Bamonti Patricia M, Kennedy Meaghan A, Ward Rachel E, Travison Thomas G, Bean Jonathan F
Research & Development, VA Boston Healthcare System, Boston, Massachusetts, United States.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States.
Arch Rehabil Res Clin Transl. 2024 Apr 26;6(2):100342. doi: 10.1016/j.arrct.2024.100342. eCollection 2024 Jun.
To assess the association between depression symptoms and physical functioning and participation in daily life over 2 years in older adults at risk of mobility decline.
A secondary analysis of 2-year observational data from the Boston Rehabilitative Impairment Study of the Elderly.
Nine primary care clinics within a single health care system.
Participants (N=432; mean age ± SD, 76.6±7.0y; range, 65-96y; 67.7% women) were community-dwelling adults (>65y) at risk of mobility decline.
Not applicable.
Secondary data analyses of the Late Life Function and Disability Instrument (primary outcome), Short Physical Performance Battery (secondary outcome), and Patient Health Questionnaire-9 (PHQ-9) (predictor). Measures were administered at baseline, 12 months, and 24 months. Participants completed a self-report survey asking about 16 medical comorbidities, and demographic information was collected at baseline.
Participants had an average ± SD PHQ-9 score of 1.3±3.1, ranging from 0 to 24 at baseline. Twenty-nine percent of participants reported a history of depression. Greater depression symptoms were associated with lower physical functioning (unstandardized beta []=-0.14, SE=0.05, P=.011) and restricted participation (frequency subscale: =-0.21, SE=0.11, =.001; limitation subscale: =-0.45, SE=0.04, <.001) cross-sectionally over 2 years. PHQ-9 was not significantly associated with the rate of change in Late Life Function and Disability Instrument score over 2 years.
Treating depression in primary care may be an important strategy for reducing the burden of functional limitations and participation restrictions at any 1 time. Further research is needed on treatment models to cotarget depression and physical functioning among at-risk older adults.
评估有行动能力下降风险的老年人在两年内抑郁症状与身体功能及日常生活参与度之间的关联。
对波士顿老年康复障碍研究的两年观察数据进行二次分析。
单一医疗系统内的九家初级保健诊所。
参与者（N = 432；平均年龄±标准差，76.6±7.0岁；范围65 - 96岁；67.7%为女性）为有行动能力下降风险的社区居住成年人（>65岁）。
不适用。
对晚年功能与残疾量表（主要结局）、简短体能状况量表（次要结局）和患者健康问卷-9（PHQ - 9）（预测指标）进行二次数据分析。在基线、12个月和24个月时进行测量。参与者完成一份自我报告调查，询问16种合并症情况，并在基线时收集人口统计学信息。
参与者在基线时PHQ - 9评分的平均值±标准差为1.3±3.1，范围为0至24。29%的参与者报告有抑郁症病史。在两年的横断面研究中，更严重的抑郁症状与较低的身体功能（未标准化β[]=-0.14，标准误=0.05，P = 0.011）和受限的参与度（频率子量表：=-0.21，标准误=0.11，=0.001；限制子量表：=-0.45，标准误=0.04，<0.001）相关。PHQ - 9与两年内晚年功能与残疾量表评分的变化率无显著关联。
在初级保健中治疗抑郁症可能是在任何时候减轻功能受限和参与限制负担的重要策略。需要进一步研究针对有风险的老年人同时治疗抑郁症和身体功能的治疗模式。
