St. Mary's Research Centre, St. Mary's Hospital Center, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Psychiatry, St. Mary's Hospital and McGill University, Montreal, Quebec, Canada.
Arch Gerontol Geriatr. 2014 May-Jun;58(3):332-8. doi: 10.1016/j.archger.2013.11.010. Epub 2013 Dec 1.
The objectives of this study were: (1) to describe the prevalence and 6-month incidence of observer-rated depression in residents age 65 and over of long-term care (LTC) facilities; (2) to describe risk factors for depression, at baseline and over time. A multisite, prospective observational study was conducted in residents aged 65 and over of 7 LTC facilities. The Cornell Scale for Depression in Dementia (CSDD) was completed by nurses monthly for 6 months. We measured demographic, medical, and functional factors at baseline and monthly intervals, using data from research assessments, nurse interviews, and chart reviews. 274 residents were recruited and completed baseline depression assessments. The prevalence of depression (CSDD score of 6+) was 19.0%. The incidence of depression among those without prevalent depression was 73.3 per 100 person-years. A delirium diagnosis, pain, and diabetes were independently associated with prevalent depression. CSDD score at baseline and development of severe cognitive impairment at follow-up were independent risk factors for incident depression. A diagnosis of delirium and uncorrected visual impairment at follow-up occurred concurrently with incident depression. The results of this study have implications for the detection and prevention of depression in LTC. Delirium diagnosis, pain and diabetes at baseline were associated with prevalent depression; depression symptoms at baseline and development of severe cognitive impairment at follow-up were risk factors for incident depression.
（1）描述长期护理（LTC）机构中 65 岁及以上居民的观察性抑郁的患病率和 6 个月发病率；（2）描述基线和随时间变化的抑郁风险因素。在 7 个 LTC 机构中进行了一项多站点、前瞻性观察研究。护士每月使用研究评估、护士访谈和图表审查的数据，对 65 岁及以上的居民进行为期 6 个月的康奈尔痴呆抑郁量表（CSDD）评估。共招募了 274 名居民，并完成了基线抑郁评估。抑郁的患病率（CSDD 评分≥6）为 19.0%。无明显抑郁的居民中，抑郁的发病率为每 100 人年 73.3 例。谵妄诊断、疼痛和糖尿病与明显抑郁独立相关。基线 CSDD 评分和随访时严重认知障碍的发展是新发抑郁的独立危险因素。随访时发生的谵妄诊断和未矫正的视力障碍与新发抑郁同时发生。本研究结果对 LTC 中抑郁的检测和预防具有重要意义。基线时的谵妄诊断、疼痛和糖尿病与明显抑郁有关；基线时的抑郁症状和随访时严重认知障碍的发展是新发抑郁的危险因素。
