Rivera Eleanor, Hirschman Karen B, Naylor Mary D
NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia.
Innov Aging. 2020 Jun 9;4(3):igaa021. doi: 10.1093/geroni/igaa021. eCollection 2020.
Long-term services and supports (LTSS) are vital for older adults with physical and cognitive disabilities. LTSS can be provided in settings such as nursing homes, assisted living, or via community-based services. During the transition to LTSS, older adults are at risk of increased depressive symptoms. In addition, older adults may identify unmet needs despite having access to new LTSS resources. The goal of this study was to examine the factors associated with increased depressive symptoms among a pool of older adults, with a focus on change in reported needs after starting LTSS.
This cross-sectional analysis of a cohort study included 352 older adults new to LTSS (R01AG025524). The outcome of depressive symptoms was measured using the Geriatric Depression Scale-Short Form. Reported needs included supportive equipment, devices, transportation, and social activities. Bivariate and linear regression modeling using change in needs 3 months later were performed.
Depressive symptoms were present among 40% of the LTSS recipients at enrollment and 3 months. At baseline, 29% of LTSS recipients reported a need for supportive equipment, 30% for transportation, and 23% for social activities. After 3 months, an average of 12% of LTSS recipients' needs were met, 13% of LTSS recipients' needs persisted, and 11% of LTSS recipients reported new needs. Depressive symptoms 3 months later were higher for those who reported persistent unmet needs compared with those who reported no needs at all, controlling for functional status and LTSS type.
The transition to LTSS is a vulnerable time for older adults. Assessing the need for equipment, transportation, and social activities during this period may identify opportunities to improve the lives and emotional status of this population.
长期服务与支持(LTSS)对于有身体和认知残疾的老年人至关重要。LTSS可以在养老院、辅助生活设施等场所提供,也可以通过社区服务提供。在向LTSS过渡期间,老年人有出现抑郁症状加重的风险。此外,尽管老年人能够获得新的LTSS资源,但他们可能仍存在未满足的需求。本研究的目的是探讨一组老年人中与抑郁症状加重相关的因素,重点关注开始接受LTSS后报告需求的变化。
这项队列研究的横断面分析纳入了352名新接受LTSS的老年人(R01AG025524)。使用老年抑郁量表简版测量抑郁症状这一结果。报告的需求包括辅助设备、器械、交通和社交活动。使用3个月后需求的变化进行双变量和线性回归建模。
在入组时和3个月时,40%的LTSS接受者存在抑郁症状。基线时,29%的LTSS接受者报告需要辅助设备,30%需要交通服务,23%需要社交活动。3个月后,平均12%的LTSS接受者的需求得到满足,13%的LTSS接受者的需求仍然存在,1