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时空步态参数的差异是否预示着晚年患抑郁症的风险?

Do Differences in Spatiotemporal Gait Parameters Predict the Risk of Developing Depression in Later Life?

机构信息

The Irish Longitudinal Study on Ageing Trinity College Dublin, Dublin, Ireland.

Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.

出版信息

J Am Geriatr Soc. 2019 May;67(5):1050-1056. doi: 10.1111/jgs.15783. Epub 2019 Feb 5.

Abstract

BACKGROUND/OBJECTIVES: There is growing interest in the association between gait disturbance and depression in later life. The aim of this study is to clarify the longitudinal relationship between specific gait parameters and incident depression within a population-representative sample of older people.

DESIGN

Longitudinal analysis of spatiotemporal gait parameters at baseline (wave 1) and incident depression at 2 and 4 years (waves 2/3). Logistic regression models were used to assess the relationship between tertiles of gait parameters and incident depression.

SETTING

The Irish Longitudinal Study on Aging.

PARTICIPANTS

Over 3600 nondepressed community-dwelling people aged 50 years or older.

MEASUREMENTS

A score of 9 or greater on the eight-item Center for Epidemiological Studies Depression Scale at wave 2 or 3 was indicative of incident depression. The GAITRite system was used to measure gait speed, step length, step width, and double support phase during usual speed walking and under dual task conditions.

RESULTS

Participants with incident depression (344/3615) had slower gait speed (129.9 [95% confidence interval {CI} = 127.2-132.6] cm/s vs 134.1 [95% CI = 133.0-135.1] cm/s; F = 8.82; P = .003) and shorter step length (68.0 [95% CI = 66.9-69.2] cm vs 70.3 [95% CI = 69.9-70.7] cm; F = 13.99; P < .001) at baseline than those who did not develop depression. Logistic regression models demonstrated that those within the slowest tertile for gait speed and shortest tertile for step length had significantly increased likelihood of incident depression in fully adjusted models, with odds ratios of 1.54 (95% CI = 1.08-2.19) and 1.54 (95% CI = 1.01-2.35), respectively. Measures of step width and double support time were not associated with depression.

CONCLUSIONS

This study demonstrates that older people with incident depression have significantly slower gait speed and shorter step length at initial assessment. These findings are clinically significant given the impact both conditions have on functional status in later life, as well as the possibility that gait problems may represent a potentially modifiable risk factor for depression. J Am Geriatr Soc 67:1050-1056, 2019.

摘要

背景/目的:人们对老年人步态障碍与抑郁之间的关联越来越感兴趣。本研究的目的是在具有代表性的老年人群体中,阐明特定步态参数与偶发性抑郁之间的纵向关系。

设计

在基线(第 1 波)时对时空步态参数进行纵向分析,并在第 2 年和第 4 年(第 2/3 波)时评估偶发性抑郁。使用逻辑回归模型评估步态参数三分位数与偶发性抑郁之间的关系。

地点

爱尔兰老龄化纵向研究。

参与者

3600 多名年龄在 50 岁或以上、无抑郁的社区居住者。

测量

第 2 波或第 3 波时,八项流行病学研究抑郁量表得分为 9 分或以上表示偶发性抑郁。使用 GAITRite 系统测量日常行走速度和双重任务条件下的步态速度、步长、步宽和双支撑阶段。

结果

患有偶发性抑郁的参与者(344/3615)的步态速度较慢(129.9 [95%置信区间 {CI} = 127.2-132.6] cm/s 与 134.1 [95% CI = 133.0-135.1] cm/s;F = 8.82;P =.003),步长较短(68.0 [95% CI = 66.9-69.2] cm 与 70.3 [95% CI = 69.9-70.7] cm;F = 13.99;P <.001)。与未发生抑郁的参与者相比,在速度最慢的三分位和步长最短的三分位的参与者在完全调整的模型中出现偶发性抑郁的可能性显著增加,比值比分别为 1.54(95%CI = 1.08-2.19)和 1.54(95%CI = 1.01-2.35)。步宽和双支撑时间的测量与抑郁无关。

结论

本研究表明,初始评估时患有偶发性抑郁的老年人的步态速度明显较慢,步长较短。鉴于这两种情况对老年人日后功能状态的影响,以及步态问题可能代表一种潜在的可改变的抑郁风险因素,这些发现具有重要的临床意义。美国老年学会杂志 67:1050-1056, 2019。

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