Trends in Depressive Symptom Burden Among Older Adults in the United States from 1998 to 2008
Trends in Depressive Symptom Burden Among Older Adults in the United States from 1998 to 2008
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DOI：
10.1007/s11606-013-2533-y
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发表时间：
2013-12-01
影响因子：
5.7
通讯作者：
Vijan, Sandeep
中科院分区：
文献类型：
--
作者：
Zivin, Kara;Pirraglia, Paul A.;Vijan, Sandeep
背景：在过去的十年中，美国抑郁症的诊断和治疗有所增加。老年人自我报告的抑郁症状是否伴随下降尚不清楚。为了检查1998年至2008年美国老年人抑郁症状的趋势。六项两年期评估的系列横断面分析。健康与退休研究（HRS），一项全国代表性调查。患者或其他参与者55岁及以上的成年人流行病学研究中心抑郁量表（CES-D8）评估了三个级别的抑郁症状（无= 0，升高= 4+，重度= 6+），根据人口统计学和临床特征进行调整。10年来，没有抑郁症状的人从40.9%增加到47.4%（患病率[PR]：1.16，95%CI：1.13-1.19），与55-59岁的人群相比，60岁的人群患病率显著增加。升高症状的患病率从15.5%降至14.2%（PR：0.93，95%CI：0.88-0.98），这在80-84岁的人群中最为明显，其中升高症状的患病率从14.3%降至9.6%。重度抑郁症状的患病率从5.8%增加到6.8%（PR：1.17，95%CI：1.06-1.28）;然而，这种增加仅限于55-59岁的人群，重度症状的概率从8.7%增加到11.8%。1998年至2008年，老年抑郁症状负担总体上显著下降。这种下降似乎主要是由于最年长者的抑郁症状减少，而没有抑郁症状的人增加。这些症状负担的变化对身体、功能、人口统计学和经济因素具有鲁棒性。未来的研究应该检查抑郁症状的减少是否与治疗结果的改善有关，以及不同年龄组接受的治疗是否发生了变化。
CONTEXT: Diagnosis and treatment of depression has increased over the past decade in the United States. Whether self-reported depressive symptoms among older adults have concomitantly declined is unknown.To examine trends in depressive symptoms among older adults in the US between 1998 and 2008.Serial cross-sectional analysis of six biennial assessments.Health and Retirement Study (HRS), a nationally-representative survey.PATIENTS OR OTHER PARTICIPANTSAdults aged 55 and older (N = 16,184 in 1998).The eight-item Center for Epidemiologic Studies Depression scale (CES-D8) assessed three levels of depressive symptoms (none = 0, elevated = 4+, severe = 6+), adjusting for demographic and clinical characteristics.Having no depressive symptoms increased over the 10-year period from 40.9 % to 47.4 % (prevalence ratio [PR]: 1.16, 95 % CI: 1.13-1.19), with significant increases in those aged a parts per thousand yen 60 relative to those aged 55-59. There was a 7 % prevalence reduction of elevated symptoms from 15.5 % to 14.2 % (PR: 0.93, 95 % CI: 0.88-0.98), which was most pronounced among those aged 80-84 in whom the prevalence of elevated symptoms declined from 14.3 % to 9.6 %. Prevalence of having severe depressive symptoms increased from 5.8 % to 6.8 % (PR: 1.17, 95 % CI: 1.06-1.28); however, this increase was limited to those aged 55-59, with the probability of severe symptoms increasing from 8.7 % to 11.8 %. No significant changes in severe symptoms were observed for those aged a parts per thousand yen 60.Overall late-life depressive symptom burden declined significantly from 1998 to 2008. This decrease appeared to be driven primarily by greater reductions in depressive symptoms in the oldest-old, and by an increase in those with no depressive symptoms. These changes in symptom burden were robust to physical, functional, demographic, and economic factors. Future research should examine whether this decrease in depressive symptoms is associated with improved treatment outcomes, and if there have been changes in the treatment received for the various age cohorts.