Beaumont Research Institute, Beaumont Health System, Royal Oak, MI, United States of America.
Deparment of Public Health, Falk College, Syracuse University, Syracuse, New York, USA.
Arch Gerontol Geriatr. 2022 May-Jun;100:104663. doi: 10.1016/j.archger.2022.104663. Epub 2022 Feb 18.
We sought to identify distinctive concurrent trajectory classes of depressive symptoms (DS) and cognitive function (CF) in Mexican Americans aged 75+ years, and to examine whether these trajectories were associated with an increased risk of adverse outcomes.
We used 4 waves of Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) data from 2004 to 5 to 2013. Latent growth curve analysis was used to identify distinctive concurrent trajectory classes of DS and CF. Generalized linear mixed models were further used to examine the association between the concurrent trajectories and health outcomes. Cox proportional hazards regression model was used to examine the risk of mortality as a function of the concurrent trajectories.
1,302 older adults followed-up approximately 9-years were successfully classified into 6 distinct concurrent trajectory classes of DS (low-increasing, high) and CF (high, high-declining, medium-declining). Compared to the co-occurrence of low DS and high CF trajectories, those with the high DS and declining CF trajectories were at greater risk of ADL and IADL functional limitations (1.6 - 2.9 times), more medical visits (1.3 - 1.4 times), hospital admissions (1.6 - 1.9 times), and mortality (1.7 - 2.6 times).
Differences in adverse health outcomes across concurrent trajectory classes of DS and CF suggest that differences in underlying co-occurrence and progression have important implications for public health interventions as well as development of aging social and health policies.
我们试图确定 75 岁以上墨西哥裔美国人的抑郁症状（DS）和认知功能（CF）的独特并发轨迹类别，并检验这些轨迹是否与不良后果风险增加有关。
我们使用了 2004 年至 2013 年期间 4 波西班牙裔美国人老龄化人群流行病学研究（H-EPESE）的数据。采用潜在增长曲线分析识别 DS 和 CF 的独特并发轨迹类别。进一步采用广义线性混合模型检验并发轨迹与健康结果之间的关系。采用 Cox 比例风险回归模型检验并发轨迹作为死亡率函数的风险。
1302 名年龄较大的成年人随访约 9 年，成功分为 6 种不同的 DS（低升高、高）和 CF（高、高下降、中下降）并发轨迹类别。与 DS 和 CF 轨迹低发生率相比，DS 高和 CF 下降轨迹的发生率更高，ADL 和 IADL 功能受限（1.6-2.9 倍）、就诊次数（1.3-1.4 倍）、住院（1.6-1.9 倍）和死亡率（1.7-2.6 倍）。
DS 和 CF 并发轨迹类别中不良健康结果的差异表明，潜在共病和进展的差异对公共卫生干预措施以及老龄化社会和健康政策的制定具有重要意义。
