Pulska T, Pahkala K, Laippala P, Kivelä S L
University of Oulu, Department of Public Health Science and General Practice, Finland.
Int J Geriatr Psychiatry. 1997 Sep;12(9):942-50.
The 6-year survival of depressed elderly (N = 290) Finns was assessed and compared to that of a non-depressed population (N = 982), and the factors related to high mortality were analysed.
Depression was determined according to the DSM-III criteria, and a majority of the depressed population suffered from dysthymic disorder. Survival distributions were represented as Kaplan-Meier survival curves. The Cox proportional hazards model was used to analyse the simultaneous relationships between mortality and certain variables.
The survival curves showed an increased mortality of the depressed elderly in both men and women. However, when the simultaneous relationships of age, marital status, education, smoking, functional abilities, somatic illnesses and depression were taken into account, depression did not predict mortality. The predictors of mortality were high age, a high number of medicines, smoking, disability, male sex and occurrence of somatic illnesses.
Evidence of once measured depression is not predictive of increased mortality in an unselected elderly population (60+) when the other factors known to influence survival probability are taken into account.
评估了290名芬兰老年抑郁症患者的6年生存率，并与982名非抑郁症患者的生存率进行比较，同时分析了与高死亡率相关的因素。
根据《精神疾病诊断与统计手册》第三版（DSM-III）标准确定抑郁症，大多数抑郁症患者患有心境恶劣障碍。生存分布以Kaplan-Meier生存曲线表示。采用Cox比例风险模型分析死亡率与某些变量之间的同时关系。
生存曲线显示，老年抑郁症患者无论男女死亡率均有所增加。然而，在考虑年龄、婚姻状况、教育程度、吸烟、功能能力、躯体疾病和抑郁症的同时关系时，抑郁症并不能预测死亡率。死亡率的预测因素包括高龄、大量用药、吸烟、残疾、男性以及躯体疾病的发生。
当考虑到其他已知影响生存概率的因素时，单次测量的抑郁症证据并不能预测未经过筛选的老年人群（60岁以上）死亡率的增加。
