Depressed mood, cognitive impairment, and survival in older people admitted to care homes in England.
Depressed mood, cognitive impairment, and survival in older people admitted to care homes in England.
复制标题
英国养老院老年人的抑郁情绪、认知障碍和生存情况。
DOI：
10.1097/jgp.0b013e3180381537
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
P. Huxley
中科院分区：
文献类型：
--
作者：
C. Sutcliffe;Alistair Burns;D. Challis;C. Mozley;L. Cordingley;Heather Bagley;P. Huxley
客观化
调查新入住疗养院的居民的精神疾病发病率、认知功能障碍、依赖性和存活率。
方法
共有308名老年人接受了认知障碍和抑郁症状测量的评估，可采访的居民完成了生活质量访谈。通过与工作人员的访谈评估依赖程度，并从家庭记录中收集用药数据。在5个月和9个月时进行了后续评估。大约12个月后的电话随访增加了生存数据。
结果
在结果已知的居民中，73%的人在9个月的研究期间存活下来。在五个月的随访前死亡的居民在抑郁测量上的得分高于那些存活时间更长的居民。基线时更大的依赖性预示着存活率的降低。在188名幸存的居民中，63人(38%)在基线时被归类为抑郁症。后者中的27人(43%)在5个月和9个月时仍被归类为抑郁症。在基线被评为抑郁的居民中，只有19%的人开了抗抑郁药物，在每次随访时增加到26%。认知障碍和抑郁症状显著共存。
结论
居民的高死亡率、精神病发病率和慢性抑郁情绪要求疗养院改善获得专科资源的机会，如老年咨询、老年精神病学、职业治疗和物理治疗。研究结果表明，未来的护理标准应包括外部因素，如弱势老年人获得相关专业服务的程度。
OBJECTIVE
To investigate psychiatric morbidity, cognitive impairment, dependency, and survival in residents newly admitted to care homes.
METHODS
A total of 308 older people were assessed using measures of cognitive impairment and depressive symptomatology, and interviewable residents completed a quality-of-life interview. Dependency levels were assessed by interviews with staff and medication data were collected from home records. Follow-up assessments were carried out at five and nine months. A telephone follow-up approximately 12 months later augmented the survival data.
RESULTS
Of residents whose outcomes were known, 73% survived throughout the nine-month study period. Residents who died before the five-month follow-up had higher scores on the depression measure than those surviving longer. Reduced survival was predicted by greater dependency at baseline. Of 188 surviving residents, 63 (38%) were classified as depressed at baseline. Twenty-seven (43%) of the latter were still classed as depressed at five and nine months. Just 19% of residents rated as depressed at baseline were prescribed antidepressant medication, increasing to 26% at each follow-up. There was significant coexistence of cognitive impairment and depressive symptomatology.
CONCLUSION
High levels of mortality, psychiatric morbidity, and chronicity of depressed mood among residents requires care homes to improve access to specialist resources such as geriatric consultation, old-age psychiatry, occupational therapy, and physiotherapy. Findings suggest that future care standards should include external factors, such as the extent of access to relevant specialist services for vulnerable older people.