Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey.
School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania.
J Am Geriatr Soc. 2019 Aug;67(S3):S538-S544. doi: 10.1111/jgs.15801.
This prospective cohort study examined the relationship between depressive symptoms and onset of functional disability over 2 years among US Chinese older adults, a rapidly growing minority older adult population.
This study used survey data from 2713 Chinese older adults who completed both baseline (2011-2013) and follow-up (2013-2015) interviews of the Population Study of Chinese Elderly in Chicago. Depressive symptoms were assessed at baseline by the nine-item Patient Health Questionnaire. Functional disability was measured by three validated scales, Katz Index of Independence in Activities of Daily Living (ADLs), the Lawton Instrumental Activities of Daily Living (IADLs) scale, and the Rosow and Breslau mobility scale. Multivariate logistic regression was conducted to examine the relationship between baseline depressive symptoms and the development of functional disability (ADLs, IADLs, mobility) at 2-year follow-up while adjusting for covariates.
Of the 2713 participants, 5.2% experienced ADL disability onset, 35.6% experienced IADL disability onset, and 23.3% experienced mobility disability onset over 2 years. After adjusting for covariates, the odds of ADL disability onset (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02-1.11), IADL disability onset (OR = 1.05; 95% CI = 1.01-1.09), and mobility disability onset (OR = 1.05; 95% CI = 1.01-1.09) were consistently higher in US Chinese older adults with higher levels of depressive symptoms than their less-depressed counterparts. Other significant risk factors included older age and more chronic physical conditions.
Study findings underscore a significant relationship between depressive symptoms and onset of functional disability. Screening and, subsequently, treating depressive symptoms have the potential to reduce disability among US Chinese older adults. Culturally relevant depressive symptom screening may help identify Chinese older adults who are at greater risks for the development of functional disability. J Am Geriatr Soc 67:S538-S544, 2019.
本前瞻性队列研究考察了抑郁症状与美国华裔老年人在 2 年内功能障碍发生的关系，华裔老年人是一个快速增长的少数族裔老年人群体。
本研究使用了来自 2713 名华裔老年人的调查数据，他们完成了芝加哥华人老年人群体研究的基线（2011-2013 年）和随访（2013-2015 年）访谈。基线时通过 9 项患者健康问卷评估抑郁症状。通过三个经过验证的量表评估功能障碍：卡茨日常生活活动独立性量表（ADLs）、劳顿工具性日常生活活动量表（IADLs）和罗索和布雷索流动性量表。多变量逻辑回归用于检验基线时抑郁症状与 2 年随访时 ADLs、IADLs、流动性功能障碍发展之间的关系，同时调整了协变量。
在 2713 名参与者中，5.2%在 2 年内出现 ADL 残疾，35.6%出现 IADL 残疾，23.3%出现流动性残疾。调整协变量后，ADL 残疾发病的可能性（优势比 [OR] = 1.06；95%置信区间 [CI] = 1.02-1.11）、IADL 残疾发病（OR = 1.05；95%CI = 1.01-1.09）和流动性残疾发病（OR = 1.05；95%CI = 1.01-1.09）在抑郁症状水平较高的美国华裔老年人中均高于抑郁症状水平较低的老年人。其他显著的危险因素包括年龄较大和更多的慢性身体疾病。
研究结果强调了抑郁症状与功能障碍发生之间的显著关系。对抑郁症状进行筛查和随后治疗有可能减少美国华裔老年人的残疾。具有文化相关性的抑郁症状筛查可能有助于确定功能障碍风险较高的华裔老年人。美国老年学会杂志 67：S538-S544，2019 年。
