压力负荷与城市成年人抑郁症状的纵向关联：多样性生活跨度社区的健康老龄化研究。
Longitudinal association of allostatic load with depressive symptoms among urban adults: Healthy Aging in Neighborhoods of Diversity across the Life Span study.
机构信息
Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA.
出版信息
Psychoneuroendocrinology. 2023 Mar;149:106022. doi: 10.1016/j.psyneuen.2022.106022. Epub 2023 Jan 3.
BACKGROUND
Evidence suggests that lifetime exposure to stressful life events and chronic stressors may be linked to geriatric depression. Allostatic load (AL) is considered a mediator of the stress-health relationship and has been linked to psychosocial factors reflecting health disparities. The purpose of this study was to examine the longitudinal associations of AL with depressive symptoms scores among urban adults, before and after stratifying by sex and race.
METHODS
Secondary analyses were performed using Visit 1 (2004-2009), Visit 2 (2009-2013) and Visit 3 (2013-2017) data collected on 2298 Healthy Aging in Neighborhoods of Diversity across the Life Span study participants (baseline age: 30-64 y). AL at Visit 1 (AL) and z-transformed probability of higher AL trajectory (AL) between Visits 1 and 3 were calculated using cardiovascular, metabolic and inflammatory risk indicators. The 20-item Center for Epidemiologic Studies Depression (CES-D) scale was used to calculate total and domain-specific depressive symptoms scores. Mixed-effects linear models controlled for socio-demographic, lifestyle and health characteristics.
RESULTS
In fully adjusted models, a positive cross-sectional relationship was observed between AL and "somatic complaints" depressive symptoms (β = 0.21, P = 0.006) score at Visit 1, whereas AL was associated with increasing depressive symptoms score (β = 0.086, P = 0.003) between Visits 1 and 3. An inverse relationship was observed between AL and "positive affect" depressive symptoms score at Visit 1 among women (β = -0.31, P < 0.0001) and White adults (β = -0.32, P = 0.004). Among women, AL was also positively related to change in "somatic complaints" depressive symptoms score between Visits 1 and 3 (β = 0.043, P = 0.020).
CONCLUSIONS
Among urban adults, AL may be associated with "somatic complaints" depressive symptoms at baseline. Higher AL trajectories may predict increasing depressive symptoms (overall) and increasing "somatic complaints" depressive symptoms (among women). A higher AL trajectory may be associated with lower "positive affect" depressive symptoms at baseline among women and White adults only.
背景
有证据表明，终生暴露于应激性生活事件和慢性应激源可能与老年抑郁症有关。适应负荷（AL）被认为是压力-健康关系的中介因素，并且与反映健康差异的心理社会因素有关。本研究的目的是在按性别和种族分层之前，检查 AL 与城市成年人抑郁症状评分之间的纵向关联。
方法
使用 2298 名多样性在生命跨度中的邻里健康老化研究参与者的访问 1（2004-2009 年）、访问 2（2009-2013 年）和访问 3（2013-2017 年）的数据进行二次分析（基线年龄：30-64 岁）。使用心血管、代谢和炎症风险指标计算第 1 次就诊时的第 1 次就诊时的 AL（AL）和第 1 次就诊和第 3 次就诊之间的更高 AL 轨迹的 z 变换概率（AL）。使用 20 项中心流行病学研究抑郁量表（CES-D）计算总分和特定领域的抑郁症状评分。混合效应线性模型控制了社会人口统计学、生活方式和健康特征。
结果
在完全调整的模型中，在第 1 次就诊时观察到 AL 与“躯体症状”抑郁症状（β=0.21，P=0.006）评分之间存在正横断面关系，而 AL 与第 1 次就诊和第 3 次就诊之间抑郁症状评分的增加（β=0.086，P=0.003）有关。在女性（β=-0.31，P<0.0001）和白人成年人（β=-0.32，P=0.004）中，在第 1 次就诊时观察到 AL 与“积极情绪”抑郁症状评分之间呈负相关。在女性中，AL 还与第 1 次就诊和第 3 次就诊之间“躯体症状”抑郁症状评分的变化呈正相关（β=0.043，P=0.020）。
结论
在城市成年人中，AL 可能与基线时的“躯体症状”抑郁症状有关。较高的 AL 轨迹可能预示着抑郁症状（整体）和“躯体症状”抑郁症状（女性）的增加。仅在女性和白人成年人中，较高的 AL 轨迹与基线时的“积极情绪”抑郁症状较低有关。
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