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患有双重感官丧失的老年人的居住差异与抑郁

Residential Differences and Depression Among Older Adults With Dual Sensory Loss.

作者信息

Wang Ethan B, Garcia Morales Emmanuel E, Gross Alden L, Lin Frank R, Reed Nicholas S, Deal Jennifer A

机构信息

Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

出版信息

JAMA Otolaryngol Head Neck Surg. 2025 Mar 1;151(3):202-210. doi: 10.1001/jamaoto.2024.4488.

Abstract

IMPORTANCE

Investigating rural-urban and regional differences in the association between dual sensory loss (concurrent hearing and vision loss) and depression may highlight gaps in sensory loss research and health care services, and by socioeconomic status. Whether urbanicity and region may modify associations between sensory loss and depression is unknown.

OBJECTIVE

To describe the rural-urban and regional differences in the association of dual sensory loss with depression among older adults.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from wave 1 (April 2017-December 2019) of the population-based Longitudinal Aging Study in India (LASI). Participants were recruited from 35 states and union territories in India. LASI incorporated a multistage stratified area probability cluster sampling design to recruit participants 45 years and older and their spouses; 31 447 eligible participants 60 years of age or older were interviewed. Data analyses were conducted from May 17, 2022, to November 11, 2023.

EXPOSURES

Sensory loss (no sensory loss, hearing loss only, vision loss only, and dual sensory loss) was determined by respondents' self-reported perceived difficulty regarding hearing and vision function.

MAIN OUTCOMES AND MEASURES

The Composite International Diagnostic Interview (CIDI-SF) scale was used to identify major episodic depression. Logistic regression was used to estimate the odds ratios (ORs) and 95% CIs of depression comparing participants with vs without sensory loss, adjusting for demographic and clinical covariates. Rural-urban and regional differences were assessed by including interaction terms between these variables and sensory loss.

RESULTS

The study analysis included 27 927 participants (mean [SD] age, 68.0 [7.2] years; 14 477 [51%] females and 13 450 [49%] males). The fully adjusted models showed that the odds of depression with dual sensory loss (vs no loss) was higher in urban (OR, 3.16; 95% CI, 2.00-4.99) vs rural (OR, 1.73; 95% CI, 1.31-2.29) residents and among residents in the West (OR, 5.10; 95% CI, 1.74-14.97) vs North (OR, 1.38; 95% CI, 0.81-2.35) regions.

CONCLUSIONS AND RELEVANCE

These findings indicate that sensory loss is associated with depression in older adults, with differences by urbanicity and region. Adults with sensory loss across multiple systems may be an important group to target for intervention.

摘要

重要性

研究城乡及地区在双重感官丧失(同时存在听力和视力丧失)与抑郁症之间关联的差异,可能凸显感官丧失研究及医疗服务方面的差距,以及社会经济地位方面的差距。城市性和地区是否会改变感官丧失与抑郁症之间的关联尚不清楚。

目的

描述老年人中双重感官丧失与抑郁症关联的城乡及地区差异。

设计、背景和参与者:这项横断面研究使用了印度基于人群的纵向衰老研究(LASI)第1波(2017年4月至2019年12月)的数据。参与者从印度的35个邦和联邦属地招募。LASI采用多阶段分层区域概率整群抽样设计,招募年龄在45岁及以上的参与者及其配偶;对31447名60岁及以上的合格参与者进行了访谈。数据分析于2022年5月17日至2023年11月11日进行。

暴露因素

根据受访者自我报告的听力和视力功能感知困难情况确定感官丧失(无感官丧失、仅听力丧失、仅视力丧失和双重感官丧失)。

主要结局和测量指标

使用综合国际诊断访谈(CIDI-SF)量表识别主要发作性抑郁症。采用逻辑回归估计有与无感官丧失参与者抑郁症的比值比(OR)和95%置信区间(CI),并对人口统计学和临床协变量进行调整。通过纳入这些变量与感官丧失之间的交互项来评估城乡和地区差异。

结果

研究分析纳入了27927名参与者(平均[标准差]年龄为68.0[7.2]岁;女性14477名[51%],男性13450名[49%])。完全调整后的模型显示,双重感官丧失(与无丧失相比)的抑郁症患病几率在城市居民(OR,3.16;95%CI,2.00 - 4.99)高于农村居民(OR,1.73;95%CI,1.31 - 2.29),在西部地区居民(OR,5.10;95%CI,1.74 - 14.97)高于北部地区居民(OR,1.38;95%CI,0.81 - 2.35)。

结论及意义

这些发现表明,感官丧失与老年人的抑郁症相关,且存在城乡和地区差异。多系统存在感官丧失的成年人可能是重要的干预目标群体。

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