The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, and Barwon Health, Geelong, Victoria, Australia.
Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
Acta Psychiatr Scand. 2023 Jan;147(1):92-104. doi: 10.1111/acps.13513. Epub 2022 Nov 11.
Gerontology and ageing research are increasingly focussing on healthy life span (healthspan), the period of life lived free of serious disease and disability. Late-life depression (LLD) is believed to impact adversely on physical health. However, no studies have examined its effect on healthspan. This study investigated the effect of LLD and subthreshold depression on disability-free survival, a widely accepted measure of healthspan.
This prospective cohort study used data from the ASPirin in Reducing Events in the Elderly study. Participants were aged ≥70 years (or ≥65 years for African-American and Hispanic participants) and free of dementia, physical disability and cardiovascular disease. Depressive symptoms were measured using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10). LLD and subthreshold depression were defined as CES-D-10 scores ≥8 and 3-7, respectively. Disability-free survival was defined as survival free of dementia and persistent physical disability.
A total of 19,110 participants were followed up for a maximum of 7.3 years. In female participants, LLD was associated with lower disability-free survival adjusting for sociodemographic and lifestyle factors, medical comorbidities, polypharmacy, physical function and antidepressant use (HR, 1.50; 95% CI, 1.23-1.82). In male participants, LLD was associated with lower disability-free survival adjusting for sociodemographic and lifestyle factors (HR, 1.30; 95% CI, 1.03-1.64). Subthreshold depression was also associated with lower disability-free survival in both sexes.
LLD may be a common and important risk factor for shortened healthspan.
老年医学和衰老研究越来越关注健康寿命（健康跨度），即没有严重疾病和残疾的生活时期。人们认为，晚年抑郁症（LLD）会对身体健康产生不利影响。然而，尚无研究探讨其对健康跨度的影响。本研究调查了 LLD 和亚临床抑郁症对无残疾生存的影响，这是健康跨度的广泛接受的衡量标准。
本前瞻性队列研究使用了 ASPirin in Reducing Events in the Elderly 研究的数据。参与者年龄≥70 岁（或≥65 岁的非裔美国人和西班牙裔参与者），且无痴呆、身体残疾和心血管疾病。使用 10 项流行病学研究抑郁量表（CES-D-10）测量抑郁症状。LLD 和亚临床抑郁症分别定义为 CES-D-10 评分≥8 和 3-7。无残疾生存定义为无痴呆和持续身体残疾的生存。
共有 19110 名参与者接受了最长 7.3 年的随访。在女性参与者中，在校正了社会人口统计学和生活方式因素、合并症、多种药物治疗、身体功能和抗抑郁药使用后，LLD 与较低的无残疾生存相关（HR，1.50；95%CI，1.23-1.82）。在男性参与者中，在校正了社会人口统计学和生活方式因素后，LLD 与较低的无残疾生存相关（HR，1.30；95%CI，1.03-1.64）。亚临床抑郁症在两性中也与较低的无残疾生存相关。
LLD 可能是健康跨度缩短的一个常见且重要的危险因素。
