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台湾老年人多病共存模式与抑郁发生的相关性研究:社会参与的作用。

Association between multimorbidity patterns and incident depression among older adults in Taiwan: the role of social participation.

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.

Department of Family Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan.

出版信息

BMC Geriatr. 2023 Mar 27;23(1):177. doi: 10.1186/s12877-023-03868-4.

Abstract

BACKGROUND

Previous research has found different multimorbidity patterns that negatively affects health outcomes of older adults. However, there is scarce evidence, especially on the role of social participation in the association between multimorbidity patterns and depression. Our study aimed to explore the relationship between multimorbidity patterns and depression among older adults in Taiwan, including the social participation effect on the different multimorbidity patterns.

METHODS

Data were retracted from the Taiwan longitudinal study on ageing (TLSA) for this population-based cohort study. 1,975 older adults (age > 50) were included and were followed up from 1996 to 2011. We used latent class analysis to determine participants' multimorbidity patterns in 1996, whereas their incident depression was determined in 2011 by CES-D. Multivariable logistic regression was used to analyse the relationship between multimorbidity patterns and depression.

RESULTS

The participants' average age was 62.1 years in 1996. Four multimorbidity patterns were discovered through latent class analysis, as follows: (1) Cardiometabolic group (n = 93), (2) Arthritis-cataract group (n = 105), (3) Multimorbidity group (n = 128) and (4) Relatively healthy group (n = 1649). Greater risk of incident depression was found among participants in the Multimorbidity group (OR: 1.62; 95% CI: 1.02-2.58) than the Relatively healthy group after the multivariable analysis. Compare to participants in the relatively healthy group with social participation, participants in the arthritis-cataract group without social participation (OR: 2.22, 95% CI: 1.03-4.78) and the multimorbidity group without social participation (OR: 2.21, 95% CI: 1.14-4.30) had significantly increased risk of having depression.

CONCLUSION

Distinct multimorbidity patterns among older adults in Taiwan are linked with the incident depression during later life, and social participation functioned as a protective factor.

摘要

背景

先前的研究发现了不同的多种疾病模式,这些模式对老年人的健康结果产生负面影响。然而,证据稀缺,尤其是关于社会参与在多种疾病模式与抑郁之间的关联中的作用。我们的研究旨在探讨台湾老年人中多种疾病模式与抑郁之间的关系,包括社会参与对不同多种疾病模式的影响。

方法

本基于人群的队列研究从台湾老龄化纵向研究(TLSA)中提取数据。共纳入 1975 名年龄在 50 岁以上的老年人,并在 1996 年至 2011 年期间进行随访。我们使用潜在类别分析来确定参与者在 1996 年的多种疾病模式,而在 2011 年通过 CES-D 确定其抑郁的发生情况。使用多变量逻辑回归分析多种疾病模式与抑郁之间的关系。

结果

参与者在 1996 年的平均年龄为 62.1 岁。通过潜在类别分析发现了四种多种疾病模式,如下:(1)心血管代谢组(n=93),(2)关节炎-白内障组(n=105),(3)多种疾病组(n=128)和(4)相对健康组(n=1649)。多变量分析后,多种疾病组(OR:1.62;95%CI:1.02-2.58)参与者发生抑郁的风险高于相对健康组。与相对健康组且有社会参与的参与者相比,关节炎-白内障组无社会参与(OR:2.22,95%CI:1.03-4.78)和多种疾病组无社会参与(OR:2.21,95%CI:1.14-4.30)的参与者抑郁的风险显著增加。

结论

台湾老年人中不同的多种疾病模式与晚年发生抑郁有关,而社会参与起到了保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dc1/10045862/d2554702be2c/12877_2023_3868_Fig1_HTML.jpg

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