Graduate School of Health Sciences, Hirosaki University, Aomori, Japan.
Department of Nutrition, Faculty of Health Sciences, Graduate School of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan.
BMC Public Health. 2024 Nov 14;24(1):3171. doi: 10.1186/s12889-024-19091-8.
Apathetic and depressive symptoms are frequently observed among older adults, and are risk factors for functional decline and dementia progression. However, how these symptoms influence functional capacity remains unclear. This study investigated the relationship between apathetic and depressive symptoms and functional capacity, considering the interaction between apathetic and depressive symptoms.
A cross-sectional questionnaire survey targeting community dwelling middle-aged or older adults was conducted. We sent a questionnaire to 984 individuals and received 320 responses. Data with missing values and participants aged under 50 were excluded, resulting in 212 participants (88 men and 124 women, mean age = 73.4 ± 9.3 years). Apathetic symptoms were evaluated using the Dimensional Apathy Scale (J-DAS), which comprises executive, emotional, and cognitive and behavioral initiation aspects of apathy. Depressive symptoms were evaluated using the Geriatric Depression Scale (GDS). Functional capacity was assessed using the Japan Science and Technology Agency Index of Competence, which comprises technology usage, information practice, life management, and social engagement.
Mean score of each J-DAS factor and GDS was 5.3 ± 3.4 (executive), 12.0 ± 3.0 (emotional), 11.8 ± 5.1 (initiation), and 4.5 ± 3.3, respectively. The emotional and initiation aspects of J-DAS were significantly associated with information practice (β = -0.15, p < .05 for emotional; β = -0.27, p < .001 for initiation) and life management (β = -0.20, p < .01 for emotional; β = -0.22, p < .01 for initiation) in functional capacity. GDS was associated only with social engagement (β = -0.31, p < .001). Although the interaction between the initiation factor of J-DAS and GDS was significantly associated with life management (β = -0.16, p < .05), the R change was insignificant. The emotional factor of J-DAS was associated with technology usage (β = -0.13, p < .05), although less strongly than age. The executive factor of J-DAS had insignificant associations with all aspects of functional capacity.
Apathetic and depressive symptoms are independently, rather than interactively, associated with different aspects of functional capacity. As older adults with apathetic or depressive symptoms might struggle to seek help from public health services, they should be targeted with active interventions from healthcare professionals.
在老年人中经常观察到冷漠和抑郁症状，它们是功能下降和痴呆进展的危险因素。然而，这些症状如何影响功能能力尚不清楚。本研究调查了冷漠和抑郁症状与功能能力之间的关系，同时考虑了冷漠和抑郁症状之间的相互作用。
对居住在社区的中年或老年人进行了一项横断面问卷调查。我们向 984 人发送了问卷，并收到了 320 份回复。排除数据缺失和年龄在 50 岁以下的参与者，最终纳入 212 名参与者（88 名男性和 124 名女性，平均年龄 73.4±9.3 岁）。使用多维冷漠量表（J-DAS）评估冷漠症状，该量表包括冷漠的执行、情感、认知和行为启动方面。使用老年抑郁量表（GDS）评估抑郁症状。使用日本科学技术署能力指数评估功能能力，该指数包括技术使用、信息实践、生活管理和社会参与。
J-DAS 各因子和 GDS 的平均得分为 5.3±3.4（执行）、12.0±3.0（情感）、11.8±5.1（启动）和 4.5±3.3。J-DAS 的情感和启动方面与信息实践（β=-0.15，p<.05 为情感；β=-0.27，p<.001 为启动）和生活管理（β=-0.20，p<.01 为情感；β=-0.22，p<.01 为启动）显著相关。GDS 仅与社会参与相关（β=-0.31，p<.001）。尽管 J-DAS 启动因子与 GDS 的相互作用与生活管理显著相关（β=-0.16，p<.05），但 R 变化不显著。J-DAS 的情感因子与技术使用相关（β=-0.13，p<.05），尽管不如年龄相关。J-DAS 的执行因子与所有功能能力方面均无显著关联。
冷漠和抑郁症状与功能能力的不同方面独立相关，而不是相互作用。由于有冷漠或抑郁症状的老年人可能难以从公共卫生服务中寻求帮助，因此应该成为医疗保健专业人员积极干预的目标。
