Passler Jesse S, Sander Angelle M, Temkin Nancy R, Barber Jason, Gardner Raquel C, Manley Geoffrey T
H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX.
H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX; Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX; Department of Physical Medicine and Rehabilitation, Harris Health System, Houston, TX.
Arch Phys Med Rehabil. 2022 Jan;103(1):83-89. doi: 10.1016/j.apmr.2021.08.021. Epub 2021 Sep 26.
To investigate depression at 12 months after traumatic brain injury (TBI) in older adults compared with younger adults.
Prospective longitudinal cohort study of persons with medically documented mild, moderate, and severe TBI at 12 months postinjury.
Eighteen participating Level 1 trauma centers in the United States.
Participants with TBI (N=1505) and primary outcome data at 12-month follow-up.
Not applicable.
Patient Health Questionnaire-9 (PHQ-9).
PHQ-9 total scores were significantly lower for older adults (age≥65y; M=3.2) compared with younger adults (age<65y; M=5.0; B=-1.63, P<.001), indicating fewer depressive symptoms in older adults. Age did not interact with education, sex, race/ethnicity, psychiatric history, substance use, or Glasgow Coma Scale severity to affect PHQ-9 scores. Of the 29% of older adults who endorsed symptoms consistent with depression, 14% were classified as minor depression and 15% as major depression. The odds of older adults falling in the major depression vs no depression group were significantly lower (decreased by 56%) compared with younger adults (odds ratio=0.44, P=.001).
At 12 months post-TBI, older adults endorse lower depressive symptoms than their younger counterparts and are less likely to experience major depression; however, over one-fourth of older adults endorsed symptoms consistent with depression, warranting evaluation and treatment.
比较老年人与年轻人创伤性脑损伤（TBI）后12个月时的抑郁情况。
对有医学记录的轻度、中度和重度TBI患者在受伤后12个月进行前瞻性纵向队列研究。
美国18个参与研究的一级创伤中心。
TBI患者（N = 1505），并在12个月随访时有主要结局数据。
不适用。
患者健康问卷-9（PHQ-9）。
与年轻人（年龄<65岁；M = 5.0；B = -1.63，P <.001）相比，老年人（年龄≥65岁；M = 3.2）的PHQ-9总分显著更低，表明老年人的抑郁症状更少。年龄与教育程度、性别、种族/民族、精神病史、物质使用或格拉斯哥昏迷量表严重程度之间不存在交互作用来影响PHQ-9评分。在认可有与抑郁相符症状的29%老年人中，14%被归类为轻度抑郁，15%为重度抑郁。与年轻人相比，老年人处于重度抑郁组而非无抑郁组的几率显著更低（降低了56%）（优势比 = 0.44，P =.001）。
TBI后12个月时，老年人的抑郁症状比年轻人少，且患重度抑郁的可能性更小；然而，超过四分之一的老年人认可有与抑郁相符的症状，需要进行评估和治疗。
