Aging and the Course of Depressive Symptoms

描述(申请人提供)：衰老和抑郁之间的关系是个谜。使用标准化诊断标准的流行病学研究经常报告抑郁障碍的患病率和发病率随着年龄的增长而下降，即使在非常年长的成年人群体中也是如此。最近对现有研究的解读表明，抑郁症状的年龄差异表明，老年人的负担较低，这可能是通过降低风险和提高老年患者的情绪弹性来实现的。然而，其他研究表明，抑郁症状的负担随着年龄的增长而增加。对抑郁症如何与年龄和衰老相关的知情调查需要使用既定工具在具有代表性的样本中收集纵向数据。密歇根大学进行的健康和退休调查(HRS)是一项大型的、具有代表性的纵向研究，其中包括以流行病学研究中心抑郁量表(CES-D)为模型的抑郁症状问卷，以加深我们对衰老和抑郁之间关系的理解。然而，使用HRS/CES-D的纵向研究受到阻碍，因为不同研究浪潮的反应规模和症状覆盖范围不同。这项研究项目的具体目标是：(1)验证基于项目反应理论的量表系统，该系统将通过HRS波的不同反应格式获得的CES-D反应置于等价度量上；(2)检查CES-D反应以寻找不同项目功能(DIF)的证据，并确定DIF的模式是否因反应形式而异；(3)分析老年人中抑郁症状的过程；以及(4)将HRS受访者的抑郁值存档，供其他调查人员使用，并发布评分算法，供研究人员在使用CES-D的其他研究中使用。这项研究项目的成功完成将提供新的数据和对美国老年人抑郁症状随年龄变化的纵向轨迹的理解，并将导致更大规模的交叉研究整合项目，将使用CES-D的其他研究--甚至是那些不同的反应量表--或可能提供一些症状覆盖范围重叠的其他抑郁症测量方法联系起来。

DESCRIPTION (provided by applicant): The relationship between aging and depression is enigmatic. Epidemiologic studies using standardized diagnostic criteria often report a decreasing prevalence and incidence of depressive disorders with age, even within very old adult age groups. Recent interpretations of available research suggests that age differences in depressive symptoms suggests a lower burden among older adults, perhaps via risk reduction and improvements in emotional resiliency accompanying old age. However, other research has suggested that the burden of depressive symptoms increases with aging. An informed inquiry of how depression relates to age and aging requires longitudinal data collected in a representative sample using established instruments. A resource for furthering our understanding of the relationship between aging and depression is the Health and Retirement Survey (HRS) conducted by the University of Michigan, a large, representative, and longitudinal study that includes a depressive symptom inventory modeled after the Center for Epidemiologic Studies - Depression scale (CES-D). However, longitudinal research using the HRS/CES-D has been hampered because the response scale and symptom coverage varies across study wave. The specific aims of this research project are: (1) to validate a scaling system, grounded in Item Response Theory, that places CES-D responses obtained using different response formats across HRS waves on an equivalent metric, (2) to examine CES-D responses for evidence of differential item functioning (DIF) and determine if patterns of DIF vary by response format, (3) to analyze the course of depressive symptoms in among aging adults, and (4) to archive depression values for HRS respondents for use by other investigators and publish the scoring algorithm for use by investigators in other studies using the CES-D. Successful completion of this research project will provide new data and understanding of the longitudinal trajectory of depressive symptoms with age among older Americans, and will lead to larger cross-study integration projects linking other studies using the CES-D -- even those different response scales -- or possibly other depression measures that provide some overlap of symptom coverage.