived disability were associated with more depressive symptoms in adjusted models (Ps < 0.05). Balance, grip strength, and seated reach were not related to depressive symptoms. The perception of being disabled was more strongly associated with depressive symptoms than reduced physical functioning. To reduce the risk of depression in arthritic populations, it may be critical to not only address physical symptoms but also to emphasize coping skills and arthritis self-efficacy.
本研究调查了身体功能和感知到的残疾与关节炎成人患者(n = 401)抑郁症状之间的关系。参与者自我报告抑郁症状和残疾情况。身体功能的客观测量指标包括30秒椅子站立测试、6分钟步行测试、步速、平衡能力、握力和坐位体前屈测试。分别采用分位数回归模型来检验每项功能测量指标与抑郁症状之间的关联,并对年龄、性别、种族、体重指数、自我报告的健康状况和关节炎药物使用情况进行了控制。同时也检验了感知到的残疾与抑郁症状之间的关联。参与者的平均年龄为56.3±10.7岁;85.8%为女性;64.3%为白人。在未调整的模型中,6分钟步行测试中的距离较短、椅子站立次数较少、步速较慢以及感知到的残疾程度较高与更严重的抑郁症状相关(P<0.05)。在调整后的模型中,椅子站立次数较少和感知到的残疾程度较高与更多的抑郁症状相关(P<0.05)。平衡能力、握力和坐位体前屈与抑郁症状无关。与身体功能下降相比,感知到残疾与抑郁症状的关联更强。为降低关节炎患者群体中抑郁症的风险,不仅解决身体症状,还强调应对技巧和关节炎自我效能感可能至关重要。