Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Germany.
Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Germany.
J Gerontol B Psychol Sci Soc Sci. 2020 Mar 9;75(4):811-820. doi: 10.1093/geronb/gby083.
This study examines the relationship between late-life depressive symptoms, cognitive and functional impairment in a cohort of very old community-based participants.
A sample of 1,226 primary care patients was assessed at baseline (Mage = 80.6 years). Statistical analyses were conducted using baseline and 12-month follow-up data.
At baseline, depressed participants showed minor cognitive deficits compared with nondepressed participants, whereas functional deficits were pronounced. Depressive symptoms and global cognition were not associated longitudinally. In contrast, follow-up functional impairment was predicted by baseline level and increase of depressive symptoms between baseline and follow-up. Reversely, follow-up depressive symptoms were predicted by functional decline between baseline and follow-up, whereas baseline functional status was not predictive.
Depressive symptoms and global cognitive function were not associated longitudinally, but level and increase of depressive symptoms over time predicted functional impairment after 1 year. Interventions to reduce depressive symptoms, or to encourage coping strategies might be promising to reduce functional impairment. Elevated follow-up depressive symptoms were only predicted by functional decline, supposedly emphasizing that incident functional impairment might be associated with an acute increase of depressive symptoms. Psychological adjustment processes were not examined, but might be targeted in future.
本研究调查了在一个基于社区的高龄队列中，晚年抑郁症状与认知和功能障碍之间的关系。
在基线评估时，对 1226 名初级保健患者进行了样本评估（平均年龄为 80.6 岁）。使用基线和 12 个月随访数据进行了统计分析。
在基线时，与非抑郁组相比，抑郁组参与者表现出轻微的认知缺陷，而功能缺陷则较为明显。抑郁症状与整体认知能力无纵向相关性。相反，基线和随访之间抑郁症状的增加预测了随访时的功能障碍。相反，随访时的抑郁症状可由基线和随访之间的功能下降来预测，而基线的功能状态则无预测性。
抑郁症状和整体认知功能没有纵向相关性，但随着时间的推移，抑郁症状的水平和增加预测了 1 年后的功能障碍。减少抑郁症状或鼓励应对策略的干预措施可能对减少功能障碍有帮助。随访时的抑郁症状仅由功能下降预测，这可能强调了新发的功能障碍可能与抑郁症状的急性增加有关。未对心理调整过程进行检查，但可能是未来的目标。
