Prevalence and risk factors for depression in a longitudinal, population-based study including individuals in the community and residential care
Prevalence and risk factors for depression in a longitudinal, population-based study including individuals in the community and residential care
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DOI：
10.1097/jgp.0b013e31802e21d8
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发表时间：
2007-06-01
影响因子：
7.2
通讯作者：
Luszcz, Mary A.
中科院分区：
文献类型：
--
作者：
Anstey, Kaarin J.;von Sanden, Chwee;Luszcz, Mary A.
目的：作者报告了生活在社区和寄宿护理中的老年人的抑郁症患病率。人口统计、医疗、健康行为、功能和认知测量以及向住院护理的过渡被评估为八年来抑郁症的危险因素。方法：抑郁症患病率估计值是从澳大利亚老龄化纵向研究的初始选举角色样本中获得的，其中包括居住在寄宿护理中的人员。基于随访数据的子样本 (N = 1,116) 被纳入纵向多级分析，该分析评估与流行病学中心抑郁量表评分相关的人际和人内预测因素。结果：在第一波中，14.4% 的社区居民和 32.0% 的寄宿护理参与者患有抑郁症（占总病例的 15.2%）。抑郁症的增加与抗抑郁状态、性别、教育和婚姻状况有关，但与高血压、中风、糖尿病、心脏病或吸烟史无关。随时间变化的预测因素，包括住宿护理、日常生活活动、日常生活工具性活动、健康自评和简易精神状态检查，可以预测人与人之间和人体内的抑郁症状。结论：抑郁症与依赖性增加的因素密切相关。预防晚年抑郁症的风险评估和干预策略目标应纳入功能能力、精神状态和住院护理需求的变化。
Objective: The authors report the population prevalence of depression in older adults living in the community and in residential care. Demographic, medical, health behavior, functional and cognitive measures, and transition to residential care are evaluated as risk factors for depression over eight years. Methods: Depression prevalence estimates were obtained from the initial electoral role sample of the Australian Longitudinal Study of Ageing that included persons living in residential care. A subsample (N = 1,116) based on follow-up data were included in longitudinal multilevel analyses that evaluated between-person and within-person predictors associated with scores from the Center for Epidemiology - Depression Scale. Results: At wave 1, 14.4% of community-dwelling and 32.0% of residential care-dwelling participants were depressed (15.2% of total cases). Increase in depression was associated with antidepressant status, sex, education, and marital status, but not history of hypertension, stroke, diabetes, heart disease, or smoking. Time-varying predictors, including residential care, activities of daily living, instrumental activities of daily living, self-rated health, and Mini-Mental State Examination, predicted depressive symptoms both between and within persons. Conclusions: Depression is strongly linked with factors indicating increased dependency. Risk assessment and targeting of intervention strategies to prevent depression in late life should incorporate changes in functional capacity, mental status, and need for residential care.