Comorbidities and depression in older adults with HIV
Comorbidities and depression in older adults with HIV
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DOI：
10.1071/sh11017
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发表时间：
2011-01-01
期刊：
影响因子：
1.6
通讯作者：
Karpiak, Stephen E.
中科院分区：
文献类型：
--
作者：
Havlik, Richard J.;Brennan, Mark;Karpiak, Stephen E.
目的：调查老年艾滋病毒感染者中抑郁症的高发病率是否与合并症的数量和类型相关。方法：老年艾滋病毒感染者研究 (ROAH) 研究收集了纽约市 1000 名 50 岁及以上艾滋病毒阳性男性和女性的自我报告健康数据。参与者提供了过去一年中经历的健康问题和抑郁症状的数据（流行病学研究中心抑郁量表（CES-D））。使用非参数关联检验和多元回归分析来分析数据。结果：CES-D 评分与合并症数量之间存在显着相关性 (r = 0.24)。在多变量分析中，除了女性、收入不足、吸毒和酗酒史、艾滋病诊断和健康自评之外，抑郁症仍然是合并症数量的一个显着协变量。抑郁症与特定合并症的相关性各不相同。观察到与感觉丧失和皮肤病问题的显着相关性。与心脏和呼吸系统疾病以及骨折存在显着相关性，但这些横截面关系的方向性尚不确定。结论：研究结果表明需要进一步的纵向研究来了解抑郁症状的高发生率与合并症的相关性。致力于防止免疫系统崩溃的集中临床护理必须发展成为针对多种疾病的有效治疗策略，其中艾滋病毒只是许多其他慢性疾病之一。如果抑郁症的治疗仍然不被重视，那么老年艾滋病毒感染者的预期寿命可能会缩短，这是可以避免的。
Objective: To investigate whether the high rates of depression found in older adults living with HIV are associated with the number and types of comorbidities. Methods: The Research on Older Adults with HIV (ROAH) study collected self-reported health data on similar to 1000 New York City HIV-positive men and women aged 50 years and older. Participants provided data on health problems experienced in the past year and depressive symptomatology (Center for Epidemiological Studies Depression Scale (CES-D)). Data were analysed using a non-parametric test of association and multiple regression analysis. Results: The correlation between CES-D scores and number of comorbidities was significant (r = 0.24). In multivariate analyses, depression remained a significant covariate of the number of comorbid conditions, in addition to female gender, inadequate income, history of drug and alcohol use, AIDS diagnosis and self-rated health. Correlations of depression with specific comorbidities varied. Significant correlations with sensory loss and dermatological problems were observed. Significant correlations existed with heart and respiratory conditions as well as fractures, but the directionality of these cross-sectional relationships is uncertain. Conclusions: The findings suggest the need for further longitudinal research to understand how high rates of depressive symptoms are related to comorbidities. Focussed clinical care that strives to prevent the collapse of the immune system must evolve into an effective treatment strategy for multimorbidities, where HIV is but one of many other chronic illnesses. If the management of depression continues to be a low priority, the older person with HIV may experience an avoidable reduction in life expectancy.