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连续住院老年心力衰竭患者身体机能参数与抑郁的关系。

The Relation between Parameters of Physical Performance and Depression in Consecutive Hospitalized Geriatric Patients with Heart Failure.

机构信息

Department of Geriatrics, Medical Centre of Postgraduate Education, 00-416 Warsaw, Poland.

Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 00-416 Warsaw, Poland.

出版信息

Nutrients. 2024 Oct 6;16(19):3392. doi: 10.3390/nu16193392.

Abstract

BACKGROUND

In the geriatric population, the risk of cardiometabolic diseases is strongly influenced by comorbidities. The aim of the study was to estimate the prevalence of depression among hospitalized patients with heart failure (HF) and to assess the relation between physical performance and depression in this population.

METHODS

We included consecutive hospitalized patients with HF aged >65 years. The depression symptoms were evaluated using the Geriatric Depression Scale (GDS), the physical performance was assessed using the grip strength measurements, the Back Scratch Test, the Timed Up and Go Test (TUGT), the Five Times Sit to Stand Test (5 × SST), and the 6 min walk test.

RESULTS

We included 206 patients (134 females and 72 males, median age 82 years (77-86) years). Altogether, 33% of participants had signs of depression. The association was found between depression severity and economic status ( = 0.001), stressful events ( = 0.005), self-reported general health status ( = 0.001), and heart failure severity assessed by the New York Heart Association class (NYHA), = 0.003. The Back Scratch Test, the TUGT, and the 5xSST were associated with depression severity in a univariable regression analysis (β coefficient 0.04 [95% CI 0.00-0.08], 0.20 [95% CI 0.12-0.27], 0.18 [95% CI 0.07-0.27], respectively); however, when adjusted for co-factors, the TUGT and the 5xSST (0.17 [95% CI 0.08-0.26] and 0.14 [95% CI 0.02-0.26], respectively) were significantly related to the GDS score. Grip strength and the 6 min walk test were not related to the GDS score in the univariable nor multivariable analysis. These findings were confirmed in the logistic analyses.

CONCLUSIONS

Our study indicated a high incidence of depression among elderly hospitalized patients with heart failure. Depression severity in older patients with HF is related to physical performance decline as assessed by the Timed Up and Go Test and the Five Times Sit to Stand Test. Grip strength and the 6 min walk test are not related to the GDS score in this population.

摘要

背景

在老年人群中,心血管代谢疾病的风险受合并症的强烈影响。本研究的目的是评估住院心力衰竭(HF)患者中抑郁的患病率,并评估该人群中身体表现与抑郁之间的关系。

方法

我们纳入了年龄> 65 岁的连续住院 HF 患者。使用老年抑郁量表(GDS)评估抑郁症状,使用握力测量、背部搔抓试验、计时起立行走试验(TUGT)、五次坐立试验(5×SST)和 6 分钟步行试验评估身体表现。

结果

我们纳入了 206 名患者(134 名女性和 72 名男性,中位年龄 82 岁(77-86)岁)。共有 33%的参与者有抑郁迹象。抑郁严重程度与经济状况( = 0.001)、压力事件( = 0.005)、自我报告的一般健康状况( = 0.001)和纽约心脏协会(NYHA)分级评估的心力衰竭严重程度( = 0.003)之间存在关联。在单变量回归分析中,背部搔抓试验、TUGT 和 5xSST 与抑郁严重程度相关(β系数分别为 0.04 [95% CI 0.00-0.08]、0.20 [95% CI 0.12-0.27]和 0.18 [95% CI 0.07-0.27]);然而,当调整协变量后,TUGT 和 5xSST(0.17 [95% CI 0.08-0.26]和 0.14 [95% CI 0.02-0.26])与 GDS 评分显著相关。握力和 6 分钟步行试验在单变量和多变量分析中均与 GDS 评分无关。这些发现在逻辑回归分析中得到了证实。

结论

我们的研究表明,老年住院心力衰竭患者中抑郁的发生率较高。老年 HF 患者的抑郁严重程度与 TUGT 和 5xSST 评估的身体表现下降有关。在该人群中,握力和 6 分钟步行试验与 GDS 评分无关。

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