Cohen-Mekelburg Shirley, Jordan Ariel, Kenney Brooke, Burgess Helen J, Chang Joy W, Hu Hsou Mei, Tapper Elliot, Langa Kenneth M, Levine Deborah A, Waljee Akbar K
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan; Veterans Affairs Center for Clinical Management Research, US Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan.
Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan.
Clin Gastroenterol Hepatol. 2024 Mar;22(3):621-629.e2. doi: 10.1016/j.cgh.2023.08.027. Epub 2023 Sep 9.
BACKGROUND & AIMS: Current approaches to managing digestive disease in older adults fail to consider the psychosocial factors contributing to a person's health. We aimed to compare the frequency of loneliness, depression, and social isolation in older adults with and without a digestive disease and to quantify their association with poor health.
We conducted an analysis of Health and Retirement Study data from 2008 to 2016, a nationally representative panel study of participants 50 years and older and their spouses. Bivariate analyses examined differences in loneliness, depression, and social isolation among patients with and without a digestive disease. We also examined the relationship between these factors and health.
We identified 3979 (56.0%) respondents with and 3131 (44.0%) without a digestive disease. Overall, 60.4% and 55.6% of respondents with and without a digestive disease reported loneliness (P < .001), 12.7% and 7.5% reported severe depression (P < .001), and 8.9% and 8.7% reported social isolation (P = NS), respectively. After adjusting for covariates, those with a digestive disease were more likely to report poor or fair health than those without a digestive disease (odds ratio [OR], 1.25; 95% CI, 1.11-1.41). Among patients with a digestive disease, loneliness (OR, 1.43; 95% CI, 1.22-1.69) and moderate and severe depression (OR, 2.93; 95% CI, 2.48-3.47; and OR, 8.96; 95% CI, 6.91-11.63, respectively) were associated with greater odds of poor or fair health.
Older adults with a digestive disease were more likely than those without a digestive disease to endorse loneliness and moderate to severe depression and these conditions are associated with poor or fair health. Gastroenterologists should feel empowered to screen patients for depression and loneliness symptoms and establish care pathways for mental health treatment.
目前针对老年消化疾病的管理方法未考虑影响个体健康的社会心理因素。我们旨在比较患与未患消化疾病的老年人中孤独、抑郁和社会隔离的发生率,并量化它们与健康状况不佳之间的关联。
我们对2008年至2016年健康与退休研究数据进行了分析,该研究是一项针对50岁及以上参与者及其配偶的全国代表性面板研究。双变量分析检查了患与未患消化疾病的患者在孤独、抑郁和社会隔离方面的差异。我们还研究了这些因素与健康之间的关系。
我们确定了3979名(56.0%)患有消化疾病的受访者和3131名(44.0%)未患消化疾病的受访者。总体而言,患与未患消化疾病的受访者中分别有60.4%和55.6%报告感到孤独(P <.001),12.7%和7.5%报告有严重抑郁(P <.001),8.9%和8.7%报告有社会隔离(P =无统计学意义)。在对协变量进行调整后,患有消化疾病的人比未患消化疾病的人更有可能报告健康状况不佳或一般(优势比[OR],1.25;95%置信区间,1.11 - 1.41)。在患有消化疾病的患者中,孤独(OR,1.43;95%置信区间,1.22 - 1.69)以及中度和重度抑郁(分别为OR,2.93;95%置信区间,2.48 - 3.47;和OR,8.96;95%置信区间,6.91 - 11.63)与健康状况不佳或一般的较高几率相关。
患有消化疾病的老年人比未患消化疾病的老年人更有可能认可孤独以及中度至重度抑郁,并且这些情况与健康状况不佳或一般相关。胃肠病学家应有能力对患者进行抑郁和孤独症状筛查,并建立心理健康治疗的护理途径。