Exploring the effect of depression on physical disability: Longitudinal evidence from the established populations for epidemiologic studies of the elderly
Exploring the effect of depression on physical disability: Longitudinal evidence from the established populations for epidemiologic studies of the elderly
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DOI：
10.2105/ajph.89.9.1346
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发表时间：
1999-09-01
影响因子：
12.7
通讯作者：
Guralnik, JM
中科院分区：
文献类型：
--
作者：
Penninx, BWJH;Leveille, S;Guralnik, JM
目标。这项研究考察了抑郁对肢体残疾发生率的影响，以及混淆变量和解释变量在这种关系中的作用。一组6247名65岁及以上的受试者，他们最初没有残疾AM，进行了6年的随访。基线抑郁由流行病学研究中心抑郁量表评估。每年对患者的活动障碍和日常生活能力障碍进行评定。与5751名非抑郁者相比，496名抑郁者在日常生活和行动能力方面发生残疾的相对危险度(95%可信区间)分别为1.67(1.44，1.95)和1.73(1.54，1.94)。对社会人口特征和基线慢性病的调整将风险降低到1.39(1.18。1.63)和1.45(1.29，1.93)，抑郁症患者较少的体力活动和较少的社会接触进一步解释了他们残疾风险增加的部分原因。老年人抑郁可能会增加意外残疾的风险。这种额外风险的部分原因是抑郁症患者的体力活动和社交活动减少。应审查其他因素(例如，生物机制)的作用。
Objectives. This study examined thr effect of depression on the incidence of physical disability and the role of confounding and explanatory variables in this relationship.Methods. A cohort of 6247 subjects 65 years and older who were initially free of disability ams followed up for 6 years. Baseline depression was assessed by the Center for Epidemiological Studies Depression Scale. Disability in mobility and disability in activities of daily living were measured annually.Results. Compared with the 5751 nondepressed subjects, the 496 depressed subjects had a relative risk (95% confidence interval) of 1.67 (1.44, 1.95) and 1.73 (1.54, 1.94) for incident disability in activities of daily living and mobility, respectively. Adjustment for sociodemographic characteristics and baseline chronic conditions reduced the risks to 1.39 (1.18. 1.63) and 1.45 (1.29, 1.93), respectively Less physical activity and fewer social contacts among depressed persons further explained part of their increased disability risk.Conclusions. Depression in older persons may increase the risk for incident disability. This excess risk is partly explained by depressed persons' decreased physical activity and social interaction. The role of other factors (e.g., biological mechanisms) should be examined.