Are Depression and Frailty Overlapping Syndromes in Mid- and Late-life? A Latent Variable Analysis
Are Depression and Frailty Overlapping Syndromes in Mid- and Late-life? A Latent Variable Analysis
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DOI：
10.1016/j.jagp.2012.12.019
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发表时间：
2013-06-01
影响因子：
7.2
通讯作者：
Lapane, Kate L.
中科院分区：
文献类型：
--
作者：
Mezuk, Briana;Lohman, Matthew;Lapane, Kate L.
背景：抑郁和虚弱都预示着晚年的残疾和发病率。然而，目前还不清楚这些常见的老年综合征在多大程度上代表了重叠的结构。前言：目的：考察抑郁与脆弱的结构之间的关系。方法：数据来自2004年至2005年巴尔的摩流行病学流域研究的浪潮，分析仅限于40岁及以上的参与者，并具有关于脆弱和抑郁指标的完整数据(N=683)。抑郁用诊断性面谈程序测量，脆弱程度用修改后的Fry标准标示。一系列验证性潜在分类分析被用来评估抑郁症和虚弱综合征识别相同人群的程度。还估计了两个构造体之间的潜在卡帕系数(卡帕(L))。结果：验证性潜在分类分析表明，抑郁和虚弱代表不同的症状，而不是一个单一的结构。两个结构的联合模型支持抑郁的三级解决方案和脆弱的两级解决方案，2.9%的人被归类为重度抑郁，19.4%的人被归类为轻度抑郁，77.7%的人被归类为不抑郁，21.1%的人被归类为虚弱，78.9%的人被归类为不虚弱。机会校正一致性统计量显示抑郁与脆弱结构之间具有中等的一致性(Kappa(L)：66，95%可信区间：0.58~0.74)。结论：结果表明抑郁和脆弱是相互关联的概念，但他们的操作标准确定了实质上重叠的亚群。这些发现对于理解影响晚年抑郁和虚弱的病因和预后的因素具有重要意义。
Background: Depression and frailty both predict disability and morbidity in later life. However, it is unclear to what extent these common geriatric syndromes represent overlapping constructs. Objective: To examine the joint relationship between the constructs of depression and frailty. Methods: Data come from 2004-2005 wave of the Baltimore Epidemiologic Catchment Area Study, and the analysis is limited to participants 40 years and older, with complete data on frailty and depression indicators (N = 683). Depression was measured using the Diagnostic Interview Schedule, and frailty was indexed by modified Fried criteria. A series of confirmatory latent class analyses were used to assess the degree to which depression and frailty syndromes identify the same populations. A latent kappa coefficient (kappa(l)) was also estimated between the constructs. Results: Confirmatory latent class analyses indicated that depression and frailty represent distinct syndromes rather than a single construct. The joint modeling of the two constructs supported a three-class solution for depression and two-class solution for frailty, with 2.9% categorized as severely depressed, 19.4% as mildly depressed, and 77.7% as not depressed, and 21.1% categorized as frail and 78.9% as not frail. The chance-corrected agreement statistic indicated moderate correspondence between the depression and frailty constructs (kappa(l): 66, 95% confidence interval: 0.58-0.74). Conclusions: Results suggest that depression and frailty are interrelated concepts, yet their operational criteria identify substantively overlapping subpopulations. These findings have implications for understanding factors that contribute to the etiology and prognosis of depression and frailty in later life.