Incidence of disability among preretirement adults: The impact of depression
Incidence of disability among preretirement adults: The impact of depression
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DOI：
10.2105/ajph.2004.050948
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发表时间：
2005-11-01
影响因子：
12.7
通讯作者：
Chang, RW
中科院分区：
文献类型：
--
作者：
Dunlop, DD;Manheim, LM;Chang, RW
目标。我们在标准化评估的基础上，评估了抑郁症对日常生活活动能力 (ADL) 残疾风险的影响。方法。 2 年 ADL 残疾的抑郁相关风险是根据全国人口样本中 6871 名年龄在 54-65 岁且无基线 ADL 残疾的参与者估算得出的。我们评估了适合临床和公共卫生干预的因素的影响，这些因素可能解释抑郁症和事故致残之间的关系。结果。抑郁症成年人出现 ADL 障碍的几率是非抑郁症同龄人的 4.3 倍（95% 置信区间 = 3.1, 6.0）。在患有抑郁症的成年人中，18.7% 的非裔美国人、8.0% 的白人和 7.8% 的西班牙裔美国人在 2 年内出现残疾。因抑郁症引起的人口比例为 17.3%（95% 置信区间 = 11%、24%）。同时存在的健康因素可调节抑郁相关风险。结论。在医疗费用即将通过医疗保险支付的人群中，因抑郁症而导致的 ADL 残疾风险升高，会因适合公共卫生干预的因素而减弱。预防和/或公共卫生/政策计划可以提供更容易获得和更有效的心理健康和医疗护理，可以减少抑郁成人中日常生活能力障碍的发展。
Objectives. We evaluated the effect of,depression on risk, on the basis of standardized assessment, for developing activities of daily living (ADL) disability.Methods. Depression-related risk on 2-year ADL disability is estimated from 6871 participants in a population-based national sample aged 54-65 years and free of baseline ADL disability. We evaluated the effects of factors amenable to clinical and public health intervention that may explain the relationship between depression and incident disability.Results. The odds of ADL disability were 4.3 times greater for depressed adults than their non-depressed peers (95% confidence interval = 3.1, 6.0). Among depressed adults, 18.7% of African Americans, 8.0% of Whites, and 7.8% of Hispanics developed disability within 2 years. The attributable population fraction because of depression is 17.3% (95% confidence interval = 11%, 24%). Concurrent health factors moderated depression-associated risk.Conclusions. Elevated risk of ADL disability onset because of depression, in a cohort whose medical costs will imminently be covered via Medicare, is attenuated by factors amenable to public health intervention. Prevention and/or public health/ policy programs that lead to more accessible and effective mental health and medical care could reduce the development of ADL disability among depressed adults.