The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.
The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.
J Am Med Dir Assoc. 2021 Nov;22(11):2251-2257. doi: 10.1016/j.jamda.2021.09.003. Epub 2021 Sep 13.
OBJECTIVES: It is a concern that public health measures to prevent older people contracting COVID-19 could lead to a rise in mental health problems such as depression. The aim of this study therefore is to examine trends of depressive symptoms before and during the COVID-19 pandemic in a large cohort of older people. DESIGN: Observational study with 6-year follow-up. SETTING & PARTICIPANTS: More than 3000 community-dwelling adults aged ≥60 years participating in The Irish Longitudinal Study on Ageing (TILDA). METHODS: Mixed effects multilevel models were used to describe trends in depressive symptoms across 3 waves of TILDA: wave 4 (2016), wave 5 (2018), and a final wave conducted July-November 2020. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale (CES-D), with a score ≥9 indicating clinically significant symptoms. RESULTS: The prevalence of clinically significant depressive symptoms at waves 4 and 5 was 7.2% [95% confidence interval (CI) 6.5, 7.9] and 7.2% (95% CI 6.5, 8.0), respectively. This more than doubled to 19.8% (95% CI 18.5, 21.2) during the COVID-19 pandemic. There was no change in CES-D scores between waves 4 and 5 (β = 0.09, 95% CI -0.04, 0.23), but a large increase in symptoms was observed during the pandemic (β = 2.20, 95% CI 2.07, 2.33). Age ≥70 years was independently associated with depressive symptoms (β = 0.45, 95% CI 0.18, 0.72) during the pandemic but not from wave 4 to 5 (β = 0.09, 95% CI -0.18, 0.36). Living with others was associated with a lower burden of symptoms during the pandemic (β = -0.40, 95% CI -0.71, -0.09) but not between waves 4 and 5 (β = -0.40, 95% CI -0.71, -0.09). CONCLUSIONS AND IMPLICATIONS: This study demonstrates significant increases in the burden of depressive symptoms among older people during the COVID-19 pandemic, particularly those aged ≥70 years and/or living alone. Even a small increase in the incidence of late life depression can have major implications for health care systems and societies in general. Improving access to age-attuned mental health care should therefore be a priority.
目的：预防老年人感染 COVID-19 的公共卫生措施可能导致心理健康问题（如抑郁症）增加，这令人担忧。因此，本研究旨在检查在一大群老年人中 COVID-19 大流行前后抑郁症状的趋势。
设计：具有 6 年随访的观察性研究。
地点和参与者：参加爱尔兰老龄化纵向研究（TILDA）的 3000 多名年龄在 60 岁及以上的社区居住成年人。
方法：使用混合效应多级模型描述 TILDA 的 3 个波次中的抑郁症状趋势：第 4 波（2016 年）、第 5 波（2018 年）和 2020 年 7 月至 11 月进行的最后一波。使用 8 项中心流行病学研究抑郁量表（CES-D）测量抑郁症状，得分≥9 表示存在临床显著症状。
结果：第 4 波和第 5 波时，临床显著抑郁症状的患病率分别为 7.2%（95%置信区间 6.5%，7.9%）和 7.2%（95%置信区间 6.5%，8.0%）。在 COVID-19 大流行期间，这一比例翻了一番多，达到 19.8%（95%置信区间 18.5%，21.2%）。第 4 波和第 5 波之间的 CES-D 评分没有变化（β=0.09，95%置信区间-0.04，0.23），但在大流行期间症状明显增加（β=2.20，95%置信区间 2.07，2.33）。70 岁及以上年龄与大流行期间的抑郁症状独立相关（β=0.45，95%置信区间 0.18，0.72），但与第 4 波至第 5 波无关（β=0.09，95%置信区间-0.18，0.36）。与他人同住与大流行期间症状负担较低相关（β=-0.40，95%置信区间-0.71，-0.09），但与第 4 波至第 5 波无关（β=-0.40，95%置信区间-0.71，-0.09）。
结论和意义：本研究表明，在 COVID-19 大流行期间，老年人的抑郁症状负担显著增加，尤其是 70 岁及以上或独居的老年人。即使晚年抑郁症的发病率略有增加，也会对医疗保健系统和整个社会产生重大影响。因此，应优先考虑改善针对老年人的心理健康护理的可及性。
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