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晚年的抑郁与衰弱:共同易损性的证据

Depression and Frailty in Late Life: Evidence for a Common Vulnerability.

作者信息

Lohman Matthew, Dumenci Levent, Mezuk Briana

机构信息

Department of Psychiatry, Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, New York.

Department of Social and Behavioral Health and.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2016 Jul;71(4):630-40. doi: 10.1093/geronb/gbu180. Epub 2015 Jan 23.

Abstract

OBJECTIVES

The study purpose is to estimate the correlation between depression and competing models of frailty, and to determine to what degree the comorbidity of these syndromes is determined by shared symptomology.

METHODS

Data come from the 2010 Health and Retirement Study. Analysis was limited to community-dwelling participants 65 and older (N = 3,453). Depressive symptoms were indexed by the 8-item Centers for Epidemiologic Studies Depression (CESD) scale. Frailty was indexed by 3 alternative conceptual models: (a) biological syndrome, (b) frailty index, and (c) functional domains. Confirmatory factor analysis (CFA) was used to estimate the correlation between depression and each model of frailty.

RESULTS

Each of the 3 frailty latent factors was significantly correlated with depression: biological syndrome (ρ = .68, p < .01), functional domains (ρ = .70, p < .01), and frailty index (ρ = .61, p < .01). Substantial correlation remained when accounting for shared symptoms between depression and the biological syndrome (ρ = .45) and frailty index (ρ = .56) models.

DISCUSSION

Results indicate that the correlation of frailty and depression in late life is substantial. The association between the two constructs cannot be fully explained by symptom overlap, suggesting that psychological vulnerability may be an important component of frailty.

摘要

目的

本研究旨在评估抑郁与衰弱的不同模型之间的相关性,并确定这些综合征的共病在多大程度上由共同的症状学决定。

方法

数据来自2010年健康与退休研究。分析仅限于65岁及以上的社区居住参与者(N = 3453)。抑郁症状采用8项流行病学研究中心抑郁量表(CESD)进行索引。衰弱采用3种替代概念模型进行索引:(a)生物学综合征,(b)衰弱指数,以及(c)功能领域。验证性因子分析(CFA)用于评估抑郁与每种衰弱模型之间的相关性。

结果

3种衰弱潜在因子中的每一种都与抑郁显著相关:生物学综合征(ρ = 0.68,p < 0.01)、功能领域(ρ = 0.70,p < 0.01)和衰弱指数(ρ = 0.61,p < 0.01)。在考虑抑郁与生物学综合征(ρ = 0.45)和衰弱指数(ρ = 0.56)模型之间的共同症状后,仍存在显著相关性。

讨论

结果表明,晚年衰弱与抑郁之间的相关性很强。这两种结构之间的关联不能完全由症状重叠来解释,这表明心理易损性可能是衰弱的一个重要组成部分。

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