Depressive symptoms and physical decline in community-dwelling older persons
Depressive symptoms and physical decline in community-dwelling older persons
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DOI：
10.1001/jama.279.21.1720
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发表时间：
1998-06-03
影响因子：
120.7
通讯作者：
Wallace, RB
中科院分区：
文献类型：
--
作者：
Penninx, BWJH;Guralnik, JM;Wallace, RB
背景：抑郁症的显着症状在老年社区居民中很常见。尽管抑郁症状和残疾通常可能发生在同一个人身上，但抑郁症状是否会导致随后的功能下降尚未得到阐明。目的：通过基于客观表现的测试来确定老年人的抑郁症状是否会增加随后身体功能下降的风险。设计。-一项为期 4 年的前瞻性队列研究。背景。-爱荷华州和华盛顿县的社区。参与者。-总共 1286 名 71 岁及以上的人在 1988 年完成了一系列简短的身体机能测试，并于 4 年后再次完成。主要结果测量 - 基线抑郁症状由流行病学研究中心抑郁量表进行评估。身体机能测试包括站立平衡评估、定时 2.4 米（8 英尺）步行，以及 5 次重复从椅子上站起来和坐下的定时测试。结果 - 在调整远基线性能评分、健康状况和社会人口学因素后，抑郁症状水平的增加预示着 4 年内身体机能会出现更大的下降（情绪抑郁者与情绪低落者相比，下降的优势比为 1.55；95% 置信度 区间[CI]，1.02-2.34），即使在那些没有报告残疾的功能谱高端的人中，抑郁症状的严重程度也预示着随后身体表现的下降（下降的优势比，1.03；95% CI，1.00-1.08）。结论。-这项研究提供的证据表明，报告抑郁症状的老年人随后身体表现下降的风险更高。这些结果表明，预防 或减少抑郁情绪可能有助于减少老年人的功能衰退。
Context.-Significant symptoms of depression are common in the older community-dwelling population. Although depressive symptoms and disability may commonly occur in the same person, whether depressive symptoms contribute to subsequent functional decline has not been elucidated,Objective.-To determine whether depressive symptoms in older persons increase the risk of subsequent decline in physical function as measured by objective performance-based tests.Design.-A 4-year prospective cohort study.Setting.-The communities of Iowa and Washington counties, Iowa.Participants.-A total of 1286 persons aged 71 years and older who completed a short battery of physical performance tests in 1988 and again 4 years later.Main Outcome Measures.-Baseline depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale. Physical performance tests included an assessment of standing balance, a timed 2.4-m (8-ft) walk, and a timed test of 5 repetitions of rising from a chair and sitting down.Results.-After adjustment far baseline performance score, health status, and sociodemographic factors, increasing levels of depressive symptoms were predictive of greater decline in physical performance over 4 years (odds ratio for decline in those with depressed mood vs those without, 1.55; 95% confidence interval [CI], 1.02-2.34), Even among those at the high end of the functional spectrum, who reported no disability, the severity of depressive symptoms predicted subsequent decline in physical performance (odds ratio for decline, 1.03; 95% CI, 1.00-1.08).Conclusions.-This study provides evidence that older persons who report depressive symptoms are at higher risk of subsequent physical decline, These results suggest that prevention or reduction of depressed mood could play a role in reducing functional decline in older persons.