Meyers B S, Bruce M L
Department of Psychiatry, Cornell University Medical College, White Plains, NY 10605, USA.
Psychopharmacol Bull. 1997;33(4):701-5.
Most randomized controlled trials of antidepressant efficacy in older depressive patients use outcome measures similar to those applied in younger patients. Defining subjects as geriatric based on chronological age alone misses the opportunity to study relationships among efficacy, safety, and the range of impairments associated with aging. Assessment of outcomes related to the medical comorbidities and disabilities associated with late-life depression is needed to understand the broad range of treatment effects. Assessment of changes in subjective and objective measures of functioning can address relationships between clinical state and health-related quality of life. Sensitive measurement of the number and severity of comorbid medical illnesses can precisely characterize the study sample and assess the impact of efficacious treatment on medical illnesses. In long-term studies of heterogeneous geriatric samples, use of appropriate outcome measures can determine the effect of efficacious treatment on changes in health status and functional independence.
大多数针对老年抑郁症患者抗抑郁疗效的随机对照试验所使用的结局指标，与用于年轻患者的指标类似。仅根据实际年龄将受试者定义为老年人，就错失了研究疗效、安全性以及与衰老相关的一系列损伤之间关系的机会。需要评估与晚年抑郁症相关的医学合并症和残疾的结局，以了解广泛的治疗效果。评估功能的主观和客观指标的变化，可以揭示临床状态与健康相关生活质量之间的关系。对合并症的数量和严重程度进行灵敏测量，能够精确地描述研究样本，并评估有效治疗对医学疾病的影响。在对异质性老年样本的长期研究中，使用适当的结局指标可以确定有效治疗对健康状况变化和功能独立性的影响。
