美国养老院中拉丁裔和非拉丁裔白人居民的语言障碍与抑郁症的关联。
Association of Language Barriers and Depression Among Latino and Non-Latino White US Nursing Home Residents.
作者信息
Nielsen Natalia N, Castañeda-Avila Maira A, Dosa David, Liu Shao-Hsien, Jesdale Bill M, Yuan Yiyang, Baek Jonggyu, Lapane Kate L
机构信息
Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.
出版信息
J Am Med Dir Assoc. 2025 Aug 27:105850. doi: 10.1016/j.jamda.2025.105850.
OBJECTIVES
Despite recent demographic shifts, little is known about the association between race/ethnicity, language barriers, and mental health among US nursing home residents. We aimed to quantify the relationship between Spanish language barriers and depression in US nursing homes.
DESIGN
Cross-sectional study.
SETTING AND PARTICIPANTS
Latino and non-Latino White adults aged ≥50 years newly admitted to US nursing homes.
METHODS
Using national 2022 Minimum Data Set 3.0, we identified 19,780 Latino newly admitted residents who wanted or needed a Spanish interpreter to communicate with a physician or health care staff, and residents without need for interpreter (n = 56,969 Latino individuals, 812,456 non-Latino White individuals). A clinical depression diagnosis and self-reported Patient Health Questionnaire (PHQ-9) scores ≥10 for moderate/severe depressive symptoms were evaluated using multivariable log binomial models.
RESULTS
Our sample was mostly female, and ≥75 years. Depression prevalence was 29.5% and 31.5% for Spanish and English-speaking Latino individuals, respectively, and 36.0% for English-speaking non-Latino White individuals; moderate/severe depressive symptoms were reported in 17.5% and 15.9% for Spanish and English-speaking Latino individuals, respectively, and 15.6% for English-speaking non-Latino White individuals. Antidepressant use was common (lowest: 32.2% Spanish-speaking, Latino individuals; highest: 43.2% non-Latino White individuals); psychotherapy was received by <2%, in all language groups. Compared with English-speaking non-Latino White individuals, the prevalence of clinically diagnosed depression was lower among Latino individuals (Latino individuals adjusted prevalence ratio [aPR], 0.93; 95% CI, 0.92-0.95), and among Latino individuals, lower among those who spoke Spanish than English (aPR, 0.95; 95% CI, 0.93-0.98), with similar patterns for moderate/severe depressive symptoms (aPR [Latino individuals vs non-Latino White individuals], 0.93; 95% CI, 0.91-0.95); aPR [Spanish-speaking vs English-speaking Latino individuals], 0.95; 95% CI, 0.91-0.99).
CONCLUSIONS AND IMPLICATIONS
Latino individuals newly admitted to nursing homes appear to have less clinically diagnosed depression and are less likely to report moderate/severe depression. Language barriers in nursing homes should be addressed to help meet the needs of residents from ethnic minority populations.
目的
尽管最近人口结构发生了变化，但对于美国养老院居民的种族/族裔、语言障碍与心理健康之间的关联，我们知之甚少。我们旨在量化美国养老院中西班牙语语言障碍与抑郁症之间的关系。
设计
横断面研究。
设置与参与者
年龄≥50岁新入住美国养老院的拉丁裔和非拉丁裔白人成年人。
方法
利用2022年全国最低数据集3.0，我们识别出19780名新入住的拉丁裔居民，他们希望或需要西班牙语翻译来与医生或医护人员交流，以及不需要翻译的居民（n = 56969名拉丁裔个体，812456名非拉丁裔白人个体）。使用多变量对数二项式模型评估临床抑郁症诊断以及自我报告的患者健康问卷（PHQ - 9）得分≥10表示中度/重度抑郁症状。
结果
我们的样本大多为女性，且年龄≥75岁。说西班牙语和英语的拉丁裔个体的抑郁症患病率分别为29.5%和31.5%，说英语的非拉丁裔白人个体为36.0%；说西班牙语和英语的拉丁裔个体分别有17.5%和15.9%报告有中度/重度抑郁症状，说英语的非拉丁裔白人个体为15.6%。抗抑郁药的使用很普遍（最低：说西班牙语的拉丁裔个体为32.2%；最高：非拉丁裔白人个体为43.2%）；所有语言组中接受心理治疗的比例均<2%。与说英语的非拉丁裔白人个体相比，拉丁裔个体中临床诊断抑郁症的患病率较低（拉丁裔个体调整患病率比[aPR]，0.93；95%置信区间，0.92 - 0.95），并且在拉丁裔个体中，说西班牙语的个体比说英语的个体患病率更低（aPR，0.95；95%置信区间，0.93 - 0.98），中度/重度抑郁症状也有类似模式（aPR[拉丁裔个体与非拉丁裔白人个体相比]，0.93；95%置信区间，0.91 - 0.95）；aPR[说西班牙语与说英语的拉丁裔个体相比]，0.95；95%置信区间，0.91 - 0.99）。
结论与启示
新入住养老院的拉丁裔个体似乎临床诊断抑郁症的情况较少，且报告中度/重度抑郁症的可能性也较小。应解决养老院中的语言障碍问题，以帮助满足少数族裔居民的需求。
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