DEPRESSION, DISABILITY & REHAB IN VISION IMPAIRED ELDERS

拟议的研究建立在目前的研究解决间- 慢性损伤、残疾和抑郁症之间的关系 他的一生，将做出许多独特的贡献。 该研究的 重点是老年人的亚组经历了一个非常普遍的年龄- 相关的残疾，视力障碍，其中， 功能性残疾和抑郁症的比例特别高，但 相对较少受到系统的研究关注。 的 纵向设计将允许对课程进行深入研究 抑郁症随着时间的推移，利用压力和应对概念模型 它包括关键的个人和社会资源， 残疾与抑郁症的关系 最重要的是 关注寻求康复的样本使我们能够凭经验 挑战不可避免的假设，功能的相互下降 和抑郁状态 通过遵循两者的自然过程 抑郁症和康复服务的使用，一个主要的长期目标是 审查这种非- 心理干预可能影响残疾人的抑郁状态 长老 这些知识将为今后的研究奠定基础。 干预研究。 具体的研究目的是：1.以记录 视障者抑郁症的患病率、病程和严重程度 老人随着时间 2. 研究抑郁症对 使用视力康复服务。 3. 审查 视力康复服务可能影响 抑郁症的严重程度和病程。 4. 来测试纵向模型 阐述了视力损害严重程度， 病态健康状况，功能性残疾，康复服务 利用和抑郁，以及这种关系是如何 通过个人和社会资源进行调解。 5. 审视性别 与上述目标1-4有关的差异。 从申请人中抽取600名长者（男女各300名），年龄 65岁以上，视力康复机构。 将对受试者进行评估4 时间（基线，6，12和18个月），以检查两个短 以及关键变量之间的长期因果关系。 分析 解决并发关联（横截面）和前瞻性 使用回归和结构方程的关系（纵向） 建模（SEM）技术。

The proposed study builds upon current research addressing the inter- relationships among chronic impairment, disability and depression in later life and will make several unique contributions. The study's focus is on subgroup of elders experiencing an extremely common age- related disability, vision impairment, in which the rates of both functional disability and depression are particularly high, but which has received relatively little systematic research attention. The longitudinal design will permit an in-depth examination of the course of depression over time, utilizing a stress and coping conceptual model which incorporates key personal and social resources as mediators of the relationship between disability and depression. Most importantly, the focus on a sample seeking rehabilitation permits us to empirically challenge the assumption of inevitable, reciprocal decline in functional and depressive status. By following the natural course of both depression and rehabilitation service use, a primary long-term goal is to examine the extent to which, and mechanisms by which, this non- psychiatric intervention may influence depression status among disabled elders. This knowledge will provide a foundation for future intervention studies. The specific study aims are: 1. to document the prevalence, course, and severity of depression among visually impaired elders over time. 2. to examine the influence of depression on utilization of vision rehabilitation services. 3. to examine the mechanisms by which vision rehabilitation services may affect the severity and course of depression. 4. to test a longitudinal model explicating the interrelationships among vision impairment severity, co- morbid health conditions, functional disability, rehabilitation service utilization and depression, and how such relationships are mediated by personal and social resources. 5. to examine gender differences relative to aims 1-4 above. 600 elders (300 of each gender) will be sampled from applicants, age 65+, of a vision rehabilitation agency. Subjects will be assessed 4 times (at baseline, 6, 12 and 18 months) in order to examine both short and long-term causal relationships among key variables. Analyses address concurrent associations (cross-sectional) and prospective relationships (longitudinal) using regression and structural equation modeling (SEM) techniques.