Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany.
Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, Leipzig 04103, Germany.
J Affect Disord. 2021 Mar 15;283:285-292. doi: 10.1016/j.jad.2021.02.008. Epub 2021 Feb 4.
The proportion of older adults is increasing due to demographic changes. Depression belongs to the most common mental disorders in late life. The loss of an emotionally significant person is a risk factor for the development of depression. The aim of this study is to analyze the association between depression and grief burden resulting from loss. Based on prior evidence, we examined loneliness as a possible mediator and social support as possible moderator of this association.
The cross-sectional analyses are based on a sample (N = 863) of study participants aged 75+ (M = 81.4 years, SD = 4.4, 62.2% female) with loss experience deriving from the multicenter prospective German cohort study AgeMooDe. Regression analyses (moderated mediation) were performed.
With increasing age (β = 0.10, p = .005) and grief burden (β = 0.33, p <. 001) depression severity increased. There was an indirect mediating effect of loneliness on the correlation of grief burden and depression (b = 0.04, CI [0.03, 0.05]), but no moderating effect of social support on the correlation of grief burden and loneliness. People living alone had a significantly higher risk of depression, increased loneliness and lack of social support.
Assessments were based on self-reporting and recorded dimensionally. The cross-sectional design limits conclusions about directions and causality of associations. Sampling bias cannot be completely excluded.
The study provides empirical evidence and a better understanding of the association between grief and depression among the very old and the mediating role of loneliness.
由于人口结构变化，老年人的比例正在增加。抑郁症属于老年人中最常见的精神障碍之一。失去情感上重要的人是导致抑郁症发展的一个风险因素。本研究旨在分析抑郁与因丧失而产生的悲伤负担之间的关联。基于先前的证据，我们研究了孤独感作为这种关联的一个可能的中介因素，以及社会支持作为一个可能的调节因素。
横断面分析基于一项来自多中心前瞻性德国队列研究 AgeMooDe 的样本（N=863，年龄 75 岁及以上，M=81.4 岁，SD=4.4，62.2%为女性），有丧失经历。采用回归分析（中介调节）进行分析。
随着年龄的增长（β=0.10，p=0.005）和悲伤负担的增加（β=0.33，p<0.001），抑郁严重程度也随之增加。孤独感在悲伤负担与抑郁的相关性中存在间接中介效应（b=0.04，CI [0.03，0.05]），但社会支持对悲伤负担与孤独感的相关性没有调节作用。独居的人患抑郁症、孤独感增加和缺乏社会支持的风险显著更高。
评估基于自我报告和维度记录。横断面设计限制了对关联方向和因果关系的结论。抽样偏差不能完全排除。
该研究提供了经验证据，更好地理解了非常老年人中悲伤与抑郁之间的关联，以及孤独感的中介作用。
