Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Mich.
Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Mich.
J Allergy Clin Immunol Pract. 2017 Nov-Dec;5(6):1691-1697.e1. doi: 10.1016/j.jaip.2017.03.034. Epub 2017 Jun 19.
Older adults have high rates of asthma morbidity and mortality, as well as increased rates of depression. There are no nationally representative studies describing the association of depression on key asthma outcomes such as emergency department (ED) visits among older adults.
The objective of this study was to determine the association of depression with asthma outcomes in older adults (age ≥ 55) from the National Health and Nutrition Examination Survey (NHANES).
Data from the NHANES survey (2007-2012) were analyzed. Bivariate analyses and multivariate Poisson regression models were used to examine associations between depression and asthma outcomes among adults above the age of 55.
Approximately 7.01% (n = 509) of the sample reported a physician diagnosis of asthma. Older adults with asthma and depression (n = 196) had increased asthma episodes (prevalence ratio [PR], 1.53; 95% confidence interval [CI], 1.00-2.35), ED/urgent care visits for asthma (PR, 2.24; 95% CI, 1.15-4.34), sleep disturbances due to asthma (PR 2.75; 95% CI, 1.54-4.92), and activity limitation (PR, 1.77; 95% CI, 1.00-3.18; P = .05) compared with older asthmatics without depression. They also reported worse health-related quality of life measures across 4 domains including days of poor general health, physical health, mental health, and inactivity (P < .001 for all). No significant differences in spirometric values were observed.
Older adults with asthma and depression are nearly twice as likely to have poor asthma outcomes across several indicators, including asthma-related ED/urgent care visits compared with those without depression. Screening for depression and providing supportive resources may decrease the burden of asthma among older adults.
老年人哮喘发病率和死亡率较高，抑郁发病率也较高。目前尚无全国代表性研究描述老年人抑郁与关键哮喘结局之间的关系，如老年人急诊就诊率。
本研究旨在确定全国健康和营养调查（NHANES）中老年（年龄≥55 岁）抑郁与哮喘结局的关系。
分析 NHANES 调查数据（2007-2012 年）。采用双变量分析和多元 Poisson 回归模型，检测 55 岁以上成年人中抑郁与哮喘结局之间的关系。
约 7.01%（n=509）的样本报告了医生诊断的哮喘。患有哮喘和抑郁的老年患者（n=196）哮喘发作次数增加（患病率比 [PR]，1.53；95%置信区间 [CI]，1.00-2.35）、因哮喘就诊的急诊/紧急护理就诊次数增加（PR，2.24；95%CI，1.15-4.34）、哮喘导致的睡眠障碍增加（PR，2.75；95%CI，1.54-4.92）和活动受限增加（PR，1.77；95%CI，1.00-3.18；P=0.05），与无抑郁的老年哮喘患者相比。他们还报告了在 4 个领域的健康相关生活质量指标更差，包括健康状况不佳、身体健康、心理健康和活动受限天数（所有 P<0.001）。未观察到肺量计值有显著差异。
患有哮喘和抑郁的老年患者发生多项哮喘结局不良的风险几乎增加一倍，包括与抑郁无关的哮喘相关急诊/紧急护理就诊率。对抑郁进行筛查并提供支持性资源可能会降低老年人群哮喘的负担。
