The emergence of depressive symptoms in late life: the importance of declining health and increasing disability.
The emergence of depressive symptoms in late life: the importance of declining health and increasing disability.
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DOI：
10.1007/bf01321314
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发表时间：
1990-04-01
影响因子：
5.9
通讯作者：
Thomas, C
中科院分区：
文献类型：
--
作者：
Kennedy, G J;Kelman, H R;Thomas, C
尽管晚年抑郁症的流行病学取得了相当大的进展，但晚年抑郁症状的决定因素和病程仍不清楚。横断面研究中一致发现，抑郁症和残疾之间存在明显的相互关系，这进一步混淆了估计老年人抑郁症状重要性的努力。在一项针对 1457 名老年社区居民的纵向研究中，他们在基线和 24 个月后完成了流行病学研究中心抑郁量表，其中 163 名受访者 (11%) 出现了显着的抑郁症状，而 1080 名受访者 (74%) 仍然没有症状。与其他研究不同的是，我们发现医疗状况、社会支持、生活事件和人口特征的数量对于区分那些出现症状的人和那些没有症状的人几乎没有贡献。然而，残疾的增加和健康状况的恶化先于抑郁症状的出现，并且占判别分析解释的方差的 70%。这些发现对晚年抑郁症的病程和决定因素具有病因学意义。
Despite considerable progress in the epidemiology of late life depressive disorders, the determinants and course of late life depressive symptoms remain unclear. The apparent reciprocal relationship between depression and disability, a consistent finding in cross-sectional studies further confounds efforts to estimate the importance of depressive symptoms in the elderly. In a longitudinal study of 1457 aged community residents who completed the Center for Epidemiologic Studies Depression scale at baseline and 24 months later, a significant level of depressive symptoms emerged in 163 respondents (11%), while 1080 (74%) remained symptom free. Unlike other studies, we found that the number of medical conditions, social support, life events, and demographic characteristics contributed little to distinguish those with emerging symptoms from those who remained symptom free. However, increasing disability and declining health preceded the emergence of depressive symptoms and accounted for seventy percent of the variance explained by discriminant analysis. These findings have etiologic implications for both the course and determinants of depression in late life.