与社会密切接触者存在与否分层的抑郁症症状与心脏病发作或中风的关联：来自国家健康与老龄化趋势研究队列的研究结果。
The association of a heart attack or stroke with depressive symptoms stratified by the presence of a close social contact: findings from the National Health and Aging Trends Study Cohort.
机构信息
Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
出版信息
Int J Geriatr Psychiatry. 2018 Jan;33(1):96-103. doi: 10.1002/gps.4684. Epub 2017 Feb 21.
OBJECTIVE
The objective of the study is to examine whether the risk of having clinically significant depressive symptoms following a heart attack or stroke varies by the presence of a close social contact.
METHODS
The National Health and Aging Trends Study is a nationally representative longitudinal survey of US Medicare beneficiaries aged 65 and older initiated in 2011. A total of 5643 older adults had information on social contacts at baseline and depressive symptoms at the 1-year follow-up interview. The two-item Patient Health Questionnaire identified clinically significant depressive symptoms. Interview questions examined social contacts and the presence of self-reported heart attack or stroke during the year of follow-up.
RESULTS
A total of 297 older adults reported experiencing a heart attack and/or stroke between their baseline and follow-up interviews. In regression analyses accounting for sociodemographics, baseline depressive symptoms, medical comorbidity, and activities of daily living impairment, older adults with no close social contacts had increased odds of depressive symptoms at follow-up after experiencing a heart attack or stroke, while those with close social contacts had increased odds of depressive symptoms at follow-up after experiencing a stroke, but not a heart attack.
CONCLUSIONS
Older adults have increased odds of having depressive symptoms following a self-reported stroke, but only those with no close social contacts had increased odds of depressive symptoms following a heart attack. Social networks may play a role in the mechanisms underlying depression among older adults experiencing certain acute health events. Future work exploring the potential causal relationships suggested here, if confirmed, could inform interventions to alleviate or prevent depression among at risk older adults. Copyright © 2017 John Wiley & Sons, Ltd.
目的
本研究旨在探讨在心脏病发作或中风后，是否存在密切的社会联系会影响出现临床显著抑郁症状的风险。
方法
国家健康老龄化趋势研究是一项对美国年满 65 岁及以上的医疗保险受益人进行的全国代表性纵向调查，于 2011 年启动。共有 5643 名老年人在基线时有关于社会联系的信息，并在随访 1 年的访谈中有抑郁症状的信息。采用两项目病人健康问卷来确定临床显著抑郁症状。访谈问题调查了社会联系以及在随访年内自我报告的心脏病发作或中风的情况。
结果
共有 297 名老年人报告在基线和随访访谈之间经历了心脏病发作和/或中风。在考虑了社会人口统计学因素、基线抑郁症状、合并症和日常生活活动障碍的回归分析中，与没有密切社会联系的老年人相比，经历心脏病发作或中风后，有密切社会联系的老年人在随访时出现抑郁症状的几率更高，而经历中风而不是心脏病发作的老年人则出现抑郁症状的几率更高。
结论
老年人在自我报告发生中风后出现抑郁症状的几率增加，但只有那些没有密切社会联系的老年人在发生心脏病发作后出现抑郁症状的几率增加。社交网络可能在老年人经历某些急性健康事件时的抑郁机制中发挥作用。如果这里提出的潜在因果关系得到证实，未来探索这些关系的工作可以为有风险的老年人群提供缓解或预防抑郁的干预措施。
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