Sanders Joost B, Comijs Hannie C, Bremmer Marijke A, Deeg Dorly J H, Beekman Aartjan T F
Department of Old Age Psychiatry, Altrecht, Institute for Mental Health Care, Den Dolder, the Netherlands.
EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
Int J Geriatr Psychiatry. 2015 Jul;30(7):751-7. doi: 10.1002/gps.4224. Epub 2014 Oct 29.
The primary aim of the study is to investigate the effect of age and aging on the association between pain and depression over 13 years. We hypothesized that (1) this association would become stronger with age and frailty and that (2) this association is mainly driven by somatic and psychological factors.
Data were derived from the Longitudinal Aging Study Amsterdam, a prospective population-based cohort study with four follow-up measurements over 13 years, consisting of 1528 respondents (mean age 67.9 ± 8.1). Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale; pain was measured with an adapted version of the Nottingham Health Profile. Follow-up time and age were used as proxy variables for aging and gait speed as frailty marker. Cognition, mastery and neuroticism were measured using the mini mental state examination, the Pearlin Mastery Scale and the Dutch Personality Questionnaire respectively.
Linear mixed models showed that pain and depressive symptoms were associated over the 13-year follow-up: b = 0.095, p < 0.001. Neither aging nor frailty changed this association. Measured somatic and psychological characteristics explained 40% of the covariance between pain and depressive symptoms over time.
When dealing with people suffering from pain and depression, interventions should be similar for all aged people, encompassing both somatic and psychological factors, irrespective of age or frailty status.
本研究的主要目的是调查年龄及衰老对13年间疼痛与抑郁之间关联的影响。我们假设：（1）这种关联会随着年龄增长和身体虚弱而增强；（2）这种关联主要由躯体和心理因素驱动。
数据来自阿姆斯特丹纵向衰老研究，这是一项基于人群的前瞻性队列研究，在13年中进行了四次随访测量，共有1528名受访者（平均年龄67.9±8.1岁）。使用流行病学研究中心抑郁量表测量抑郁症状；使用诺丁汉健康概况的改编版测量疼痛。随访时间和年龄用作衰老的替代变量，步态速度用作身体虚弱的标志物。分别使用简易精神状态检查表、皮尔林掌控量表和荷兰人格问卷测量认知、掌控感和神经质。
线性混合模型显示，在13年的随访中，疼痛与抑郁症状相关：b = 0.095，p < 0.001。衰老和身体虚弱均未改变这种关联。随着时间的推移，所测量的躯体和心理特征解释了疼痛与抑郁症状之间40%的协方差。
在应对疼痛和抑郁患者时，所有年龄段的人的干预措施都应相似，包括躯体和心理因素，无论年龄或身体虚弱状况如何。
