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老年人共病抑郁和焦虑症状与衰弱:来自华西健康与老龄化趋势研究的发现。

Comorbid depressive and anxiety symptoms and frailty among older adults: Findings from the West China health and aging trend study.

机构信息

National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, China.

National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, China; Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No.37 GuoXueXiang, Chengdu, China.

出版信息

J Affect Disord. 2020 Dec 1;277:970-976. doi: 10.1016/j.jad.2020.08.070. Epub 2020 Sep 2.

Abstract

BACKGROUND

Depression and anxiety are two common mental disorders in older people. Studies have reported that depression is strongly associate with frailty, but few studies focus on anxiety disorder and comorbid two mental disorders. In this study, we aimed to identify associations between comorbid depressive and anxiety symptoms with frailty in older adults.

METHODS

4,103 community-dwellings adults aged 60 and older from the baseline of the West China Health and Aging Trend (WCHAT) study were included. Frailty was measured by the Fried frailty phenotype criteria. The 15-item Geriatric Depression Scale (GDS-15) and 7-item Generalized Anxiety Disorder Scale (GAD-7) assessed for depressive and anxiety symptoms with a cut-off value of 5. Multinomial logistic regression was used to explore the association between different depressive and anxiety status and frailty.

RESULTS

8.7% of old adults suffered comorbid depressive and anxiety symptoms in the present study. The prevalence of pre-frailty and frailty was 47.0% and 6.7%, respectively. After adjusting for covariates, individuals with comorbid depressive and anxiety symptoms had higher odds of being pre-frail (OR=1.86, 95% CI=1.41, 2.45) and frail (OR=7.03, 95% CI=4.48, 11.05) compared to those without depressive and anxiety symptoms. In the comorbidity group, those with severe comorbid symptoms also had higher prevalence of pre-frailty and frailty.

LIMITATIONS

Depressive and anxiety symptom assessments were based on screening tools.

CONCLUSIONS

This study suggested comorbid depressive and anxiety symptoms were associated with frailty among Chinese older adults. Further efforts to screen and target depression and anxiety comorbidity may be warranted.

摘要

背景

抑郁和焦虑是老年人中两种常见的精神障碍。研究报告称,抑郁与虚弱密切相关,但很少有研究关注焦虑症和两种精神障碍并存。本研究旨在确定老年人中并存的抑郁和焦虑症状与虚弱之间的关系。

方法

本研究纳入了来自华西健康与老龄化趋势研究(WCHAT)基线的 4103 名 60 岁及以上的社区居住成年人。采用 Fried 虚弱表型标准来衡量虚弱。使用 15 项老年抑郁量表(GDS-15)和 7 项广泛性焦虑症量表(GAD-7)评估抑郁和焦虑症状,以 5 分为临界值。使用多项逻辑回归来探讨不同的抑郁和焦虑状态与虚弱之间的关系。

结果

在本研究中,8.7%的老年人患有并存的抑郁和焦虑症状。衰弱前期和衰弱的患病率分别为 47.0%和 6.7%。在调整了混杂因素后,与无抑郁和焦虑症状的个体相比,患有并存的抑郁和焦虑症状的个体更有可能处于衰弱前期(OR=1.86,95%CI=1.41,2.45)和衰弱(OR=7.03,95%CI=4.48,11.05)。在并存组中,那些有严重并存症状的个体也有更高的衰弱前期和衰弱的患病率。

局限性

抑郁和焦虑症状的评估基于筛查工具。

结论

本研究表明,并存的抑郁和焦虑症状与中国老年人的虚弱有关。进一步努力筛查和针对抑郁和焦虑并存可能是必要的。

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