The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland.
The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Ireland.
Am J Geriatr Psychiatry. 2015 Feb;23(2):189-99. doi: 10.1016/j.jagp.2014.04.005. Epub 2014 May 2.
This study examined the relationships between late-onset depressive symptoms, antidepressants, and single and dual task gait in older adults.
Cross-sectional study.
The Irish Longitudinal Study on Ageing (TILDA), a nationally representative cohort study.
Community-dwelling adults aged 60 years and older, with Mini-Mental State Examination score ≥24, no history of Parkinson's disease or early onset depression, and unaided completion of a gait assessment (N = 1,998). This study compared participants with and without potentially clinically relevant depressive symptoms (i.e., ≥16 on the Centre for Epidemiological Studies Depression scale) and participants who were and were not on antidepressant therapy.
Gait measures were obtained during single and dual task (reciting alternate letters of alphabet, A-C-E) walking using a 4.88 m GAITRite walkway. Regression analysis was used to examine the associations between each group and gait adjusting for sociodemographics and health.
In the unadjusted models, depressive symptoms and antidepressant use were associated with gait deficits. After adjusting for covariates, antidepressant use was associated with reduced gait speed and stride length in single and dual task walking; depressive symptoms were not associated with any deficits.
As gait impairments are associated with an increased risk of adverse outcomes including falls, clinicians should be aware of the impact of antidepressants on gait in older adults. Subsequent to this, interventions aimed at improving physical function, which is a known precursor to falls and functional disability, should be recommended.
本研究旨在探讨老年人迟发性抑郁症状、抗抑郁药物治疗与单任务和双任务步态之间的关系。
横断面研究。
爱尔兰老龄化纵向研究(TILDA),这是一项具有全国代表性的队列研究。
年龄在 60 岁及以上、简易精神状态检查评分≥24、无帕金森病或早发性抑郁病史且能独立完成步态评估的社区居住成年人(N=1998)。本研究比较了有和无潜在临床相关抑郁症状(即中心流行病学研究抑郁量表≥16)以及服用和未服用抗抑郁药物治疗的参与者。
使用 4.88 m GAITRite 步道进行单任务和双任务(背诵字母表中的交替字母,A-C-E)行走时,获取步态测量值。回归分析用于检查每个组与步态之间的关联,同时调整社会人口统计学和健康状况。
在未调整的模型中,抑郁症状和抗抑郁药物的使用与步态缺陷有关。在调整了协变量后,抗抑郁药物的使用与单任务和双任务行走时的步速和步长降低有关;抑郁症状与任何缺陷均无关。
由于步态障碍与跌倒等不良后果的风险增加有关,临床医生应意识到抗抑郁药物对老年人步态的影响。在此之后,应推荐旨在改善身体功能的干预措施,因为身体功能是跌倒和功能障碍的已知前兆。