Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada.
Office of Public Health Studies, University of Hawaii, Honolulu, HI, USA.
Aging Ment Health. 2020 May;24(5):747-757. doi: 10.1080/13607863.2019.1571018. Epub 2019 Feb 6.
Our study aims to assess whether multimorbidity is an independent risk factor for the development of depression in older adults living in Canada, Brazil, Colombia, and Albania and examines differences in incidence of depression regarding social and psychosocial characteristics. The longitudinal International Mobility Aging Study (IMIAS) collected information from adults between 65-74 years old. Depression was defined by a 16 or higher score assessed by the Centre for Epidemiological Studies Depression (CES-D) Scale. Multimorbidity was defined as having two or more chronic conditions, which were self-reported by participants using a list of eight physical chronic conditions. Poisson regression was performed to estimate the relative risk of depression in older adults with multimorbidity compared to those living with 0-1 chronic conditions, adjusting for sex, age, education, number of doctor visits, degree of assistance needed, social support, and smoking status. The analysis was stratified by study region (Canada; Latin America; Albania). Crude and adjusted models showed no statistically significant associations between multimorbidity and the incidence of depression in any of the study regions, confirmed by sensitivity analyses. However, the incidence of depression varied across study region, confirmed by the intra-class correlation coefficient which indicated that 13% of variations in depression incidence were due to geographic differences. Multimorbidity does not appear to increase the risk of developing depression in older adults between 65-74. Higher rates of depression in Latin America and Albania (compared to Canada) may be attributed to lifecourse exposures to social and economic adversity in these regions.
我们的研究旨在评估在加拿大、巴西、哥伦比亚和阿尔巴尼亚居住的老年人中，多病共存是否是抑郁发生的独立风险因素，并探讨了社会和心理社会特征方面的抑郁发生率差异。国际流动老龄化研究（IMIAS）收集了 65-74 岁成年人的信息。抑郁的定义是通过使用中心流行病学研究抑郁量表（CES-D）评估得分为 16 或更高分。多病共存被定义为患有两种或两种以上慢性疾病，参与者使用一份八种身体慢性疾病的清单自行报告。采用泊松回归来估计与患有 0-1 种慢性疾病的老年人相比，多病共存的老年人发生抑郁的相对风险，调整了性别、年龄、教育程度、就诊次数、需要的帮助程度、社会支持和吸烟状况。按研究区域（加拿大、拉丁美洲、阿尔巴尼亚）对分析进行分层。在任何研究区域，粗模型和调整模型均未显示多病共存与抑郁发生率之间存在统计学显著关联，敏感性分析也证实了这一点。然而，抑郁的发生率在研究区域之间存在差异，这一事实通过组内相关系数得到了证实，该系数表明抑郁发生率的 13%差异归因于地理差异。多病共存似乎不会增加 65-74 岁老年人发生抑郁的风险。拉丁美洲和阿尔巴尼亚（与加拿大相比）的抑郁发生率较高，可能归因于这些地区在整个生命周期中面临社会和经济逆境的暴露。
