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衰弱是否可以解释老年期抑郁症与其他老年综合征之间的关联?

Could Frailty be an Explanatory Factor of the Association between Depression and Other Geriatric Syndromes in Later Life?

机构信息

Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo , São Paulo, Brazil.

Department of Psychiatry, University of Groningen, University Medical Center Groningen , Groningen, The Netherlands.

出版信息

Clin Gerontol. 2021 Mar-Apr;44(2):143-153. doi: 10.1080/07317115.2020.1836106. Epub 2020 Oct 25.

Abstract

OBJECTIVES

This study aimed to investigate whether frailty could be an explanatory factor of the association between depression and the number of geriatric syndromes.

METHODS

Cross-sectional baseline data from a cohort study (MiMiCS-FRAIL) were analyzed in a sample of 315 older adults. Depression was measured according to DSM-5 criteria and a self-report questionnaire (PHQ-9). Frailty was assessed according to the FRAIL questionnaire and a 30-item Frailty Index (FI). We considered six geriatric syndromes. Multiple linear regression analyses were performed and adjusted for potential confounders.

RESULTS

Multiple linear regression analyses yielded significant associations between depression and geriatric syndromes. These associations decreased substantially in strength when frailty was added to the models. Findings were consistent for different definitions of depression and frailty.

CONCLUSIONS

Among depressed patients, frailty may be hypothesized as a causal pathway toward adverse health outcomes associated with depression. Longitudinal studies should explore the causality of this association.

CLINICAL IMPLICATIONS

Frailty should be treated or prevented in order to minimize the impact of other geriatric syndromes among depressed older adults. Screening for frailty would be of utmost importance in mental health care, as frailty is neglected especially in this field. Integrated care models are crucial for clinical practice in mental illness care.

摘要

目的

本研究旨在探讨衰弱是否可以解释抑郁与老年综合征数量之间的关联。

方法

对一项队列研究(MiMiCS-FRAIL)的横断面基线数据进行分析,样本包括 315 名老年人。根据 DSM-5 标准和自我报告问卷(PHQ-9)来测量抑郁。根据 FRAIL 问卷和 30 项衰弱指数(FI)来评估衰弱。我们考虑了六种老年综合征。进行了多元线性回归分析,并对潜在的混杂因素进行了调整。

结果

多元线性回归分析显示抑郁与老年综合征之间存在显著关联。当将衰弱纳入模型后,这些关联的强度显著降低。对于不同的抑郁和衰弱定义,结果都是一致的。

结论

在抑郁患者中,衰弱可能被假设为与抑郁相关的不良健康结果的因果途径。纵向研究应探索这种关联的因果关系。

临床意义

为了最大限度地减少抑郁老年患者中其他老年综合征的影响,应治疗或预防衰弱。在精神卫生保健中,对衰弱进行筛查非常重要,因为在该领域尤其容易忽视衰弱。综合护理模式对于精神疾病护理的临床实践至关重要。

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