Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain.
Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain.
J Affect Disord. 2019 Mar 1;246:329-337. doi: 10.1016/j.jad.2018.12.122. Epub 2018 Dec 25.
This study aimed at depicting the course of depression symptoms over the old age, with a special interest in a) uncovering its relationships with sociodemographic and health-related factors; b) analysing its predictive role on healthy-ageing outcomes later in life.
The sample comprised 8317 older adults (46.02% men) from the English Longitudinal Study of Ageing. Robust structural equation modelling was used to identify symptom trajectories and their relationships with time-varying factors. Trajectory class and covariates were used to predict outcomes (quality of life, satisfaction with life, and daily living functioning) in a 2-year follow-up.
Three trajectory classes (so-called, normative, subclinical, chronic symptom trajectories) were identified for both sexes. Rising hearing difficulties and history of psychiatric problems were consistently associated with the chronic symptom trajectory. Lower education level, history of psychiatric problems, and increasing visual difficulties were connected with the subclinical trajectories. Finally, participants with either a subclinical or a chronic symptom trajectory showed worse outcomes than the remaining participants in the follow-up.
This study highlighted the presence of varying courses of depression symptoms (each showing some distinctive features from other another) over the old age, pointing to some relevant implications for clinical assessment and treatment prescription.
本研究旨在描述老年人抑郁症状的发展过程，特别关注：a）揭示其与社会人口学和健康相关因素的关系；b）分析其对晚年健康老龄化结果的预测作用。
该样本包括来自英国老龄化纵向研究的 8317 名老年人（46.02%为男性）。采用稳健结构方程模型来识别症状轨迹及其与随时间变化的因素之间的关系。轨迹类别和协变量用于预测 2 年后的结果（生活质量、生活满意度和日常生活功能）。
为男性和女性确定了三种轨迹类别（所谓的正常、亚临床、慢性症状轨迹）。听力困难加重和精神病史与慢性症状轨迹始终相关。教育水平较低、精神病史和视觉困难增加与亚临床轨迹有关。最后，在随访中，具有亚临床或慢性症状轨迹的参与者的结果比其余参与者更差。
本研究强调了老年人抑郁症状存在不同的发展过程（每种症状都有别于其他症状），这对临床评估和治疗方案具有重要意义。
