Bruce M L, Seeman T E, Merrill S S, Blazer D G
Department of Epidemiology and Public Health, Yale University, New Haven, CT 06520-8034.
Am J Public Health. 1994 Nov;84(11):1796-9. doi: 10.2105/ajph.84.11.1796.
The purpose of these analyses was to test the hypothesis that depressive symptomatology affects the risk of onset of physical disability in high-functioning elderly adults.
The data come from the MacArthur Study of Successful Aging, a community-based cohort of high-functioning adults aged 70 through 79 years who were assessed twice at a 2.5-year interval. Physical and cognitive status was assessed by performance as well as by self-report measures.
In gender-stratified logistic regression models, high depressive symptoms as measured by the depression subscale of the Hopkins Symptom Checklist were associated with an increased risk of onset of disability in activities of daily living for both men and women, adjusting for baseline sociodemographic factors, physical health status, and cognitive functioning.
Joined with evidence that physical disability is a potential risk factor for depression, these findings suggest that both depressive symptoms and physical disability can initiate a spiralling decline in physical and psychological health. Given the important impact of activities-of-daily-living functioning on utilization of medical services and quality of life, prevention or reduction of depressive symptoms should be considered an important point of intervention.
这些分析的目的是检验这样一个假设,即抑郁症状会影响功能良好的老年人出现身体残疾的风险。
数据来自麦克阿瑟成功老龄化研究,这是一个基于社区的队列研究,研究对象为70至79岁功能良好的成年人,每隔2.5年进行两次评估。通过表现以及自我报告测量来评估身体和认知状况。
在按性别分层的逻辑回归模型中,根据霍普金斯症状清单抑郁分量表测量的高抑郁症状与男性和女性日常生活活动中出现残疾的风险增加相关,对基线社会人口学因素、身体健康状况和认知功能进行了调整。
结合身体残疾是抑郁的潜在风险因素这一证据,这些发现表明抑郁症状和身体残疾都会引发身心健康的螺旋式下降。鉴于日常生活活动功能对医疗服务利用和生活质量有重要影响,预防或减轻抑郁症状应被视为一个重要的干预点。