Atlas Astrid, Kerse Ngaire, Rolleston Anna, Teh Ruth, Bacon Catherine
University of Auckland, School of Population Health, General Practice and Primary Health Care, Auckland, New Zealand.
Auckland University of Technology, School of Population Health, Auckland, New Zealand.
J Prim Health Care. 2017 Dec;9(4):311-315. doi: 10.1071/HC17012.
INTRODUCTION Falls and injury have the most devastating consequences for very old people. Depression may be a significant cause and consequence of falls. AIM To examine the association between falls and depression in octogenarians. METHODS LiLACS NZ (Life and Living in Advanced Age: A Cohort Study in New Zealand), cohort study data of Māori (aged 80-90 years, 11-year age band) and non-Māori (aged 85 years, 1-year age band) followed for 3 years was used to describe the incidence and prevalence of falls and depression. Falls by self-report were accumulated over 3 years. Geriatric depression score (GDS) was ascertained at baseline. RESULTS Over 3 years, fewer Māori (47%) than non-Māori (57%) fell; 19% of non-Māori and 20% of Māori scored 5+ (depressed) on the GDS. For non-Māori and Māori, people with depression were more likely to fall than Māori not diagnosed with depression (OR 2.72, CI 1.65-4.48 for non-Māori and OR 2.01, CI 1.25-3.25 for Māori). This remained significant, adjusted for age and sex. Depression was a significant predictor of hospitalisations from falls for Māori (OR 5.59, CI 2.4-12.72, adjusted for age and sex) and non-Māori (OR 4.21, 2.3-7.44, adjusted for sex). CONCLUSION Depression and falls are common and co-exist in octogenarians. GPs thinking about falls should also think about depression and vice versa.
引言 跌倒和受伤对高龄老人有着最具毁灭性的后果。抑郁症可能是跌倒的一个重要原因和后果。目的 研究八旬老人跌倒与抑郁症之间的关联。方法 使用新西兰高龄生活队列研究(LiLACS NZ)中毛利人(年龄80 - 90岁,11岁年龄组)和非毛利人(年龄85岁,1岁年龄组)为期3年的队列研究数据,描述跌倒和抑郁症的发病率及患病率。通过自我报告累积3年的跌倒情况。在基线时确定老年抑郁量表(GDS)得分。结果 在3年期间,跌倒的毛利人(47%)少于非毛利人(57%);19%的非毛利人和20%的毛利人GDS得分≥5分(抑郁)。对于非毛利人和毛利人,患有抑郁症的人比未被诊断患有抑郁症的毛利人更易跌倒(非毛利人的比值比为2.72,95%置信区间为1.65 - 4.48;毛利人的比值比为2.01,95%置信区间为1.25 - 3.25)。在对年龄和性别进行调整后,这一关联仍然显著。抑郁症是毛利人(比值比为5.59,95%置信区间为2.4 - 12.72,经年龄和性别调整)和非毛利人(比值比为4.21,95%置信区间为2.3 - 7.44,经性别调整)因跌倒住院的一个重要预测因素。结论 抑郁症和跌倒在八旬老人中很常见且并存。考虑跌倒问题的全科医生也应考虑抑郁症,反之亦然。