Poor Vision, Functioning, and Depressive Symptoms: A Test of the Activity Restriction Model
Poor Vision, Functioning, and Depressive Symptoms: A Test of the Activity Restriction Model
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DOI：
10.1093/geront/gnr051
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发表时间：
2011-12-01
期刊：
影响因子：
5.7
通讯作者：
Lawson, Brendan
中科院分区：
文献类型：
--
作者：
Bookwala, Jamila;Lawson, Brendan
目的：本研究旨在检验抑郁情绪的活动限制模型在老年视力不良背景下的适用性。该模型假设晚年压力源不仅直接而且间接地通过限制日常功能而导致心理健康状况恶化。方法：我们使用的数据来自全国基于概率的老年人样本（N = 1，178; M = 69.2岁，约50%为女性）。通过主观（通过自我报告）和客观（通过视力测试）评估视力。受访者还报告了他们的身体和驾驶限制，社会孤立感和抑郁症状的水平。结果：路径分析表明，主观视觉的活动限制模型的数据非常适合。除了直接导致更高的抑郁症，主观视觉间接预测更多的身体限制和社会孤立感，反过来，导致更多的抑郁症症状，抑郁症状;驾驶限制没有调解主观视觉和抑郁症之间的关系。客观视力对身体和驾驶限制有显着影响，但与社会孤立感和抑郁症状无关。含义：支持活动限制模型，晚年的自我评估视力较差直接导致心理健康下降，也通过限制个人进行日常身体活动的能力和增加他们的社会孤立感间接导致心理健康下降。对有视力相关问题的老年人的干预措施可以集中在维持或增强他们的身体和社会功能，以促进他们适应视力不良。
Purpose: This study tested the applicability of the activity restriction model of depressed affect to the context of poor vision in late life. This model hypothesizes that late-life stressors contribute to poorer mental health not only directly but also indirectly by restricting routine everyday functioning. Method: We used data from a national probability-based sample of older adults (N = 1,178; M = 69.2 years, approximately 50% female). Vision was assessed both subjectively (via self-report) and objectively (via a visual acuity test). Respondents also reported on their levels of physical and driving limitations, feelings of social isolation, and symptoms of depression. Results: Path analyses indicated a strong fit of the data to the activity restriction model for subjective vision. In addition to directly contributing to higher depressive symptomatology, subjective vision contributed to depressive symptoms indirectly by predicting more physical limitations and feelings of social isolation that, in turn, contributed to more symptoms of depression; driving limitations did not mediate the relationship between subjective vision and depressive symptomatology. Objective vision contributed significantly to physical and driving limitations but was unrelated to feelings of social isolation and depressive symptomatology. Implications: Supporting the activity restriction model, poorer self-rated vision in late life contributes to lower mental health directly and also indirectly by restricting individuals' ability to carry out routine day-to-day physical activities and increasing their feelings of social isolation. Interventions for older adults with vision-related problems could focus on maintaining or enhancing their physical and social functioning in order to promote their adaptation to poor vision.