Sivertsen Heidi, Bjørkløf Guro Hanevold, Engedal Knut, Selbæk Geir, Helvik Anne-Sofie
Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Dement Geriatr Cogn Disord. 2015;40(5-6):311-39. doi: 10.1159/000437299. Epub 2015 Sep 12.
Depression is a prevalent and disabling condition in older persons (≥ 60 years) that increases the risk of mortality and negatively influences quality of life (QOL). The relationship between depression, or depressive symptoms, and QOL has been increasingly addressed by research in recent years, but a review that can contribute to a better understanding of this relationship in older persons is lacking. Against this background, we undertook a literature review to assess the relationship between depression and QOL in older persons.
Extensive electronic database searches revealed 953 studies. Of these, 74 studies fulfilled our criteria for inclusion, of which 52 were cross-sectional studies and 22 were longitudinal studies. Thirty-five studies were conducted in a clinical setting, while 39 were community-based epidemiological studies. A clear definition of the QOL concept was described in 25 studies, and 24 different assessment instruments were employed to assess QOL. Depressed older persons had poorer global and generic health-related QOL than nondepressed individuals. An increase in depression severity was associated with a poorer global and generic health-related QOL. The associations appeared to be stable over time and independent of how QOL was assessed.
This review found a significant association between severity of depression and poorer QOL in older persons, and the association was found to be stable over time, regardless which assessment instruments for QOL were applied. The lack of a definition of the multidimensional and multilevel concept QOL was common, and the large variety of QOL instruments in various studies make a direct comparison between the studies difficult.
抑郁症在老年人(≥60岁)中是一种普遍且致残的疾病,会增加死亡风险并对生活质量(QOL)产生负面影响。近年来,抑郁症或抑郁症状与生活质量之间的关系越来越受到研究关注,但目前缺乏有助于更好理解老年人中这种关系的综述。在此背景下,我们进行了一项文献综述,以评估老年人抑郁症与生活质量之间的关系。
广泛的电子数据库检索共发现953项研究。其中,74项研究符合我们的纳入标准,其中52项为横断面研究,22项为纵向研究。35项研究在临床环境中进行,39项为基于社区的流行病学研究。25项研究中描述了生活质量概念的明确定义,共使用了24种不同的评估工具来评估生活质量。抑郁的老年人在总体和一般健康相关生活质量方面比非抑郁个体更差。抑郁严重程度的增加与总体和一般健康相关生活质量较差有关。这些关联似乎随时间稳定,且与生活质量的评估方式无关。
本综述发现老年人抑郁症严重程度与较差的生活质量之间存在显著关联,且该关联随时间稳定,无论应用哪种生活质量评估工具。生活质量这一多维度、多层次概念缺乏定义的情况很常见,且各研究中生活质量评估工具种类繁多,使得各研究之间难以直接比较。