School of Medicine, IMPACT the Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia.
Biostatistics Unit, Deakin University, Geelong, Victoria, Australia.
J Am Geriatr Soc. 2020 Aug;68(8):1834-1841. doi: 10.1111/jgs.16468. Epub 2020 May 13.
To investigate the association between depressive symptoms and several medical morbidities, and their combination, in a large older population.
Cross-sectional study of baseline data from the ASPirin in Reducing Events in the Elderly (ASPREE) trial.
Multicentric study conducted in Australia and the United States.
A total of 19,110 older adults (mean age = 75 years [standard deviation = ±4.5]).
Depressive symptoms were measured using the Center for Epidemiological Studies Depression (CES-D 10) scale. Medical morbidities were defined according to condition-specific methods. Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) to test associations before and after accounting for possible confounders.
Depressive symptoms were significantly associated with obesity (OR = 1.19; 95% CI = 1.07-1.32), diabetes (OR = 1.22; 95% CI = 1.05-1.42), gastroesophageal reflux disease (GERD) (OR = 1.41; 95% CI = 1.28-1.57), metabolic syndrome (OR = 1.16; 95% CI = 1.03-1.29), osteoarthritis (OR = 1.41; 95% CI = 1.27-1.57), respiratory conditions (OR = 1.25; 95% CI = 1.10-1.42), history of cancer (OR = 1.19; 95% CI = 1.05-1.34), Parkinson's disease (OR = 2.56; 95% CI = 1.83-3.56), polypharmacy (OR = 1.60; 95% CI = 1.44-1.79), and multimorbidity (OR = 1.29; 95% CI = 1.12-1.49). No significant association was observed between depressive symptoms and hypertension, chronic kidney disease, dyslipidemia, and gout (P > .05). A significant dose-response relationship was evident between the number of medical comorbidities and the prevalence of depression (OR = 1.18; 95% CI = 1.13-1.22).
Late-life depressive symptoms are significantly associated with several medical morbidities, and there appears to be a cumulative effect of the number of somatic diseases on the prevalence of depression. These findings augment the evidence for a complex relationship between mental and physical health in an otherwise healthy older population and might guide clinicians toward early recognition of high-risk individuals. J Am Geriatr Soc 68:1834-1841, 2020.
在一个较大的老年人群中，研究抑郁症状与多种医学合并症及其组合之间的关系。
ASPREE 试验的基线数据的横断面研究。
澳大利亚和美国的多中心研究。
共有 19110 名老年人（平均年龄=75 岁[标准差=±4.5]）。
使用流行病学研究中心抑郁量表（CES-D 10）来衡量抑郁症状。根据特定疾病的方法定义医学合并症。使用逻辑回归计算比值比（OR）和 95%置信区间（CI）来测试在考虑可能的混杂因素之前和之后的关联。
抑郁症状与肥胖（OR=1.19；95%CI=1.07-1.32）、糖尿病（OR=1.22；95%CI=1.05-1.42）、胃食管反流病（GERD）（OR=1.41；95%CI=1.28-1.57）、代谢综合征（OR=1.16；95%CI=1.03-1.29）、骨关节炎（OR=1.41；95%CI=1.27-1.57）、呼吸系统疾病（OR=1.25；95%CI=1.10-1.42）、癌症史（OR=1.19；95%CI=1.05-1.34）、帕金森病（OR=2.56；95%CI=1.83-3.56）、多药治疗（OR=1.60；95%CI=1.44-1.79）和多种合并症（OR=1.29；95%CI=1.12-1.49）显著相关。抑郁症状与高血压、慢性肾脏病、血脂异常和痛风之间无显著相关性（P>.05）。在医学合并症数量与抑郁患病率之间存在显著的剂量反应关系（OR=1.18；95%CI=1.13-1.22）。
老年后期的抑郁症状与多种医学合并症显著相关，而且躯体疾病的数量似乎对抑郁的患病率有累积效应。这些发现增加了在一个健康的老年人群中精神和身体健康之间存在复杂关系的证据，并可能指导临床医生早期识别高危个体。美国老年医学会杂志 68：1834-1841，2020。
