Frailty and depression: A latent trait analysis

描述（由申请人提供）：本项目旨在了解脆弱和抑郁之间的结构和时间联系，并描述这些构念在衰老过程中的综合作用。虚弱在老年生活中很常见，影响10.9%至20.3%的老年人，这种综合征增加了对一系列常见健康不良后果的脆弱性，如跌倒、住院、残疾、进入养老院和死亡。因此，确定脆弱是很重要的，因为它可以作为及时干预和预防疾病和残疾的重要指标。然而，由于缺乏统一的概念和操作定义，对这种综合征的理解和识别受到阻碍。对虚弱的定义产生混乱，部分原因是由于缺乏对虚弱如何以及为什么与晚年生活中的其他常见综合征（如抑郁症）相关的知识。本项目寻求资金支持，以研究阐明脆弱和抑郁症之间的关系，以便更好地了解脆弱的概念，并提高其识别的临床用途。拟议的研究将使用健康与退休研究（HRS）的公开数据，在10年期间（2000年至2010年）进行5次随访。HRS是一个大型的、前瞻性的、基于人群的样本，大约有2万名老年人进行了身体功能和心理健康的全面测量。HRS数据提供了一个独特的机会来评估和比较虚弱和抑郁之间共病的竞争模型。来自65岁及以上且无重大疾病或功能限制的HRS参与者的数据将被汇编和分析。使用潜在特质分析和结构方程模型，我们将评估抑郁和虚弱之间的关联的竞争模型。我们希望通过建立和测试其共病的竞争性结构模型，更好地理解抑郁和虚弱之间的关系。通过评估相互竞争的模型，我们期望确定影响虚弱和抑郁综合征的因素，以及预测其合并症的因素。本研究将提供对虚弱和抑郁状况如何相关的丰富理解，探索预测这些状况的因素的差异，并确定虚弱和抑郁是否与关键健康结果的预测共同相关。通过阐明抑郁和虚弱在预测长期不良健康结果方面的共同影响，我们希望为制定更好、更准确的虚弱概念和操作定义提供信息，这些定义解释了身体和心理健康的交集。对这些关系的更好理解将有助于指导研究，以制定更准确和全面的脆弱定义。考虑到虚弱和抑郁之间的相互关系，以及完善虚弱的操作定义，将有助于更好地识别虚弱的个人，并制定更有效的预防和干预战略。

DESCRIPTION (provided by applicant): This project aims to understand the structural and temporal associations between frailty and depression, and to describe the combined role of these constructs within the aging process. Frailty is common in later life, affecting between 10.9 and 20.3% of older adults, and this syndrome increases vulnerability to a host of common poor health outcomes such as falls, hospitalization, disability, nursing home entry and mortality. Identifying frailty is thus important as it may serve as a vital indicator for timely intervention nd prevention of disease and disability. However, understanding and identification of this syndrome is hindered by lack of unified conceptual and operational definitions. Confusion in defining frailt is caused, in part, by lack of knowledge regarding how and why frailty is related to other common syndromes in later life, such as depression. This project seeks funding support for research on elucidating relationships between frailty and depression in order to develop a better conceptual understanding of frailty and to improve the clinical usefulness of its identification. The proposed research will use publically available data from the Health and Retirement Study (HRS), spanning 5 follow-up waves over a 10-year period (2000 to 2010). The HRS is a large, prospective, population-based sample of approximately 20,000 older adults with comprehensive measurements of physical functioning and mental health. The HRS data provides a unique opportunity to evaluate and compare competing models of comorbidity between frailty and depression. Data from HRS participants aged 65 years and older and without major disease or functional limitation will be compiled and analyzed. Using latent trait analysis and structural equation modeling, we will assess competing models for the association between depression and frailty. We expect to provide better understanding of the relationships between depression and frailty by building and testing competing structural models of their comorbidity. By evaluating competing models, we expect to identify factors which differentially influence the syndromes of frailty and depression and those which predict their comorbidity. This study will provide a rich understanding of how the conditions of frailty and depression are related, explore differences in the factors which predict these conditions, and determine whether frailty and depression are jointly related to prediction of key health outcomes. By clarifying the joint influence of depression and frailty in predicting poor health outcomes over time, we expect to inform the development of better, more accurate conceptual and operational definitions of frailty, which account for the intersection of physical and mental health. An improved understanding of these relationships will help guide research to development of more accurate and comprehensive definitions of frailty. Accounting for the interrelationships between frailty and depression, and refinement of the operational definition of frailty will facilitate improved identification of frail individuals and development of more effective prevention and intervention strategies.