Frailty as a predictor of the incidence and course of depressed mood.
Frailty as a predictor of the incidence and course of depressed mood.
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DOI：
10.1016/j.jamda.2015.01.088
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发表时间：
2015-06-01
影响因子：
7.6
通讯作者：
Voshaar, Richard C. Oude
中科院分区：
文献类型：
--
作者：
Collard, Rose M.;Comijs, Hannie C.;Naarding, Paul;Penninx, Brenda W.;Milaneschi, Yuri;Ferrucci, Luigi;Voshaar, Richard C. Oude
晚年抑郁和身体虚弱被认为是相互关联的，然而，缺乏纵向研究。这项研究调查了身体虚弱是否预示着抑郁症的发生率更高，以及抑郁症的病程是否更不利。一项以人群为基础的队列研究，对888名65岁及以上的人进行了3年、6年和9年的跟踪调查。根据年龄、性别、教育程度、吸烟、饮酒和整体认知功能调整后的Cox比例风险模型，计算基线时非抑郁者(n=699)的抑郁情绪发生率，以及基线时有抑郁情绪者(n=189)的缓解发生率。抑郁情绪的开始或缓解被定义为超过流行病学研究中心抑郁量表上20分的分界点，并结合这一分数的相关变化。身体虚弱是基于≥存在的5个组成部分中的3个(即体重减轻、虚弱、迟缓、疲惫和低体力活动水平)。在699名非抑郁者中，共有214人(30.6%)在随访期间出现抑郁情绪。身体虚弱预测抑郁情绪的发生，危险率为1.26(95%可信区间1.09-1.45，P=0.002)。在189名基线时有抑郁情绪的人中，96人(50.8%)在随访期间得到缓解。身体虚弱程度越高，缓解的可能性越小(危险率=0.72，95%可信区间0.58-0.91，P=0.005)。由于身体虚弱可以预测晚年抑郁情绪的发生和发展，因此在老年人的心理保健计划及其对治疗的干扰中，身体虚弱应该受到更多的关注。未来对病理生理机制的研究可能会指导这些脆弱患者开发新的治疗机会。
Late-life depression and physical frailty are supposed to be reciprocally associated, however, longitudinal studies are lacking. This study examines whether physical frailty predicts a higher incidence of depression, as well as a less favorable course of depression. A population-based cohort study of 888 people aged 65 years and over with follow-up measures at 3, 6, and 9 years. Cox proportional hazards models adjusted for age, sex, education, smoking, alcohol usage, and global cognitive functioning were applied to calculate the incidence of depressed mood in those nondepressed at baseline (n = 699) and remission in those with depressed mood at baseline (n = 189). Depressed mood onset or remission was defined as crossing the cut-off score of 20 points on the Center for Epidemiological Studies-Depression Scale combined with a relevant change in this score. Physical frailty was based on the presence of ≥3 out of 5 components (ie, weight loss, weakness, slowness, exhaustion, and low physical activity level). A total of 214 out of 699 (30.6%) nondepressed persons developed depressed mood during follow-up. Physical frailty predicted the onset of depressed mood with a hazard rate of 1.26 (95% confidence interval 1.09–1.45, P = .002). Of the 189 persons with depressed mood at baseline, 96 (50.8%) experienced remission during follow-up. Remission was less likely in the presence of a higher level of physical frailty (hazard rate = 0.72, 95% confidence interval 0.58–0.91, P = .005). Because physical frailty predicts both the onset and course of late-life depressed mood, physical frailty should receive more attention in mental health care planning for older persons as well as its interference with treatment. Future studies into the pathophysiological mechanisms may guide the development of new treatment opportunities for these vulnerable patients.
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DOI：
10.1016/j.jamda.2013.10.001
发表时间：
2014-01-01
影响因子：
7.6
作者：
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