Depressive symptoms predict incident chronic disease burden 10 years later: Findings from the English Longitudinal Study of Ageing (ELSA)
Depressive symptoms predict incident chronic disease burden 10 years later: Findings from the English Longitudinal Study of Ageing (ELSA)
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DOI：
10.1016/j.jpsychores.2018.07.009
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发表时间：
2018-10-01
影响因子：
4.7
通讯作者：
Steptoe, Andrew
中科院分区：
文献类型：
--
作者：
Poole, Lydia;Steptoe, Andrew
目的：在前瞻性纵向分析中评估抑郁症状与慢性疾病负担之间的关系。方法：我们分析了来自英国老龄化纵向研究（ELSA）的2472名参与者（62.88±8.49岁，50.8%为女性）的数据。采用流行病学研究中心抑郁量表（CES-D）于2004年基线测量抑郁症状，并对参与者进行了10年的随访。基线时患有流行疾病（冠心病、其他心脏病、中风、癌症、糖尿病/高血糖、关节炎、肺病、骨质疏松症和帕金森病）的参与者被排除在预测随访期间疾病负担（报告疾病总数）的模型之外。线性回归用于控制大范围的协变量。结果：平均慢性疾病负担为0.57，其中43.1%至少经历过一次躯体疾病。基线连续CES-D评分是10年后发生慢性疾病负担的显著预测因子（发生率比= 1.05,95%可信区间= 0.05-0.21,p = 0.003），独立于社会人口学、行为、认知和临床相关变量。敏感性分析排除了基线后2年内发生慢性疾病的参与者，证实了主要结果。结论：抑郁症状与10年后更大的慢性疾病负担相关。这些发现对身体健康的老年人抑郁症的治疗具有临床意义。
Objective: To assess the association between depressive symptoms and incident chronic illness burden in prospective longitudinal analyses.Methods: We analysed data from 2472 participants (62.88 +/- 8.49 years old; 50.8% female) from the English Longitudinal Study of Ageing (ELSA). Depressive symptoms were measured using the Centre for Epidemiological Studies Depression (CES-D) scale at baseline in 2004, and participants were followed up for 10 years. Participants with prevalent illness at baseline (coronary heart disease [CHD], other cardiac illness, stroke, cancer, diabetes/high blood glucose, arthritis, lung disease, osteoporosis and Parkinson's disease) were excluded from models predicting illness burden (the sum of illnesses reported) over follow-up. Linear regression was used controlling for a wide range of covariates.Results: The mean chronic illness burden was 0.57, with 43.1% experiencing at least one incident physical illness. Baseline continuous CES-D score was a significant predictor of incident chronic illness burden up to 10 years later (incident rate ratio = 1.05, 95% confidence intervals = 0.05-0.21, p = .003), independent of sociodemographic, behavioural, cognitive and clinical covariates. Sensitivity analyses excluding participants who developed a chronic illness within the 2 years following baseline corroborated the main results.Conclusion: Depressive symptoms were associated with greater incident chronic illness burden 10 years later. These findings have clinical implications for the treatment of depression in physically healthy older adults.