Department of Nursing, Cardinal Tien Hospital, Taipei, Taiwan.
School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
J Nurs Scholarsh. 2019 Sep;51(5):547-559. doi: 10.1111/jnu.12501. Epub 2019 Jul 22.
In this study we investigated the correlation between depression and frailty in older adults. Additionally, correlations among study designs (prospective vs. cross-sectional), regions, depression indices, frailty indices, covariance corrections, and sexes were explored to support the analysis.
A systematic literature review and meta-analysis were conducted. A total of 84,351 older adults, all 65 years of age or older, were analyzed. Both authors independently extracted and examined retrieved articles. Searched keywords included "depression" or "depressive"; "frailty" or "frail"; and "older people," "elderly," "geriatric," or "senior." Articles published between January 2000 and December 2016 were searched. A literature quality assessment was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic REVIEWS AND META-ANALYSES: Systematic literature searches were conducted on the Embase, PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases, and collected studies were analyzed using a random effects model.
Fourteen studies on people 65 years of age or older were collected, and a correlation analysis was conducted for depression and frailty. According to the meta-analysis, the risk for frailty due to depression was nonsignificant among the subgroups for study design (p for heterogeneity = .149), region (p = .429), depression criteria (p = .934), covariate adjustment (p = .702), and frailty criteria (p = .661). Notably, the risk for frailty due to depression was significantly higher in men than in women (pooled odds ratios for men and women: 4.76 and 2.25, respectively; Qbetween χ = 9.93, p = .002).
Older adults with depression are more prone to frailty than are those without depression. Regardless of study design, region, depression index, frailty index, and covariance corrections, no significant differences were observed in the results of studies on depression and frailty in older adults. The only factor that had a significant influence was sex; older men with depression were at a higher risk for frailty than were older women with depression.
Depression and frailty are pertinent health concerns related to geriatric syndromes. Because older adults with depression have a high risk for frailty, nursing personnel should use a depression index as early as possible to screen for depression and further reduce the occurrence of frailty in older adults. Furthermore, based on the aforementioned differences between the sexes, special attention should be paid to older men with depression to reduce their risk for frailty.
本研究旨在探讨老年人抑郁与衰弱之间的相关性。此外，还探讨了研究设计（前瞻性与横断面）、地域、抑郁指标、衰弱指标、协变量校正和性别之间的相关性，以支持分析。
进行了系统的文献综述和荟萃分析。共分析了 84351 名年龄在 65 岁及以上的老年人。两位作者均独立提取并检查了检索到的文章。检索的关键词包括“抑郁”或“抑郁”；“衰弱”或“虚弱”；以及“老年人”、“老年人”、“老年医学”或“老年人”。检索了 2000 年 1 月至 2016 年 12 月期间发表的文章。根据系统评价和荟萃分析的首选报告项目指南进行文献质量评估：对 Embase、PubMed、MEDLINE、护理与联合健康文献累积索引和 Cochrane 图书馆数据库进行了系统文献检索，并使用随机效应模型对收集到的研究进行了分析。
共收集了 14 项针对 65 岁及以上人群的研究，并对抑郁和衰弱进行了相关性分析。荟萃分析结果显示，在研究设计（p 异质性=.149）、地域（p =.429）、抑郁标准（p =.934）、协变量校正（p =.702）和衰弱标准（p =.661）亚组中，抑郁导致衰弱的风险无显著性差异。值得注意的是，抑郁导致男性衰弱的风险明显高于女性（男性和女性的合并优势比分别为 4.76 和 2.25；Q 间 χ = 9.93，p =.002）。
与无抑郁的老年人相比，抑郁的老年人更容易出现衰弱。无论研究设计、地域、抑郁指数、衰弱指数和协变量校正如何，老年人抑郁和衰弱的研究结果均无显著差异。唯一有显著影响的因素是性别；与抑郁的老年女性相比，抑郁的老年男性更容易出现衰弱。
抑郁和衰弱是与老年综合征相关的重要健康问题。由于抑郁的老年人患衰弱的风险较高，护理人员应尽早使用抑郁指数筛查抑郁，进一步降低老年人患衰弱的风险。此外，基于上述性别差异，应特别关注抑郁的老年男性，以降低其衰弱风险。
