Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Morioka-cho, Obu City, Aichi Prefecture, Japan; Japan Society for the Promotion of Science, Kouji-machi, Chiyoda-ku, Tokyo, Japan.
Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Morioka-cho, Obu City, Aichi Prefecture, Japan.
J Am Med Dir Assoc. 2018 Jun;19(6):504-510. doi: 10.1016/j.jamda.2018.02.008. Epub 2018 Apr 24.
To examine the association between each type of frailty status and the incidence rate of depressive symptoms among community-dwelling older adults.
Prospective cohort study.
General communities in Japan.
Participants comprised 3538 older Japanese adults.
We assessed our participants in terms of frailty status (physical frailty, cognitive impairment, and social frailty), depressive symptoms (geriatric depression scale ≥6), and other covariates, and excluded those who showed evidence of depression. Then, after a 4-year interval, we again assessed the participants for depressive symptoms. Physical frailty was defined by the Fried criteria, showing 1 or more of these were physical frailty. To screen for cognitive impairment, receiving a score below an age-education adjusted reference threshold in 1 or more tests was cognitive impairment. Finally, social frailty was defined using 5 questions, and those who answered positively to 1 or more of these were considered to have social frailty.
After multiple imputations, the incidence rate of depressive symptoms after 4 years of follow-up was 7.2%. The incidence rates of depressive symptoms for each frailty status were as follows: 9.6% for physical frailty vs 4.6% without, 9.3% for cognitive impairment vs 6.5% without, and 12.0% for social frailty vs 5.1% without. Finally, through the application of multivariable logistic regression analysis, the incidence of depressive symptoms was found to have a significant association with social frailty (odds ratio 1.55; 95% confidence interval 1.10-2.20) but not with physical frailty or cognitive impairment.
This study revealed that social frailty, in comparison with physical frailty and cognitive impairment, is more strongly associated with incidences of depressive symptoms among elderly.
探讨社区老年人不同衰弱类型与抑郁症状发生率的关系。
前瞻性队列研究。
日本普通社区。
纳入 3538 名日本老年人。
评估参与者的衰弱状态（身体衰弱、认知障碍和社会衰弱）、抑郁症状（老年抑郁量表≥6）和其他协变量，并排除有抑郁证据的参与者。4 年后，再次评估参与者的抑郁症状。身体衰弱根据 Fried 标准定义，出现 1 项或多项身体衰弱表现即为身体衰弱。认知障碍通过 1 项或多项测试的年龄教育调整参考阈值以下的分数来筛查。最后，使用 5 个问题来定义社会衰弱，回答 1 个或多个问题为阳性的人被认为患有社会衰弱。
经过多次插补后，4 年后随访的抑郁症状发生率为 7.2%。各衰弱状态的抑郁症状发生率如下：身体衰弱为 9.6%，无身体衰弱为 4.6%；认知障碍为 9.3%，无认知障碍为 6.5%；社会衰弱为 12.0%，无社会衰弱为 5.1%。最后，通过多变量逻辑回归分析，发现抑郁症状的发生与社会衰弱显著相关（比值比 1.55；95%置信区间 1.10-2.20），而与身体衰弱或认知障碍无关。
本研究表明，与身体衰弱和认知障碍相比，社会衰弱与老年人抑郁症状的发生更为密切相关。
