Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
J Korean Med Sci. 2021 Apr 26;36(16):e99. doi: 10.3346/jkms.2021.36.e99.
The prevalence of depression is much higher in people with chronic disease than in the general population. Depression exacerbates existing physical conditions, resulting in a higher-than-expected death rate from the physical condition itself. In our aging society, the prevalence of multimorbid patients is expected to increase; the resulting mental problems, especially depression, should be considered. Using a large-scale cohort from the Korean Longitudinal Study of Aging (KLoSA), we analyzed the combined effects of depression and chronic disease on all-cause mortality.
We analyzed 10-year (2006-2016) longitudinal data of 9,819 individuals who took part in the KLoSA, a nationwide survey of people aged 45-79 years. We examined the association between multimorbidity and depression using chi-square test and logistic regression. We used the Cox proportional hazard model to determine the combined effects of multimorbidity and depression on the all-cause mortality risk.
During the 10-year follow up, 1,574 people (16.0%) died. The hazard ratio associated with mild depression increased from 1.35 (95% confidence interval [CI], 1.05-1.73) for no chronic disease to 1.25 (95% CI, 0.98-1.60) for 1 chronic disease, and to 2.00 (95% CI, 1.58-2.52) for multimorbidity. The hazard ratio associated with severe depression increased from 1.73 (95% CI, 1.33-2.24) for no chronic disease, to 2.03 (95% CI, 1.60-2.57) for 1 chronic disease, and to 2.94 (95% CI, 2.37-3.65) for multimorbidity.
Patients with coexisting multimorbidity and depression are at an increased risk of all-cause mortality than those with chronic disease or depression alone.
患有慢性病的人群中抑郁症的患病率远高于普通人群。抑郁症会使现有身体状况恶化，导致身体状况本身的死亡率高于预期。在我们老龄化的社会中，患有多种疾病的患者的患病率预计会增加；由此产生的精神问题，特别是抑郁症，应予以考虑。我们使用来自韩国老龄化纵向研究（KLoSA）的大规模队列，分析了抑郁症和慢性疾病对全因死亡率的综合影响。
我们分析了参加全国性 45-79 岁人群调查 KLoSA 的 9819 名参与者的 10 年（2006-2016 年）纵向数据。我们使用卡方检验和逻辑回归检查了多种疾病和抑郁症之间的关联。我们使用 Cox 比例风险模型来确定多种疾病和抑郁症对全因死亡率风险的综合影响。
在 10 年的随访期间，有 1574 人（16.0%）死亡。与无慢性疾病相比，轻度抑郁症的风险比从无慢性疾病的 1.35（95%置信区间[CI]，1.05-1.73）增加到 1 种慢性疾病的 1.25（95% CI，0.98-1.60），再增加到多种疾病的 2.00（95% CI，1.58-2.52）。与无慢性疾病相比，严重抑郁症的风险比从无慢性疾病的 1.73（95% CI，1.33-2.24）增加到 1 种慢性疾病的 2.03（95% CI，1.60-2.57），再增加到多种疾病的 2.94（95% CI，2.37-3.65）。
患有共病多种疾病和抑郁症的患者比患有慢性疾病或单独患有抑郁症的患者全因死亡率增加的风险更高。
