Dening T R, Chi L Y, Brayne C, Huppert F A, Paykel E S, O'Connor D W
Department of Psychiatry, Addenbrooke's NHS Trust, Fulbourn Hospital, Cambridge, UK.
Age Ageing. 1998 Jan;27(1):23-33. doi: 10.1093/ageing/27.1.23.
To study the relationships between global self-rated health, reported physical symptoms and depressive symptoms and the receipt of community services by very elderly people, and to examine changes in these variables over time.
Three-wave study with follow-up at 2.4 and 6 years after first interview. Structured interview, incorporating cognitive examination (Mini-Mental State Examination) and enquiring specifically about overall self-rated health, physical symptoms and depressive symptoms.
Community setting in city of Cambridge, UK.
2609 were initially recruited: all patients aged 75 years and over from lists of six general practices (and one in three from a seventh practice). At 2.4 years, 1173 individuals re-examined and at 6 years 628 individuals.
General health self-rated in comparison to others of similar age and individual physical and depressive symptoms self-rated as present or absent. Symptoms were added to produce physical health and depressive symptom scores. Data presented from cross-sectional analysis of 6-year sample; also examined longitudinal data from all three waves of study for ageing and cohort effects. Finally the effect of health variables on the receipt of services was examined. Statistics used included chi(2) and non-parametric statistics for continuous data, also odds ratios for likelihood of receiving services.
At 6 years, 70% rated their overall health as good or very good. Overall self-rated health showed both ageing and cohort effects, improving with increasing age and especially with more recent cohort. Reported physical symptoms increased with ageing. Depression scores also increased with ageing but the relationship between depressive symptoms and ageing was less clear-cut. Receipt of services was associated with poor self-rated health and reported physical symptoms as well as with ageing. Higher depression scores at 2.4 years were associated with increased service receipt at 6 years, indicating a lag between the symptoms and the service response. Individuals in the more recent cohort were less likely to receive services, but those who did so received more frequent contact.
Although very elderly people have a high prevalence of reported physical symptoms, they often rate their overall health as good. There was a stronger relationship between ageing and physical symptoms than with depressive symptoms. Symptoms of both kinds influenced the likelihood of receiving services, although there was a lag between depressive symptoms and service response. Cohort effects on service receipt may reflect changes in public service policy.
研究高龄老人总体自评健康状况、报告的身体症状和抑郁症状与接受社区服务之间的关系，并考察这些变量随时间的变化情况。
在首次访谈后2年、4年和6年进行随访的三波研究。采用结构化访谈，包括认知检查（简易精神状态检查表），并特别询问总体自评健康状况、身体症状和抑郁症状。
英国剑桥市的社区环境。
最初招募了2609人：来自6家普通诊所名单上所有75岁及以上的患者（以及第七家诊所三分之一的患者）。在2年时，对1173人进行了重新检查，在6年时对628人进行了重新检查。
与年龄相仿的其他人相比的总体健康自评，以及身体和抑郁症状自评是否存在。将症状相加得出身体健康和抑郁症状评分。数据来自对6年样本的横断面分析；还研究了来自研究所有三波的纵向数据，以分析衰老和队列效应。最后，考察了健康变量对接受服务的影响。使用的统计方法包括用于连续数据的卡方检验和非参数统计，以及接受服务可能性的比值比。
在6年时，70%的人将他们的总体健康评为良好或非常良好。总体自评健康状况显示出衰老和队列效应，随着年龄增长尤其是较近队列的人健康状况有所改善。报告的身体症状随年龄增长而增加。抑郁评分也随年龄增长而增加，但抑郁症状与衰老之间的关系不太明确。接受服务与自评健康状况差、报告的身体症状以及衰老有关。2年时较高的抑郁评分与6年时接受服务的增加有关，表明症状与服务反应之间存在滞后。较近队列的人接受服务的可能性较小，但接受服务的人得到的联系更频繁。
尽管高龄老人报告的身体症状患病率很高，但他们通常将自己的总体健康评为良好。衰老与身体症状之间的关系比与抑郁症状之间的关系更强。两种症状都影响接受服务的可能性，尽管抑郁症状与服务反应之间存在滞后。队列效应可能反映了公共服务政策的变化。
