Xiang Xiaoling, Brooks Jessica
a School of Social Work , University of Michigan , Ann Arbor , Michigan , USA.
b Department of Disability and Addiction Rehabilitation , University of North Texas , Denton , Texas , USA.
J Gerontol Soc Work. 2017 Apr;60(3):201-214. doi: 10.1080/01634372.2017.1286625. Epub 2017 Jan 27.
This study aimed to provide a national profile of homebound and semi-homebound older adults with depressive symptoms and to compare risk factors of depressive symptoms by homebound status. A sample of 1,885 homebound and semi-homebound older adults was selected from Round 1 of the National Health and Aging Trends Study (NHATS). The prevalence of depressive symptoms was 43.9% in homebound older adults and 28.1% in semi-homebound older adults, representing over 830,000 and 1.4 million individuals in the population, respectively. Nearly two-thirds of homebound and over half of semi-homebound older adults with clinically significant depressive symptoms also had significant anxiety symptoms. Results from logistic regression showed that younger age, certain medical morbidities, severity of functional limitations, and pain were common risk factors for depressive symptoms among homebound and semi-homebound older adults. Some differences in the risk factor profile emerged between the homebound and the semi-homebound populations. Alleviating the burden of depression in the semi-homebound population may focus on early prevention that considers the diversity of this population. Home-based, integrated programs of health and mental health services that simultaneously address the medical, psychiatric, and neurologic comorbidities and disabilities of homebound older adults are needed to meet the complex needs of this population.
本研究旨在呈现居家及半居家且有抑郁症状的老年人的全国概况，并按居家状态比较抑郁症状的风险因素。从国家健康与老龄化趋势研究（NHATS）第一轮中选取了1885名居家及半居家老年人作为样本。居家老年人中抑郁症状的患病率为43.9%，半居家老年人中为28.1%，分别代表了超过83万和140万人口中的个体。近三分之二有临床显著抑郁症状的居家老年人以及超过一半有此类症状的半居家老年人也有显著的焦虑症状。逻辑回归结果显示，年龄较小、某些疾病、功能受限的严重程度以及疼痛是居家及半居家老年人抑郁症状的常见风险因素。居家和半居家人群在风险因素方面存在一些差异。减轻半居家人群的抑郁负担可能需要侧重于考虑该人群多样性的早期预防。需要有基于家庭的健康和心理健康服务综合项目，同时解决居家老年人的医疗、精神和神经共病及残疾问题，以满足该人群的复杂需求。
