身体机能差预示老年人未来患抑郁症：威尼托老年人纵向研究项目
Poor Physical Performance Predicts Future Onset of Depression in Elderly People: Progetto Veneto Anziani Longitudinal Study.
作者信息
Veronese Nicola, Stubbs Brendon, Trevisan Caterina, Bolzetta Francesco, De Rui Marina, Solmi Marco, Sartori Leonardo, Musacchio Estella, Zambon Sabina, Perissinotto Egle, Baggio Giovannella, Crepaldi Gaetano, Manzato Enzo, Maggi Stefania, Sergi Guiseppe
机构信息
Geriatrics Division, Department of Medicine, University of Padova, Via Giustiniani, 2-35128 Padova, Italy.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; and Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
出版信息
Phys Ther. 2017 Jun 1;97(6):659-668. doi: 10.1093/ptj/pzx017.
BACKGROUND
Reduced physical performance is predictive of deleterious outcomes in older adults. Data considering objective physical performance and incident depression are sparse.
OBJECTIVE
The objective of this study was to investigate during a 4-year study whether objective physical performance can predict incident depression among older adults who do not have depression at the baseline.
DESIGN
This was a longitudinal study.
METHODS
From 3,099 older people initially enrolled in the Progetto Veneto Anziani study, 970 participants without depression at the baseline were included (mean age = 72.5 years; 54.6% women). Physical performance measures included the Short Physical Performance Battery, 4-m gait speed, Five-Times Sit-to-Stand test, leg extension and flexion, handgrip strength, and 6-minute walk test, categorized in sex-specific tertiles. Depression was classified on the basis of the Geriatric Depression Scale and a diagnosis from a geriatric psychiatrist. Area under the curve and logistic regression analyses were conducted.
RESULTS
At the baseline, participants developing depression during the follow-up (n = 207) scored significantly worse across all physical performance measures than those who did not develop depression. The area under the curve and predictive power were similar for all of the physical performance tests assessed. In the logistic regression analysis, after adjustment for 14 potential confounders, worse physical performance across all tests increased the risk of depression. Participants in the lowest tertile of the Short Physical Performance Battery were at notable odds of developing depression (odds ratio = 1.79; 95% CI = 1.18-2.71). The association between poor physical performance and depression was typically stronger in women than in men, except for 4-m gait speed.
LIMITATIONS
No gold standard was used for a depression diagnosis; oxidative stress and inflammatory markers were not included; and there was a high rate of missing data at the follow-up.
CONCLUSIONS
Low physical performance appeared to be an independent predictor of depression over a 4-year follow-up in a sample of elderly people.
背景
身体机能下降可预测老年人的不良结局。关于客观身体机能与新发抑郁症的数据较为匮乏。
目的
本研究的目的是在一项为期4年的研究中，调查客观身体机能是否能够预测基线时无抑郁症的老年人发生抑郁症的情况。
设计
这是一项纵向研究。
方法
从最初纳入威尼托老年项目研究的3099名老年人中，选取了970名基线时无抑郁症的参与者（平均年龄 = 72.5岁；54.6%为女性）。身体机能测量指标包括简短身体机能量表、4米步速、五次坐立试验、腿部屈伸、握力以及6分钟步行试验，并按性别分为三分位数。根据老年抑郁量表和老年精神科医生的诊断对抑郁症进行分类。进行曲线下面积分析和逻辑回归分析。
结果
在基线时，随访期间发生抑郁症的参与者（n = 207）在所有身体机能测量指标上的得分均显著低于未发生抑郁症的参与者。所有评估的身体机能测试的曲线下面积和预测能力相似。在逻辑回归分析中，在对14个潜在混杂因素进行调整后，所有测试中较差的身体机能会增加患抑郁症的风险。简短身体机能量表得分处于最低三分位数的参与者患抑郁症的几率显著增加（优势比 = 1.79；95%置信区间 = 1.18 - 2.71）。除4米步速外，身体机能较差与抑郁症之间的关联在女性中通常比在男性中更强。
局限性
抑郁症诊断未采用金标准；未纳入氧化应激和炎症标志物；随访时缺失数据的比例较高。
结论
在一组老年人样本中，身体机能低下似乎是4年随访期间抑郁症的独立预测因素。
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