Dual sensory loss and depressive symptoms: the importance of hearing, daily functioning, and activity engagement
Dual sensory loss and depressive symptoms: the importance of hearing, daily functioning, and activity engagement
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DOI：
10.3389/fnhum.2013.00837
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发表时间：
2013-12-16
影响因子：
2.9
通讯作者：
Luszcz, Mary A.
中科院分区：
文献类型：
--
作者：
Kiely, Kim M.;Anstey, Kaarin J.;Luszcz, Mary A.
背景：双重感觉丧失（DSL）和心理健康之间的联系已经得到很好的建立。然而，大多数研究都依赖于自我报告数据，缺乏使研究人员能够检查DSL和抑郁症之间因果关系的措施。本研究旨在扩大这项研究，通过检查DSL对心理健康的影响，并确定因素，解释感官丧失和抑郁症状之间的纵向关联。方法：分段线性混合模型被用来分析16年的纵向数据收集到5个场合，从1611成年人（51%的男性）年龄在65岁和103岁之间。抑郁症状由流行病学研究中心抑郁症（CES-D）评估。视力丧失（VL）定义为较好眼的矫正视力>0.3 log MAR、失明或青光眼。听力损失（HL）定义为听力较好耳的纯音平均值（PTA）>25 dB。分析调整了社会人口统计学，医疗条件，生活方式行为，日常生活活动（ADL），认知功能，和social engagement.Results：未经调整的模型表明，较高水平的抑郁症状与HL（B = 1.16，SE = 0.33）和DSL（B = 2.15，SE = 0.39），但不是VL。在HL（B = 0.16，SE = 0.06，p < 0.01）和DSL（B = 0.30，SE = 0.09，p < 0.01）发作后，抑郁症状的变化率也明显更高。抑郁症状和感觉丧失之间的关联被解释的困难与日常生活能力，和social engagement.Conclusion：视力和HL是非常普遍的老年人和他们的共同发生可能复合各自的影响健康，功能和活动参与，从而发挥强大的影响，对心理健康和幸福的那些受影响的。因此，需要康复计划对感觉丧失对个体的综合影响敏感。
Background: The association between dual sensory loss (DSL) and mental health has been well established. However, most studies have relied on self-report data and lacked measures that would enable researchers to examine causal pathways between DSL and depression. This study seeks to extend this research by examining the effects of DSL on mental health, and identify factors that explain the longitudinal associations between sensory loss and depressive symptoms.Methods: Piecewise linear-mixed models were used to analyze 16-years of longitudinal data collected on upto five occasions from 1611 adults (51% men) aged between 65 and 103 years. Depressive symptoms were assessed by the Centre for Epidemiological Studies Depression (CES-D). Vision loss (VL) was defined by corrected visual acuity >0.3 log MAR in the better eye, blindness, or glaucoma. Hearing loss (HL) was defined by pure-tone average (PTA) >25 dB in the better hearing ear. Analyses were adjusted for socio-demographics, medical conditions, lifestyle behaviors, activities of daily living (ADLs), cognitive function, and social engagement.Results: Unadjusted models indicated that higher levels of depressive symptoms were associated with HL (B = 1.16, SE = 0.33) and DSL (B = 2.15, SE = 0.39) but not VL. Greater rates of change in depressive symptoms were also evident after the onset of HL (B = 0.16, SE = 0.06, p < 0.01) and DSL (B = 0.30, SE = 0.09, p < 0.01). The associations between depressive symptoms and sensory loss were explained by difficulties with ADLs, and social engagement.Conclusion: Vision and HL are highly prevalent among older adults and their co-occurrence may compound their respective impacts on health, functioning, and activity engagement, thereby exerting strong effects on the mental health and wellbeing of those affected. There is therefore a need for rehabilitation programs to be sensitive to the combined effects of sensory loss on individuals.