Does Informal Care Attenuate the Cycle of ADL/IADL Disability and Depressive Symptoms in Late Life?
Does Informal Care Attenuate the Cycle of ADL/IADL Disability and Depressive Symptoms in Late Life?
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DOI：
10.1093/geronb/gbr060
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发表时间：
2011-09-01
影响因子：
6.2
通讯作者：
Wu, Hsueh-Sheng
中科院分区：
文献类型：
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作者：
Lin, I-Fen;Wu, Hsueh-Sheng
目标。先前的研究已经广泛地研究了晚年残疾和抑郁症状之间的相互关系，但很少有人知道非正式护理是否会随着时间的推移减弱这种相互关系。本研究考察残疾和抑郁症状是否调动了非正式护理，以及非正式护理一旦调动起来，是否能保护老年人免受残疾和抑郁症状的发展。该分析基于6,454名居住在社区的老年人，他们在1998年至2006年的一次或多次健康与退休研究中接受了采访。扩展自回归交叉滞后模型，我们构建了残疾、抑郁症状和非正式护理之间关系的3个周期。比较三个周期之间的关系告诉我们，随着时间的推移，非正式护理对残疾和抑郁症状之间关系的减弱作用。虽然老年人的残疾和抑郁症状最初调动了非正式护理，但残疾和抑郁症状的恶化往往耗尽了支持。一般来说，接受治疗的残疾和抑郁症状增加了，而不是减少了，而且随着时间的推移，有害的影响仍然没有改变。我们需要更好地了解残疾和抑郁症状之间的联系，并寻求有效的干预措施，以减少照顾者的压力，提高接受照顾者的福祉。
Objective. Prior studies have extensively examined the reciprocal relation between disability and depressive symptoms in late life, but little is known about whether informal care attenuates the reciprocal relation over time. This study examined whether disability and depressive symptoms mobilize informal care and whether informal care, once mobilized, protects older adults against the progression of disability and depressive symptoms.Methods. The analysis was based on 6,454 community-dwelling older adults who were interviewed in one or more waves of the Health and Retirement Study between 1998 and 2006. Extending an autoregressive cross-lagged model, we constructed 3 cycles of the relations among disability, depressive symptoms, and informal care. Comparing the relations across 3 cycles informs us about the attenuating effect of informal care on the relation between disability and depressive symptoms over time.Results. Although older adults' disability and depressive symptoms mobilized informal care initially, worsening disability and depressive symptoms often exhausted support. Receipt of care generally increased, rather than decreased, disability and depressive symptoms, and the detrimental effects remained the same over time.Discussion. We need to better understand the linkage between disability and depressive symptoms and seek effective interventions to reduce caregiver strain and enhance care receivers' well-being.