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社区老年人晚发性抑郁症状中不同的潜在症状特征。

Distinct latent symptom profiles in late-onset depressive symptoms in community-dwelling older adults.

机构信息

Department of Rehabilitation Psychology and Neuropsychology, The Institute for Rehabilitation and Research (TIRR) Memorial Hermann, Houston, TX, USA.

Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.

出版信息

Aging Ment Health. 2023 Nov-Dec;27(11):2202-2210. doi: 10.1080/13607863.2023.2211545. Epub 2023 May 17.

Abstract

OBJECTIVES

To examine the symptom profiles of late-onset depressive symptoms in a sample of older adults.

METHOD

The sample included 1,192 participants from the National Alzheimer's Coordinating Center Data Set. Participants were ≥65 years old, community-dwelling, and without cognitive impairment or a prior history of depression. Depressive symptoms were assessed using the Geriatric Depression Scale, 15-item (GDS-15). Latent class analysis (LCA) was used to identify and group participants based on profiles of depressive symptoms.

RESULTS

LCA revealed three distinct symptom profiles: (1) an Anhedonia/Amotivation profile with a higher probability of endorsing a combination of low positive emotion and amotivation (6%), (2) an Amotivation/Withdrawal profile with a high probability of endorsing only amotivational depressive symptoms (35%), and (3) an asymptomatic profile with no probability of endorsing any depressive symptoms (59%). Amotivational depressive symptoms were observed across both symptomatic profiles, while depressed mood (e.g. sadness) did not predominantly characterize any profile in this sample. There were also significant differences among symptom profiles in terms of demographic and clinical characteristics.

CONCLUSIONS

Findings highlight the importance of understanding depression at the symptom pattern level. A profile-based diagnostic approach may help improve the recognition of depressive symptoms in older adults.

摘要

目的

研究老年人群体中迟发性抑郁症状的症状特征。

方法

该样本包括来自国家阿尔茨海默病协调中心数据集的 1192 名参与者。参与者年龄均在 65 岁以上,生活在社区中,且无认知障碍或既往抑郁史。使用老年抑郁量表,15 项版(GDS-15)评估抑郁症状。采用潜在类别分析(LCA)根据抑郁症状的特征对参与者进行识别和分组。

结果

LCA 揭示了三种不同的症状特征:(1)快感缺失/动机缺乏特征,即更有可能同时出现低积极情绪和动机缺乏的组合(6%);(2)动机缺乏/退缩特征,即更有可能仅出现动机缺乏性抑郁症状(35%);(3)无症状特征,即没有出现任何抑郁症状的可能性(59%)。在这两个有症状的特征中都观察到了动机缺乏性抑郁症状,而在本样本中,抑郁情绪(如悲伤)并未主要构成任何特征。在症状特征方面,在人口统计学和临床特征方面也存在显著差异。

结论

研究结果强调了在症状模式层面理解抑郁的重要性。基于特征的诊断方法可能有助于提高对老年人群体中抑郁症状的识别。

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