Deakin University, iMPACT the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia.
Biostatistics Unit, Deakin University, Geelong, Victoria, Australia.
Nat Aging. 2022 Apr;2(4):295-302. doi: 10.1038/s43587-022-00203-1. Epub 2022 Apr 19.
With the progressive aging of the world's population, prolongation of a healthy lifespan in old age has become a medical research priority. The presence of depressive symptoms in later life is associated with poor health prognosis and increased mortality. Here we explore distinct trajectories of depressive symptoms in later life and their association with several health-related outcomes in 19,110 older individuals followed for a median of 4.7 years. Using a latent class, mixed-modeling approach we identified four distinct trajectories of depressive symptoms with scoring patterns of consistently low, moderate, emerging and persistently high. Compared to those with minimal depressive symptoms, membership of any other class was associated with specific patterns of baseline sociodemographic and medical factors. Membership of any group with depressive symptoms was associated with a higher likelihood of health events, including physical disability, cancer and major bleeding episodes. Membership of the persistently depressed class was associated with increased mortality, while a diagnosis of dementia was generally limited to the class with initially low and progressively rising symptoms. The course of depressive symptoms in older individuals can vary widely and depend on several factors. The presence of depressive symptoms, including those that do not meet criteria for major depression, can flag a poor prognosis and risk for specific health conditions. Systematic assessment of depressive symptoms may facilitate early identification of at-risk populations.
随着世界人口的老龄化进程不断推进，延长老年人的健康寿命已成为医学研究的重点。老年人出现抑郁症状与健康预后不良和死亡率增加有关。在这里，我们探讨了老年人抑郁症状的不同轨迹及其与 19110 名老年人的多项健康相关结局的关联，这些老年人的中位随访时间为 4.7 年。使用潜在类别、混合模型方法，我们确定了抑郁症状的四种不同轨迹，评分模式表现为持续低、中度、新出现和持续高。与那些仅有轻微抑郁症状的人相比，属于任何其他类别的人都与特定的基线社会人口学和医学因素有关。任何有抑郁症状的组别的成员都与更高的健康事件发生的可能性相关，包括身体残疾、癌症和大出血事件。属于持续抑郁类别的人死亡的可能性更高，而痴呆症的诊断通常仅限于最初有轻度和逐渐升高症状的类别。老年人抑郁症状的过程可能差异很大，取决于多种因素。抑郁症状的存在，包括那些不符合重度抑郁症标准的症状，可能预示着预后不良和特定健康状况的风险。系统评估抑郁症状可能有助于早期识别高危人群。
