Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan.
Environmental Epidemiology Section, Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan.
J Am Geriatr Soc. 2017 Dec;65(12):2639-2645. doi: 10.1111/jgs.15107. Epub 2017 Sep 27.
BACKGROUND/OBJECTIVES: Few published studies have investigated the possibility of an association between depressive symptoms and dependence in activities of daily living (ADLs) in elderly adults. The objective of the study was to examine the association between depressive symptoms and future ADL dependence and to investigate how this association varies according to living circumstances and marital status.
Community-based prospective observational study.
Kurabuchi Town, Gunma Prefecture, Japan.
A total of 769 residents aged 65 and older were surveyed at baseline in 2005/06; they were followed up annually during the 7.5-year study period (follow-up rate, 99% (n = 763).
Presence of depressive symptoms was defined as a score of 2 or greater on the five-item Geriatric Depression Scale, and dependence in ADLs was defined as admission to a nursing home (institutionalization), eligibility for long-term care (LTC), or need for help in any of the six basic ADL items in the Katz Index of Independence in ADLs.
Depressive symptoms were observed in 232 of the 763 participants (30.4%). Those with depressive symptoms were more prone to future ADL dependence than those without (adjusted risk ratio = 1.29, 95% confidence interval = 1.04-1.61). There was no clear evidence of any effect modification according to living circumstances or marital status on this association, although living with other people or marriage was found to be associated with greater risk of institutionalization.
Our findings suggest that depressive symptoms are associated with future ADL dependence and that living circumstances (except for institutionalization) and marital status do not affect the association.
背景/目的：少数已发表的研究探讨了老年人抑郁症状与日常生活活动（ADL）依赖之间的可能关联。本研究旨在检验抑郁症状与未来 ADL 依赖之间的关联，并探讨这种关联如何因生活环境和婚姻状况而异。
基于社区的前瞻性观察研究。
日本群马县古贺町。
共有 769 名年龄在 65 岁及以上的居民在 2005/06 年基线时接受了调查；在 7.5 年的研究期间，他们每年接受一次随访（随访率为 99%（n=763））。
存在抑郁症状定义为老年人抑郁量表的五个项目中得分达到或超过 2 分，ADL 依赖定义为入住养老院（机构化）、有资格获得长期护理（LTC）或在 Katz 日常生活活动独立性指数的六项基本 ADL 项目中需要帮助的任何一项。
在 763 名参与者中，有 232 名（30.4%）出现抑郁症状。与无抑郁症状者相比，有抑郁症状者更有可能出现未来 ADL 依赖（调整风险比=1.29，95%置信区间=1.04-1.61）。虽然与他人同住或已婚与机构化的风险增加有关，但没有明确证据表明生活环境或婚姻状况对这种关联有明显的影响修饰作用。
我们的研究结果表明，抑郁症状与未来的 ADL 依赖有关，生活环境（除机构化外）和婚姻状况并不影响这种关联。
