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多种慢性疾病组合与社区居住老年人的抑郁

Multiple Chronic Condition Combinations and Depression in Community-Dwelling Older Adults.

机构信息

New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, New Jersey.

College of Public Health, Temple University, Philadelphia, Pennsylvania.

出版信息

J Gerontol A Biol Sci Med Sci. 2016 Jul;71(7):910-5. doi: 10.1093/gerona/glw025. Epub 2016 Mar 1.

Abstract

BACKGROUND

The U.S. Department of Health and Human Services recently called for a paradigm shift from the study of individual chronic conditions to multiple chronic conditions (MCCs). We identify the most common combinations of chronic diseases experienced by a sample of community-dwelling older people and assess whether depression is differentially associated with combinations of illnesses.

METHODS

Self-reports of diagnosed chronic conditions and depressive symptoms were provided by 5,688 people participating in the ORANJ BOWL(SM) research panel. Each respondent was categorized as belonging to one of 32 groups. ANOVA examined the association between depressive symptoms and combinations of illnesses.

RESULTS

People with more health conditions experienced higher levels of depression than people with fewer health conditions. People with some illness combinations had higher levels of depressive symptoms than people with other illness combinations.

CONCLUSIONS

Findings confirm extensive variability in the combinations of illnesses experienced by older adults and demonstrate the complex associations of specific illness combinations with depressive symptoms. Results highlight the need to expand our conceptualization of research and treatment around MCCs and call for a person-centered approach that addresses the unique needs of individuals with MCCs.

摘要

背景

美国卫生与公众服务部最近呼吁从研究单一的慢性疾病转变为研究多种慢性疾病(MCC)。我们确定了一组社区居住的老年人中常见的慢性疾病组合,并评估抑郁是否与疾病组合存在差异关联。

方法

5688 名参与 ORANJ BOWL(SM)研究小组的人报告了诊断出的慢性疾病和抑郁症状。每位受访者都被归类为 32 组之一。方差分析检验了抑郁症状与疾病组合之间的关联。

结果

患有更多健康问题的人比患有较少健康问题的人经历更高水平的抑郁。一些疾病组合的人比其他疾病组合的人有更高水平的抑郁症状。

结论

研究结果证实了老年人经历的疾病组合存在广泛的可变性,并证明了特定疾病组合与抑郁症状之间存在复杂的关联。结果强调需要扩大我们对 MCC 研究和治疗的概念化,并呼吁采取以个人为中心的方法,满足患有 MCC 的个体的独特需求。

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