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):S545-S550. doi: 10.1111/jgs.15669.
The prevalence and health consequences of comorbid depressive symptoms (DSs) and chronic medical conditions (CMCs) among older ethnic minority populations remain poorly understood. To bridge this gap, the present cross-sectional study examined the prevalence of comorbid DS-CMC and the association between such comorbidity and health services use among US Chinese older adults.
Data were from the Population Study of Chinese Elderly in Chicago (N = 3157). The relationship between comorbid DS-CMC and health service use (ie, emergency department [ED] visits and hospitalizations) was investigated by stratifying the sample into four groups: (1) neither DSs nor CMCs (ie, heart disease, stroke, cancer, high cholesterol, diabetes, high blood pressure, hip fraction, thyroid, and osteoarthritis); (2) DSs only; (3) CMCs only; and (4) comorbid DS-CMC. Multivariate negative binomial regression models were conducted to determine the relationship between comorbid DS-CMC and health service use.
Participants were 73 years old on average. The prevalence of comorbid DSs ranged between 0.7% and 4.6% across various CMCs. The odds of DSs were at least twice as high among US Chinese older adults with CMCs than those without the various conditions. Compared with US Chinese older adults with neither DSs nor CMCs, those with comorbid DS-CMC had more ED visits (rate ratio [RR] = 3.32; 95% confidence interval [CI] = 2.03-5.42) and hospitalizations (RR = 3.12; 95% CI = 1.95-4.97).
Recognition and treatment of comorbid DS-CMC warrant increased policy and clinical attention. The findings underscore the potential need to develop effective services targeting DSs among US Chinese older adults with CMCs. J Am Geriatr Soc 67:S545-S550, 2019.
在老年少数民族群体中，合并抑郁症状（DSs）和慢性医疗状况（CMCs）的流行率及其健康后果仍知之甚少。为了弥补这一差距，本横断面研究调查了美国华裔老年人中合并 DS-CMC 的流行率以及这种合并症与卫生服务使用之间的关系。
数据来自芝加哥华人老年人人口研究（N=3157）。通过将样本分为四组，研究了合并 DS-CMC 与卫生服务使用（即急诊室[ED]就诊和住院）之间的关系：（1）既无 DSs 也无 CMCs（即心脏病、中风、癌症、高胆固醇、糖尿病、高血压、髋部骨折、甲状腺和骨关节炎）；（2）仅有 DSs；（3）仅有 CMCs；（4）合并 DS-CMC。采用多变量负二项回归模型确定合并 DS-CMC 与卫生服务使用之间的关系。
参与者的平均年龄为 73 岁。在各种 CMC 中，合并 DSs 的患病率在 0.7%至 4.6%之间。与没有各种疾病的美国华裔老年人相比，患有 CMC 的美国华裔老年人患 DSs 的可能性至少高出两倍。与既无 DSs 也无 CMCs 的美国华裔老年人相比，患有合并 DS-CMC 的人 ED 就诊次数更多（比率比[RR] = 3.32；95%置信区间[CI] = 2.03-5.42），住院次数也更多（RR = 3.12；95% CI = 1.95-4.97）。
需要加强政策和临床关注来识别和治疗合并 DS-CMC。这些发现强调了针对患有 CMC 的美国华裔老年人中 DSs 开发有效服务的潜在需求。美国老年医学会 67:S545-S550，2019。
