Center for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Am Geriatr Soc. 2018 Jul;66(7):1290-1295. doi: 10.1111/jgs.15394. Epub 2018 Apr 20.
To assess the causal directions of interaction between depression and decline in will to live (WTL) over 2 years in community-dwelling older adults.
Community-based longitudinal study.
Three large cities in Israel.
Individuals aged 75 and older (N=870).
We tested a cross-lagged structural equation model in which WTL and depressive symptoms (DS) were tested as latent variables at each of three annual points of measurement.
Of the health and sociodemographic covariates examined, only self-rated health predicted WTL and DS, and age predicted WTL. WTL predicted DS at each point of measurement. In addition to these cross-sectional effects, WTL also predicted DS 12 months later at the second and third year. In other words, the direction of prediction was exclusively from WTL to DS, concomitantly and over time.
Our results indicate that WTL predicts DS rather than vice versa, suggesting that decline in WTL contributes and leads to depression at present and in future. Health strategies designed to promote WTL in older adults may help forestall depression. Moreover, psychotherapeutic interventions targeting WTL might be effective in the treatment of depression.
在社区居住的老年人中，评估抑郁与生存意愿（WTL）下降之间相互作用的因果关系，为期 2 年。
基于社区的纵向研究。
以色列的三个大城市。
年龄在 75 岁及以上的个体（N=870）。
我们测试了一个交叉滞后结构方程模型，其中 WTL 和抑郁症状（DS）在三个年度测量点作为潜在变量进行测试。
在所检查的健康和社会人口学协变量中，只有自我评估的健康状况预测了 WTL 和 DS，年龄预测了 WTL。WTL 在每个测量点都预测了 DS。除了这些横断面影响外，WTL 还预测了第二年和第三年的 12 个月后的 DS。换句话说，预测的方向完全是从 WTL 到 DS，同时且随着时间的推移。
我们的结果表明，WTL 预测 DS，而不是相反，这表明 WTL 的下降导致并导致目前和未来的抑郁。旨在促进老年人 WTL 的健康策略可能有助于预防抑郁。此外，针对 WTL 的心理治疗干预可能对治疗抑郁有效。
