Lukaschek Karoline, Hentschel Heidi, Rottenkolber Marietta, Alberer Martin, Winter Susanne, Sebastião Maria, Arend Florian, Dreischulte Tobias, Gágyor Ildikó, Hausen Anita, Hoelscher Michael, Janke Christian, Kühlein Thomas, Teupser Daniel, Gensichen Jochen
Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany.
Division of Infectious Diseases and Tropical Medicine, Medical Centre of the University of Munich (LMU), Germany.
PLoS One. 2025 May 9;20(5):e0323017. doi: 10.1371/journal.pone.0323017. eCollection 2025.
Investigating the association between mental health, quality of life, and SARS-CoV-2 infection in individuals in need of care compared to independent living individuals. Individuals in need of care include both care home residents and those receiving care either through an outpatient care service or from family members.
This cross-sectional study assessed symptoms of depression (PHQ-9 > 9) and anxiety (GAD-7 > 9), quality of life (EQ-5D-5L, EQ-VAS), dementia (SIS), SARS-CoV-2 infection and socio-demographic variables in the total sample (N = 978, 64.4% female, mean age: 77.5 ± 13.8 years) and subgroups (study group, STG, n = 532, individuals in need of care, SARS-CoV-2 positive; control group 1, CG1, n = 213, individuals in need of care, SARS-CoV-2 negative; control group 2, CG2, n = 233, independent living individuals, SARS-CoV-2 positive). Multivariate logistic regressions were performed.
Depressive symptoms (PHQ-9 > 9) were significantly associated with lower quality of life in the total sample (EQ-VAS: OR 0.96, 95% CI 0.95-0.97, p < 0.001; EQ-5D-5L: OR 0.14, 95% CI 0.07-0.29, p < 0.001) and across all subgroups. Anxiety (GAD-7 > 9) was significantly associated with lower quality of life in the total sample (EQ-VAS: OR 0.97, 95% CI 0.95-0.98, p < 0.001; EQ-5D-5L: OR 0.19, 95% CI 0.08-0.50, p < 0.001) and all subgroups except CG1. In individuals in need of care with COVID-19, depressive symptoms were additionally associated with symptomatic infection (OR 3.47, 95% CI 1.45-8.28, p = 0.005).
Depression and anxiety were significantly associated with reduced quality of life, irrespective of living environment or SARS-CoV-2 infection status, underscoring the need for targeted mental health interventions in older adults. While our model explained a considerable portion of the variability in depression and anxiety, further research is needed to account for the remaining proportion.
调查与独立生活的个体相比，需要护理的个体的心理健康、生活质量与新型冠状病毒2（SARS-CoV-2）感染之间的关联。需要护理的个体包括养老院居民以及那些通过门诊护理服务或由家庭成员提供护理的人。
这项横断面研究评估了总样本（N = 978，64.4%为女性，平均年龄：77.5±13.8岁）及各亚组（研究组，STG，n = 532，需要护理的个体，SARS-CoV-2阳性；对照组1，CG1，n = 213，需要护理的个体，SARS-CoV-2阴性；对照组2，CG2，n = 233，独立生活的个体，SARS-CoV-2阳性）中的抑郁症状（患者健康问卷-9[PHQ-9]＞9）、焦虑症状（广泛性焦虑障碍量表-7[GAD-7]＞9）、生活质量（欧洲五维度健康量表[EQ-5D-5L]、欧洲生活质量视觉模拟量表[EQ-VAS]）、痴呆（简易智能状态检查表[SIS]）、SARS-CoV-2感染及社会人口统计学变量。进行了多变量逻辑回归分析。
在总样本中（EQ-VAS：比值比[OR]0.96，95%置信区间[CI]0.95 - 0.97，p＜0.001；EQ-5D-5L：OR 0.14，95%CI 0.07 - 0.29，p＜0.001）以及所有亚组中，抑郁症状（PHQ-9＞9）均与较低的生活质量显著相关。在总样本中（EQ-VAS：OR 0.97，95%CI 0.95 - 0.98，p＜0.001；EQ-5D-5L：OR 0.19，95%CI 0.08 - 0.50，p＜0.001）以及除CG1之外的所有亚组中，焦虑症状（GAD-7＞9）均与较低的生活质量显著相关。在感染新型冠状病毒肺炎（COVID-19）且需要护理的个体中，抑郁症状还与有症状感染相关（OR 3.47，95%CI 1.45 - 8.28，p = 0.005）。
无论生活环境或SARS-CoV-2感染状态如何，抑郁和焦虑均与生活质量降低显著相关，这突出了对老年人进行有针对性的心理健康干预的必要性。虽然我们的模型解释了抑郁和焦虑变异性的相当一部分，但仍需要进一步研究以解释其余部分。
