Northwestern University Feinberg School of Medicine, University of Illinois at Urbana-Champaign.
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign.
Gerontologist. 2018 May 8;58(3):428-437. doi: 10.1093/geront/gnw262.
This study aims to investigate the impact of depressive symptoms on adverse consequences of unmet needs for assistance with daily activities among community-dwelling older adults.
Data came from round 1 to 5 of the National Health and Aging Trends Study. Study sample consisted of 3,400 Medicare beneficiaries needing assistance with activities of daily living (ADL), instrumental activities of daily living (IADL), or mobility for any two consecutive years between 2011 and 2015. Study outcome was the number of self-reported adverse consequences of unmet needs for assistance with daily activities (e.g., went without eating, wet or soiled clothes). Mixed-effects negative binomial regression was used to estimate the association of lagged depressive symptoms and covariates in period t-1 and the number of adverse consequences of unmet needs in period t.
The prevalence rates of adverse consequences of unmet needs were twice as high among older adults with elevated depressive symptoms as those without depression. After adjusting for covariates, prior wave depressive symptoms were associated with 1.24 times the rate of adverse consequences of unmet needs for assistance with ADL (Incidence Rate Ratio [IRR] = 1.24, 95% confidence interval [CI] = 1.09-1.41, p < .01) and IADL (IRR = 1.24, 95% CI = 1.06-1.44, p < .01), and 1.14 times the rate of adverse consequences of unmet needs for assistance with mobility (IRR = 1.14, 95% CI = 1.03-1.27, p < .05).
Caring for older adults with mental health and long-term care needs calls for an integrated social and health services system.
本研究旨在探讨抑郁症状对社区居住的老年人日常活动未满足需求的不良后果的影响。
数据来自国家健康与老龄化趋势研究的第 1 至 5 轮。研究样本包括 2011 年至 2015 年间连续两年需要日常活动（ADL）、工具性日常活动（IADL）或活动能力协助的 3400 名医疗保险受益人。研究结果是自我报告的日常活动未满足需求的不良后果数量（例如，不吃东西、衣服湿或脏）。使用混合效应负二项回归来估计滞后抑郁症状和前一时间 t-1 期协变量与 t 期未满足需求的不良后果数量之间的关联。
与无抑郁的老年人相比，抑郁症状升高的老年人未满足需求的不良后果发生率高出一倍。在调整了协变量后，前一波抑郁症状与 ADL（发病率比 [IRR] = 1.24，95%置信区间 [CI] = 1.09-1.41，p <.01）和 IADL（IRR = 1.24，95% CI = 1.06-1.44，p <.01）的未满足需求的不良后果发生率增加了 1.24 倍，与活动能力未满足需求的不良后果发生率增加了 1.14 倍（IRR = 1.14，95% CI = 1.03-1.27，p <.05）。
照顾有心理健康和长期护理需求的老年人需要一个综合的社会和卫生服务系统。
