Depression, Physical Function, and Risk of Mortality: National Diet and Nutrition Survey in Adults Older Than 65 Years
Depression, Physical Function, and Risk of Mortality: National Diet and Nutrition Survey in Adults Older Than 65 Years
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DOI：
10.1097/jgp.0b013e3181df465e
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发表时间：
2011-01-01
影响因子：
7.2
通讯作者：
Mishra, Gita D.
中科院分区：
文献类型：
--
作者：
Hamer, Mark;Bates, Christopher J.;Mishra, Gita D.
目的：作者使用客观的身体功能评估和一系列社会人口学、饮食和健康行为来探索可以解释65岁及以上社区老年参与者抑郁和死亡率之间关系的可能因素。设计：对老年人群进行国家饮食和营养调查的前瞻性随访。单位：社区样本。参与者：共有1007名参与者(522名男性，485名女性；平均年龄：76.4+/-7.3岁)。测量：用15项老年抑郁量表(GDS)评定抑郁，用握力评定身体功能。参与者接受了平均9.2年的死亡随访。结果：基线时，20.9%的参与者表现出抑郁(GDS-15评分=5)。抑郁的参与者在随访期间所有原因死亡的相对风险更高(年龄和性别调整后的危险比=1.24，95%可信区间：1.04-1.49)。抑郁症的其他风险因素也与死亡率有关，包括吸烟、缺乏体育活动和握力不足。这些因素共同解释了抑郁症和死亡率之间估计54%的关联。低度炎症和低血浆维生素C也与抑郁症和死亡率独立相关，但不能解释抑郁症和死亡率之间的任何联系。结论：老年抑郁症与较高的死亡风险相关。尽管需要进一步的纵向研究来充分阐明这些机制，但缺乏运动和身体功能障碍可能在一定程度上调节了这种联系。(《J Geriatr精神病学》2010；19：72-78)
Objective: The authors used an objective assessment of physical function and a range of sociodemographic, dietary, and health behaviors to explore the possible factors that could explain the association between depression and mortality in community-dwelling elderly participants aged 65 years and older. Design: Prospective follow-up of the National Diet and Nutrition Survey in older adults. Setting: Community sample. Participants: A total of 1,007 participants (522 men, 485 women; mean age: 76.4 +/- 7.3 years). Measurements: Depression was assessed from the 15 item Geriatric Depression Scale (GDS) and physical function using hand grip strength. Participants were followed up for death over an average of 9.2 years. Results: At baseline, 20.9% of participants demonstrated depression (GDS-15 score >= 5). Depressed participants were at a higher relative risk of all cause mortality during follow-up (age-and sex-adjusted hazard ratio = 1.24, 95% confidence interval: 1.04-1.49). Other risk factors for depression also related to mortality included smoking, physical inactivity, and low grip strength. These factors collectively explained an estimated 54% of the association between depression and mortality. Low-grade inflammation and low plasma vitamin C were also independently associated with depression and mortality but did not explain any of the association between depression and mortality. Conclusion: Late-life depression is associated with a higher risk of mortality. Physical inactivity and physical dysfunction might partly mediate this association, although further longitudinal studies are required to fully elucidate these mechanisms. (Am J Geriatr Psychiatry 2010; 19:72-78)