Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
J Am Med Dir Assoc. 2016 Feb;17(2):123-7. doi: 10.1016/j.jamda.2015.08.012. Epub 2015 Sep 26.
To elucidate whether a combination of slow gait speed and depressive symptoms result in higher risk of incident disability in older adults than either symptom individually.
Prospective cohort study.
Obu City, Aichi Prefecture, Japan.
Participants were 4038 older adults (48.7% male, mean age = 71 years) who met the study inclusion criteria.
Longitudinal data on incident disability were collected up to 33 months [median 31 months (interquartile range 29-32 months)] after baseline. We monitored monthly incident disability, defined as Japanese long-term care insurance certification for personal support or care. Baseline measurements included covariates for incident disability, gait speed, and the Geriatric Depression Scale for assessing depressive symptoms. The associations between slow gait, depressive symptoms, or their co-occurrence, and incident disability were examined.
Control participants were the reference in an adjusted Cox proportional hazard regression model. Participants with co-occurring slow gait and depressive symptoms showed a greater risk of incident disability [hazard ratio (HR) 3.08, confidence interval (CI) 95% 2.00-4.75]. Greater risk was also found for participants with slow gait speed alone (HR 2.44, CI 95% 1.71-3.47) and depressive symptoms alone (HR 1.60, CI 95% 1.01-2.53).
Older adults with both risk factors may require early detection and physical and psychological intervention.
阐明与单独存在某种症状相比，步速缓慢和抑郁症状同时存在是否会导致老年人发生失能的风险更高。
前瞻性队列研究。
日本爱知县尾张市。
符合研究纳入标准的 4038 名老年人（48.7%为男性，平均年龄 71 岁）。
在基线后最长 33 个月（中位数 31 个月[四分位距 29-32 个月]）收集失能的纵向数据。我们监测每月发生的失能情况，将其定义为日本长期护理保险对个人支持或护理的认证。基线测量包括失能、步速和老年抑郁量表（评估抑郁症状）的协变量。研究检查了步速缓慢、抑郁症状或两者同时存在与失能事件的相关性。
在调整后的 Cox 比例风险回归模型中，对照组为参考组。同时存在步速缓慢和抑郁症状的参与者发生失能事件的风险更高[风险比（HR）3.08，95%置信区间（CI）为 2.00-4.75]。仅存在步速缓慢（HR 2.44，95%CI 1.71-3.47）或抑郁症状（HR 1.60，95%CI 1.01-2.53）的参与者发生失能事件的风险也更高。
有这两种风险因素的老年人可能需要早期发现，并采取身体和心理干预措施。
