Higher burden of depression among older women - The effect of onset, persistence, and mortality over time
Higher burden of depression among older women - The effect of onset, persistence, and mortality over time
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DOI：
10.1001/archgenpsychiatry.2007.17
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发表时间：
2008-02-01
影响因子：
--
通讯作者：
Gill, Thomas M.
中科院分区：
文献类型：
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作者：
Barry, Lisa C.;Allore, Heather G.;Gill, Thomas M.
内容：老年女性抑郁症的患病率高于男性，但这种性别差异的原因尚不清楚。目的：确定老年女性抑郁症的负担高于男性是否可能归因于发病的性别差异。（即首次或复发）或抑郁症的持续存在和/或抑郁症患者的死亡率差异。设计：前瞻性队列研究。设置：在大纽黑文，康涅狄格州的一般社区，从1998年3月23日，到2005年8月31日。参与者：共754人，70岁或以上，他们在18个月的时间间隔为72个月进行评估。主要结果测量：3种结局状态为抑郁、非抑郁和死亡，流行病学研究中心抑郁量表评分≥ 20分和<20分分别表示抑郁和非抑郁。性别和6个可能的过渡（即，从非抑郁或抑郁到非抑郁，抑郁，或死亡）的可能性之间的关联进行了评估随着时间的推移。结果：抑郁症的患病率大大高于男性在每个5个时间点（P = 10点）。调整其他人口统计学特征后，女性从非抑郁症转变为抑郁症的可能性更高。（比值比，2.02; 95%置信区间，1.39-2.94）和从抑郁症转变为非抑郁症的可能性较低（比值比，0.27; 95%置信区间，0.13-0.56）或死亡（比值比，0.24; 95%可信区间，0.09-0.60）。在老年人中，妇女抑郁症的负担高于男子，这似乎是由于她们更容易患抑郁症，而且一旦抑郁，抑郁症的持续时间更长，死亡的可能性更低。
Context: The prevalence of depression is disproportionately higher in older women than men, yet the reasons for this sex difference are not clear.Objective: To determine whether the higher burden of depression among older women than men might be attributable to sex differences in the onset (ie, first or recurrent episodes) or persistence of depression and/or to differential mortality among those who are depressed.Design: Prospective cohort study.Setting: General community in greater New Haven, Connecticut, from March 23, 1998, to August 31, 2005.Participants: A total of 754 persons, 70 years or older, who were evaluated at 18-month intervals for 72 months.Main Outcome Measures: The 3 outcome states were depressed, nondepressed, and death, with scores of 20 or more and less than 20 on the Center for Epidemiological Studies Depression Scale denoting depressed and nondepressed, respectively. The association between sex and the likelihood of 6 possible transitions (namely, from nondepressed or depressed to nondepressed, depressed, or death) was evaluated over time.Results: The prevalence of depression was substantially higher among women than men at each of the 5 time points (P = 10 points). Adjusting for other demographic characteristics, women had a higher likelihood of transitioning from nondepressed to depressed (odds ratio, 2.02; 95% confidence interval, 1.39-2.94) and a lower likelihood of transitioning from depressed to nondepressed (odds ratio, 0.27; 95% confidence interval, 0.13-0.56) or death (odds ratio, 0.24; 95% confidence interval, 0.09-0.60).Conclusion: Among older persons, the higher burden of depression in women than men seems to be attributable to a greater susceptibility to depression and, once depressed, to more persistent depression and a lower probability of death.