Workplace Mental Health Institute (DJO), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Neuropsychiatry (JWH, KWK), Seoul National University Bundang Hospital, Gyeonggido, Korea.
Am J Geriatr Psychiatry. 2024 Aug;32(8):957-967. doi: 10.1016/j.jagp.2024.02.006. Epub 2024 Feb 24.
The relationship between depression and the risk of multimorbidity progression has rarely been studied in older adults. This study was aimed to determine whether depression is associated with progression in the severity and complexity of multimorbidity, considering the influence of depression's severity and subtype.
As a part of the Korean Longitudinal Study on Cognitive Aging and Dementia, this population-based cohort study followed a random sample of community-dwelling Koreans aged 60 and older for 8 years at 2-year intervals starting in 2010. Participants included those who completed mood and multimorbidity assessments and did not exhibit complex multimorbidity at the study's outset. Depression was assessed using the Geriatric Depression Scale, while multimorbidity was evaluated using the Cumulative Illness Rating Scale. The study quantified multimorbidity complexity by counting affected body systems and measured multimorbidity severity by averaging scores across 14 body systems.
The 2,486 participants (age = 69.1 ± 6.5 years, 57.6% women) were followed for 5.9 ± 2.4 years. Linear mixed models revealed that participants with depression had a faster increase in multimorbidity complexity score (β = .065, SE = 0.019, p = 0.001) than those without depression, but a comparable increase in multimorbidity severity score (β = .001, SE = .009, p = 0.870) to those without depression. Cox proportional hazard models revealed that depression was associated with the risk of developing highly complex multimorbidity affecting five or more body systems, particularly in severe or anhedonic depression.
Depression was associated with the worsening of multimorbidity in Korean older adults, particularly when severe or anhedonic. Early screening and management of depression may help to reduce the burden of multimorbidity in older adults.
抑郁症与多种疾病进展风险之间的关系在老年人中鲜有研究。本研究旨在确定抑郁症是否与多种疾病严重程度和复杂性的进展相关，同时考虑到抑郁症严重程度和亚型的影响。
作为韩国认知老化与痴呆纵向研究的一部分，本基于人群的队列研究对 2010 年开始的每两年随访一次的随机抽取的社区居住的韩国 60 岁及以上老年人进行了 8 年的随访。参与者包括完成情绪和多种疾病评估且在研究开始时未表现出复杂多种疾病的人群。使用老年抑郁量表评估抑郁症，使用累积疾病评分量表评估多种疾病。通过计算受影响的身体系统数量来量化多种疾病的复杂性，通过平均 14 个身体系统的评分来衡量多种疾病的严重程度。
2486 名参与者（年龄=69.1±6.5 岁，57.6%为女性）随访 5.9±2.4 年。线性混合模型显示，患有抑郁症的参与者的多种疾病复杂性评分增加更快（β=0.065，SE=0.019，p=0.001），但与无抑郁症的参与者相比，多种疾病严重程度评分增加相当（β=0.001，SE=0.009，p=0.870）。Cox 比例风险模型显示，抑郁症与影响五个或更多身体系统的高度复杂多种疾病的发病风险相关，尤其是在严重或快感缺失性抑郁症中。
抑郁症与韩国老年人多种疾病的恶化相关，尤其是在严重或快感缺失性抑郁症中。早期筛查和管理抑郁症可能有助于减轻老年人多种疾病的负担。
