Yang Ya-Ting, Wang Yao-Hsien, Chiu Hsien-Tsai, Wu Chia-Rong, Handa Yujiro, Liao Yin-Lin, Hsu Yi-Hsin Elsa
Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan, ROC; Golden Dream Think Tank and Research Center, Taipei, Taiwan, ROC; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan, ROC.
School of Health Care Administration, Taipei Medical University, Taipei, Taiwan, ROC; Department of Psychiatry, Buddhist Tzu-Chi General Hospital, Taipei Branch, New Taipei City, Taiwan, ROC.
Arch Gerontol Geriatr. 2015 Nov-Dec;61(3):371-7. doi: 10.1016/j.archger.2015.07.005. Epub 2015 Aug 3.
Few nationwide comprehensive studies analyzed the factors leading to the onset of depression in correlation with medical disease and other related factors concerning geriatric depression. This study examined medical diseases with other factors which lead to depression among the elderly.
This Taiwan-based longitudinal study examined a collection of 1467 seniors aged over 65. Subjects who fit this criteria were initially interviewed in 2003, and then four years later. Independent variables included baseline demographics, chronic medical illnesses, and the change of subjects' self-perceived health status, functional limitations including ADL, IADL and mobility limitation factors. The dependent variable was the symptoms of incident depression, as ascertained by the ten-item questionnaire during the later session. The logistic regression analyses were used to examine some of the predictors related to depressive disorders.
The findings showed that heart conditions (adjusted OR=1.55, 95% CI: 1.12-2.15, p=0.008) and joint disorders (adjusted OR=1.51, 95% CI: 1.09-2.09, p=0.013), as well as functional limitations, particularly IADL (adjusted OR=1.81, 95% CI: 1.24-2.65, p=0.002) and ADL (adjusted OR=1.77, 95% CI: 1.27-2.47, p=0.001) were independently associated with the onset of depression among the elderly population.
These findings indicated that when classifying symptoms of depression in geriatric patients with several underlying medical diseases, keen attention should be directed to the type of medical disorders and the functional deterioration in terms of daily activities and autonomic capabilities.
很少有全国性的综合研究分析与医学疾病相关的导致抑郁症发作的因素以及与老年抑郁症有关的其他相关因素。本研究调查了导致老年人抑郁症的医学疾病及其他因素。
这项基于台湾的纵向研究对1467名65岁以上的老年人进行了调查。符合该标准的受试者于2003年首次接受访谈,然后在四年后再次接受访谈。自变量包括基线人口统计学特征、慢性疾病以及受试者自我感知的健康状况变化、功能受限情况,包括日常生活活动能力(ADL)、工具性日常生活活动能力(IADL)和行动受限因素。因变量是在后期访谈中通过十项问卷确定的新发抑郁症症状。采用逻辑回归分析来检验一些与抑郁症相关的预测因素。
研究结果表明,心脏病(调整后的比值比[OR]=1.55,95%置信区间[CI]:1.12 - 2.15,p = 0.008)和关节疾病(调整后的OR = 1.51,95% CI:1.09 - 2.09,p = 0.013),以及功能受限,特别是IADL(调整后的OR = 1.81,95% CI:1.24 - 2.65,p = 0.002)和ADL(调整后的OR = 1.77,95% CI:1.27 - 2.47,p = 0.001)与老年人群抑郁症的发作独立相关。
这些发现表明,在对患有多种基础疾病的老年患者的抑郁症症状进行分类时,应密切关注疾病类型以及日常活动和自主能力方面的功能恶化情况。