Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center, Hamburg-Eppendorf, Germany.
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center, Hamburg-Eppendorf, Germany.
J Am Med Dir Assoc. 2021 Mar;22(3):577-582.e2. doi: 10.1016/j.jamda.2020.10.008. Epub 2020 Nov 19.
There is a lack of studies disentangling whether changes in frailty are associated with subsequent changes in depressive symptoms or vice versa among the oldest old. Consequently, we aimed to disentangle this link.
Three waves [follow-up (FU) wave 7 to FU wave 9; n = 423 individuals in the analytical sample] were used from the multicenter prospective cohort study "Needs, Health Service Use, Costs and Health-Related Quality of Life in a Large Sample of Oldest-Old Primary Care Patients (85+)" (AgeQualiDe).
Primary care patients aged 85 years and older.
The Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (CFS) was used to quantify frailty, and the Geriatric Depression Scale was used to measure depressive symptoms. It was adjusted for several covariates (sociodemographic and health-related factors) in regression analysis.
Multiple linear regressions with first differences showed that initial increases in depressive symptoms (from FU wave 7 to FU wave 8) were associated with subsequent increases in frailty (from FU wave 8 to FU wave 9; β = 0.06, P < .05), whereas initial increases in frailty (from FU wave 7 to FU wave 8) were not associated with subsequent increases in depressive symptoms (from FU wave 8 to FU wave 9).
The study findings suggest the relevance of increases in depressive symptoms for subsequent increases in frailty. Treatment of depressive symptoms may also be beneficial to postpone frailty.
在最年长的老年人中，尚缺乏研究来厘清虚弱程度的变化是否与随后抑郁症状的变化有关，或者反之亦然。因此，我们旨在厘清这一关联。
本研究使用了多中心前瞻性队列研究“大量老年初级保健患者（85 岁及以上）的需求、卫生服务利用、成本和健康相关生活质量（AgeQualiDe）”中的三个随访时间点（随访 7 波至随访 9 波；分析样本中共有 423 名个体）。
年龄在 85 岁及以上的初级保健患者。
使用加拿大健康老龄化研究（CSHA）临床虚弱量表（CFS）来量化虚弱程度，使用老年抑郁量表来衡量抑郁症状。在回归分析中，对几个协变量（社会人口统计学和健康相关因素）进行了调整。
采用一阶差分的多元线性回归显示，抑郁症状的初始增加（从随访 7 波到随访 8 波）与随后的虚弱程度增加（从随访 8 波到随访 9 波）有关（β=0.06，P<.05），而虚弱程度的初始增加（从随访 7 波到随访 8 波）与随后的抑郁症状增加（从随访 8 波到随访 9 波）无关。
研究结果表明，抑郁症状的增加与随后的虚弱程度增加有关。治疗抑郁症状也可能有助于延缓虚弱的发生。
