International Institute for Population Sciences, 400088, Mumbai, Maharashtra, India.
BMC Geriatr. 2021 Jun 15;21(1):364. doi: 10.1186/s12877-021-02314-7.
BACKGROUND: Late-life depression (LLD) is considered as a prodrome to dementia and plays a major role in the development of long-term cognitive disabilities. We aimed to estimate the prevalence and correlates of LLD and cognitive impairment and to explore their associations among older adults in India. METHODS: Data for this study was derived from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-18). The total sample included 31,464 (15,098 male and 16,366 female) older individuals aged 60 years and above. Cognitive impairment measured from various domains derived from the cognitive module of the Health and Retirement Study (HRS), and major depression measured by the CIDI-SF (Composite International Diagnostic Interview- Short Form) were the outcome variables. Descriptive, bivariate, and multivariable analyses were performed to fulfill the objectives of the study. RESULTS: The overall prevalence of LLD and cognitive impairment for the current sample was 8.7% and 13.7 % respectively. Among older individuals who have rated their health status as poor were 2.59 times more likely to suffer from LLD [OR: 2.59, CI: 2.24-2.99] as compared to their counterparts. The older adults who had difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) were 74% and 69 % more likely to suffer from LLD. Similarly, older adults who were depressed had higher odds of cognitive impairment [OR: 1.22, CI: 1.01-1.48] compared to their counterparts. Also, older adults who were depressed and belonged to rural areas were 2.58 times [AOR: 2.58, CI: 1.95-3.41] more likely to be cognitively impaired than those who were not depressed and resided in urban areas. CONCLUSIONS: Depression is linked to an increased risk of cognitive decline and dementia; therefore, failing to diagnose and treat LLD in later life may have significant health implications. Moreover, treatment under the care of a cognitive neurologist or geriatric psychiatrist is recommended for people with LLD and cognitive disability due to both the disorders' complex existence.
背景：老年抑郁症（LLD）被认为是痴呆的前驱症状，在老年人长期认知障碍的发展中起着重要作用。我们旨在评估印度老年人 LLD 和认知障碍的患病率及其相关性，并探讨它们之间的关系。
方法：本研究的数据来自印度纵向老龄化研究（LASI）第 1 波（2017-18 年）。总样本包括 31464 名（男性 15098 名，女性 16366 名）年龄在 60 岁及以上的老年人。认知障碍是通过健康和退休研究（HRS）认知模块得出的多个领域来衡量的，而主要抑郁症则是通过 CIDI-SF（综合国际诊断访谈-短表）来衡量的，这两个都是本研究的结果变量。为了实现研究目标，进行了描述性、双变量和多变量分析。
结果：当前样本中 LLD 和认知障碍的总体患病率分别为 8.7%和 13.7%。与健康自评较差的老年人相比，自评健康较差的老年人患 LLD 的可能性高 2.59 倍[比值比：2.59，95%置信区间：2.24-2.99]。日常生活活动（ADL）和工具性日常生活活动（IADL）有困难的老年人患 LLD 的可能性分别高 74%和 69%。同样，患有抑郁症的老年人认知障碍的几率更高[比值比：1.22，95%置信区间：1.01-1.48]。此外，与未患有抑郁症且居住在城市地区的老年人相比，居住在农村地区且患有抑郁症的老年人认知障碍的几率高 2.58 倍[AOR：2.58，95%置信区间：1.95-3.41]。
结论：抑郁症与认知能力下降和痴呆风险增加有关；因此，未能在晚年诊断和治疗 LLD 可能会对健康产生重大影响。此外，由于两种疾病的复杂存在，建议患有 LLD 和认知障碍的人在认知神经科医生或老年精神病医生的护理下进行治疗。
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