Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Indiana University Center for Aging Research, Indianapolis, IN, USA.
Aging Ment Health. 2024 Jun;28(6):910-916. doi: 10.1080/13607863.2023.2285499. Epub 2023 Nov 29.
Patient-family member dyads experience transitions through illness as an interdependent team. This study measures the association of depression, anxiety, and health-related quality of life (HRQOL) of older adult primary care patient-family member dyads.
Baseline data from 1,808 patient-family member dyads enrolled in a trial testing early detection of Alzheimer's disease and related dementias in primary care. Actor-Partner Independence Model was used to analyze dyadic relationships between patients' and family members' depression (PHQ-9), anxiety (GAD-7), and HRQOL (SF-36 Physical Component Summary score and Mental Component Summary score).
Family member mean (SD) age is 64.2 (13) years; 32.2% male; 84.6% White; and 64.8% being the patient's spouse/partner. Patient mean (SD) age is 73.7 (5.7) years; 47% male; and 85.1% White. For HRQOL, there were significant actor effects for patient and family member depression alone and depression and anxiety together on their own HRQOL ( < 0.001). There were significant partner effects where family member depression combined with anxiety was associated with the patient's physical component summary score of the SF-36 ( = 0.010), and where the family member's anxiety alone was associated with the patient's mental component summary score of the SF-36 ( = 0.031).
Results from this study reveal that many dyads experience covarying health status (e.g. depression, anxiety) even prior to entering a caregiving situation.
患者-家庭成员二人组作为一个相互依存的团队,共同经历疾病带来的转变。本研究旨在衡量老年初级保健患者-家庭成员二人组的抑郁、焦虑和健康相关生活质量(HRQOL)的相关性。
本研究采用 actor-partner independence model 分析了 1808 对患者-家庭成员二人组在初级保健中进行阿尔茨海默病及相关痴呆早期检测的试验中的基线数据。该模型分析了患者和家庭成员的抑郁(PHQ-9)、焦虑(GAD-7)和 HRQOL(SF-36 生理成分综合评分和心理成分综合评分)之间的二元关系。
家庭成员的平均(标准差)年龄为 64.2(13)岁;32.2%为男性;84.6%为白人;64.8%是患者的配偶/伴侣。患者的平均(标准差)年龄为 73.7(5.7)岁;47%为男性;85.1%为白人。在 HRQOL 方面,患者和家庭成员的抑郁、抑郁和焦虑单独或共同对其自身 HRQOL 有显著的个体效应( < 0.001)。有显著的伴侣效应,即家庭成员的抑郁和焦虑共同与患者的 SF-36 生理成分综合评分相关( = 0.010),而家庭成员的焦虑单独与患者的 SF-36 心理成分综合评分相关( = 0.031)。
本研究结果表明,许多二人组在进入护理环境之前就已经经历了健康状况的变化(例如抑郁、焦虑)。