Frailty and depression: Reciprocal influences or common causes?
Frailty and depression: Reciprocal influences or common causes?
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DOI：
10.1016/j.socscimed.2020.113273
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发表时间：
2020-10-01
影响因子：
5.4
通讯作者：
Freidl, Wolfgang
中科院分区：
文献类型：
--
作者：
Mayerl, Hannes;Stolz, Erwin;Freidl, Wolfgang
背景：先前的研究表明，晚年虚弱和抑郁之间存在实质性的联系，但尚不清楚这种关系是由这些变量的相互影响还是由共同原因来解释的。本研究通过检查个体内部的交叉滞后效应，同时考虑个体之间基线水平和长期发展的可变性，调查了虚弱和抑郁之间的相互依赖关系。方法：我们模拟了欧洲健康、老龄化和退休调查中收集的六个面板波的纵向数据，涵盖了长达14年的时间。总样本量为N = 58,152名年龄在50岁及以上的个体。虚弱基于缺陷积累虚弱指数，抑郁症状用EURO-D量表测量。我们使用带有结构化残差的潜在曲线模型进行统计分析。结果：研究结果未显示出虚弱和抑郁在人体内水平的相关交叉滞后效应。然而，在同一时间点，身体虚弱的增加伴随着抑郁的增加。在人与人之间的水平上，研究表明，在脆弱方面水平较高、轨迹更陡峭的个体，在抑郁方面也往往表现出更高水平、更陡峭的轨迹。结论：这些发现质疑了虚弱和抑郁在一段时间内相互影响的观点，而是表明虚弱和抑郁可能在短期和长期内都受到共同原因的影响。
Background: Previous research demonstrated substantial associations between frailty and depression in late life, but it remains unclear whether this relationship is best explained by reciprocal influences of these variables or by common causes. This study investigated the interdependencies between frailty and depression across time by examining cross-lagged effects within individuals, while accounting for variability in baseline levels and long-term development between individuals.Methods: We modeled longitudinal data from six panel waves gathered in the Survey of Health, Ageing and Retirement in Europe, covering a time period of up to 14 years. The total sample size was N = 58,152 individuals aged 50 years or older. Frailty was based on a deficit accumulation frailty index and depressive symptoms were measured with the EURO-D scale. We used a latent curve model with structured residuals for statistical analysis.Results: The results did not demonstrate relevant cross-lagged effects of frailty and depression at the within-person level. However, within-person increases in frailty were accompanied by within-person increases in depression at the same point in time. At the between-person level, it showed that individuals with higher levels and steeper trajectories in frailty also tend to show higher levels and steeper trajectories in depression.Conclusion: These findings question the notion that frailty and depression reciprocally influence each other over the course of time, but rather indicate that frailty and depression might be both affected by common causes, in both the short and the long term.