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通过参加团体运动和定期散步减轻东日本大地震后老年幸存者的抑郁症状:一项前瞻性观察研究。

Reducing depressive symptoms after the Great East Japan Earthquake in older survivors through group exercise participation and regular walking: a prospective observational study.

作者信息

Tsuji Taishi, Sasaki Yuri, Matsuyama Yusuke, Sato Yukihiro, Aida Jun, Kondo Katsunori, Kawachi Ichiro

机构信息

Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.

Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan.

出版信息

BMJ Open. 2017 Mar 3;7(3):e013706. doi: 10.1136/bmjopen-2016-013706.

Abstract

OBJECTIVES

Survivors of the 2011 Great East Japan Earthquake have an increased risk of depressive symptoms. We sought to examine whether participation in group exercise and regular walking could mitigate the worsening of depressive symptoms among older survivors.

DESIGN

Prospective observational study.

SETTING

Our baseline survey was conducted in August 2010, ∼7 months prior to the Great East Japan Earthquake and tsunami, among people aged 65 or older residing in Iwanuma City, Japan, which suffered significant damage in the disaster. A 3-year follow-up survey was conducted in 2013.

PARTICIPANTS

3567 older survivors responded to the questionnaires predisaster and postdisaster.

PRIMARY OUTCOME MEASURES

Change in depressive symptoms was assessed using the 15-item Geriatric Depression Scale (GDS).

RESULTS

From predisaster to postdisaster, the mean change in GDS score increased by 0.1 point (95% CI -0.003 to 0.207). During the same interval, the frequency of group exercise participation and daily walking time also increased by 1.9 days/year and 1.3 min/day, respectively. After adjusting for all covariates, including personal experiences of disaster, we found that increases in the frequency of group exercise participation (=-0.139, =-0.049, p=0.003) and daily walking time (=-0.087, =-0.034, p=0.054) were associated with lower GDS scores. Interactions between housing damage and changes in group exercise participation (=0.103, =0.034, p=0.063) and changes in walking habit (=0.095, =0.033, p=0.070) were marginally significant, meaning that the protective effects tended to be attenuated among survivors reporting more extensive housing damage.

CONCLUSIONS

Participation in group exercises or regular walking may mitigate the worsening of depressive symptoms among older survivors who have experienced natural disaster.

摘要

目的

2011年东日本大地震的幸存者出现抑郁症状的风险增加。我们试图研究参加团体运动和定期散步是否可以减轻老年幸存者抑郁症状的恶化。

设计

前瞻性观察研究。

地点

我们的基线调查于2010年8月进行,即东日本大地震和海啸发生前约7个月,在日本磐城市居住的65岁及以上人群中进行,该市在灾难中遭受了重大破坏。2013年进行了为期3年的随访调查。

参与者

3567名老年幸存者在灾前和灾后对问卷进行了回复。

主要结局指标

使用15项老年抑郁量表(GDS)评估抑郁症状的变化。

结果

从灾前到灾后,GDS评分的平均变化增加了0.1分(95%CI -0.003至0.207)。在同一时期,团体运动参与频率和每日步行时间也分别增加了1.9天/年和1.3分钟/天。在对所有协变量进行调整后,包括个人灾难经历,我们发现团体运动参与频率的增加(=-0.139,=-0.049,p=0.003)和每日步行时间的增加(=-0.087,=-0.034,p=0.054)与较低的GDS评分相关。住房损坏与团体运动参与变化(=0.103,=0.034,p=0.063)和步行习惯变化(=0.095,=0.033,p=0.070)之间的相互作用具有边缘显著性,这意味着在报告住房损坏更严重的幸存者中,保护作用往往会减弱。

结论

参加团体运动或定期散步可能会减轻经历自然灾害的老年幸存者抑郁症状的恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/754f/5353320/83117102d9e4/bmjopen2016013706f01.jpg

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