DEPRESSION, DISABILITY & REHAB IN VISION IMPAIRED ELDERS

拟议的研究建立在现有研究的基础上，解决了 老年人慢性功能障碍与残疾、抑郁的关系 并将做出几项独特的贡献。这项研究的 重点关注的是经历着一个极其常见的年龄的老年人的子群- 相关的残疾、视力障碍，其中两者的发生率 功能性残疾和抑郁症特别严重，但 相对较少受到系统的研究关注。这个 纵向设计将允许对课程进行深入研究 利用压力和应对概念模型，研究随时间推移的抑郁 它结合了关键的个人和社会资源，作为 残疾与抑郁之间的关系。最重要的是， 专注于样本寻求康复允许我们经验性地 挑战功能不可避免、互惠下降的假设 和抑郁状态。通过遵循两者的自然进程 抑郁症和康复服务的使用，一个主要的长期目标是 来考察这种非 心理干预可能会影响残疾人的抑郁状况 长辈们。这些知识将为未来的发展奠定基础 干预研究。具体的研究目标是：1.记录 视障人群中抑郁症的患病率、病程和严重程度 随着时间的推移，长辈们。2.研究抑郁对健康的影响 视力康复服务的利用情况。3.研究 视力康复服务可通过哪些机制影响 抑郁症的严重程度和病程。4.测试纵向模型 阐明视力损害严重程度、共同损害程度之间的相互关系 病态的健康状况、功能残疾、康复服务 利用和抑郁，以及这些关系是如何 以个人和社会资源为中介。5.审查性别 与上述目标1-4的差异。 将从申请者中抽取600名老年人(每性别300人)，年龄 65岁以上，视力康复机构。将对科目进行评估4 时间(基线、6个月、12个月和18个月)，以检查这两个短期 以及关键变量之间的长期因果关系。分析 解决并发关联(跨部门)和预期关联 使用回归和结构方程的关系(纵向) 建模(扫描电子显微镜)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.