Simning Adam, Caprio Thomas V, Infurna Frank J, Seplaki Christopher L
Department of Psychiatry, University of Rochester Medical Center (URMC), Rochester, New York, USA.
Division of Geriatrics & Aging, Department of Medicine, URMC, Rochester, New York, USA.
Aging Ment Health. 2021 Feb;25(2):269-276. doi: 10.1080/13607863.2019.1693973. Epub 2019 Nov 25.
Millions of older adults receive rehabilitation services every year, which aim to restore, maintain, or limit decline in functioning. We examine whether lower reported well-being prior to receiving rehabilitation services is associated with increased odds of worsening anxiety symptoms, depressive symptoms, and impairment in self-care and household activities following rehabilitation.
Data come from the National Health and Aging Trends Study (NHATS), an annual survey of a nationally representative sample of Medicare beneficiaries aged 65 years and older. Our sample consists of 811 NHATS participants who, in the 2015 interview, had information on well-being and, in the 2016 interview, reported receiving rehabilitation services in the prior year.
In multivariable logistic regression analyses, compared to the highest quartile, those in the lowest quartile of well-being at baseline have increased odds of having worsening depressive symptoms (OR = 9.25, 95% CI: 3.78-22.63) and worsening impairments in self-care activities (OR = 2.39, 95% CI: 1.12-5.11).
Our findings suggest that older adults with the lowest levels of baseline well-being may be susceptible to having worsening depressive symptoms and impairment in self-care activities following rehabilitation services. Examination on whether consideration of well-being during the rehabilitation process could lead to better mental health and functional outcomes following rehabilitation is needed.
每年有数百万老年人接受康复服务,其目的是恢复、维持或限制功能衰退。我们研究在接受康复服务之前报告的幸福感较低是否与康复后焦虑症状恶化、抑郁症状恶化以及自我护理和家庭活动受损的几率增加有关。
数据来自国家健康与老龄化趋势研究(NHATS),这是一项对65岁及以上医疗保险受益人的全国代表性样本进行的年度调查。我们的样本包括811名NHATS参与者,他们在2015年的访谈中有关于幸福感的信息,并在2016年的访谈中报告在前一年接受了康复服务。
在多变量逻辑回归分析中,与最高四分位数相比,基线时幸福感处于最低四分位数的人抑郁症状恶化的几率增加(OR = 9.25,95% CI:3.78 - 22.63),自我护理活动受损恶化的几率增加(OR = 2.39,95% CI:1.12 - 5.11)。
我们的研究结果表明,基线幸福感水平最低的老年人在接受康复服务后可能易出现抑郁症状恶化和自我护理活动受损。需要研究在康复过程中考虑幸福感是否会导致康复后更好的心理健康和功能结果。