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孤独与心血管疾病及晚年抑郁症的作用。

Loneliness and cardiovascular disease and the role of late-life depression.

机构信息

Department of Psychiatry, St. Antonius Ziekenhuis, Utrecht, The Netherlands.

Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Int J Geriatr Psychiatry. 2018 Jan;33(1):e65-e72. doi: 10.1002/gps.4716. Epub 2017 Apr 18.

Abstract

OBJECTIVE

Loneliness and depression have a strong reciprocal influence, and both predict adverse health outcomes at old age. Therefore, this study examines whether loneliness is associated with the presence of cardiovascular diseases taking into account the role of late-life depression.

METHODS

Cross-sectional data of 477 older adults in the Netherlands Study of Depressed Older Persons were used. Logistic regression analysis was performed to examine the relation between loneliness and cardiovascular disease. Depression was added to the regression model to examine whether depression is an explanatory factor in the association between loneliness and cardiovascular disease. Interaction terms between loneliness and depression and between loneliness and sex were introduced in the regression model to investigate whether depressed and non-depressed participants, and men and women differed in their association between loneliness and cardiovascular disease.

RESULTS

Of the overall group, 61% were lonely, 28% had a history of cardiovascular disease and 74% were depressed. Loneliness and cardiovascular disease were not associated in the overall group after adjustment for confounders (continuous: odds ratio [OR] = 1.04, 95% confidence interval [CI] = 0.98-1.10), p = 0.25; dichotomous: OR = 1.27, 95% CI = 0.80-2.03, p = 0.32). For women, there was an association between loneliness and cardiovascular diseases (continuous: OR = 1.13, 95% CI = 1.06-1.21, p < 0.001; dichotomous: OR = 2.64, 95% CI = 1.50-4.65, p = 0.001), but this association was not present in men (OR = 0.96, 95% CI = 0.88-1.05, p = 0.38). This association remained significant after adjustment for confounders, but it lost significance after adding depression to the model.

CONCLUSION

For women only, there was an association between loneliness and cardiovascular disease. However, this association was explained by depression, indicating that loneliness in its own right seems not related with cardiovascular disease. Copyright © 2017 John Wiley & Sons, Ltd.

摘要

目的

孤独和抑郁之间存在强烈的相互影响,两者都预示着老年时的健康状况不佳。因此,本研究考察了孤独感是否与心血管疾病的发生有关,同时考虑了晚年抑郁的作用。

方法

使用荷兰老年抑郁患者研究的 477 名老年人的横断面数据。采用逻辑回归分析考察孤独感与心血管疾病之间的关系。将抑郁纳入回归模型,以检验抑郁是否是孤独感与心血管疾病之间关联的解释因素。在回归模型中引入孤独感与抑郁之间以及孤独感与性别之间的交互项,以研究抑郁和非抑郁参与者以及男性和女性在孤独感与心血管疾病之间的关联是否存在差异。

结果

在整个研究人群中,61%的人感到孤独,28%的人有心血管疾病史,74%的人患有抑郁。在调整了混杂因素后,孤独感与心血管疾病在整个研究人群中没有关联(连续变量:比值比[OR] = 1.04,95%置信区间[CI] = 0.98-1.10),p = 0.25;二分变量:OR = 1.27,95%CI = 0.80-2.03,p = 0.28)。对于女性,孤独感与心血管疾病之间存在关联(连续变量:OR = 1.13,95%CI = 1.06-1.21,p < 0.001;二分变量:OR = 2.64,95%CI = 1.50-4.65,p = 0.001),但这种关联在男性中并不存在(OR = 0.96,95%CI = 0.88-1.05,p = 0.38)。在调整了混杂因素后,这种关联仍然显著,但在将抑郁纳入模型后,这种关联失去了显著性。

结论

仅对于女性,孤独感与心血管疾病之间存在关联。然而,这种关联是由抑郁引起的,表明孤独感本身与心血管疾病无关。

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