Physical Disability and Depressive Symptomatology in an Elderly Population: A Complex Relationship. The Italian Longitudinal Study on Aging (ILSA)

医学 优势比 老人忧郁量表 置信区间 日常生活活动 萧条(经济学) 人口 身体残疾 逻辑回归 队列 队列研究 老年学 物理疗法 纵向研究 抑郁症状 内科学 精神科 认知 宏观经济学 病理 经济 环境卫生
作者
Luca Dalle Carbonare,Stefania Maggi,Marianna Noale,Sandro Giannini,Renzo Rozzini,Vincenzo Lo Cascio,Gaetano Crepaldi
出处
期刊:American Journal of Geriatric Psychiatry [Elsevier BV]
卷期号:17 (2): 144-154 被引量:82
标识
DOI:10.1097/jgp.0b013e31818af817
摘要

Objectives: Depressive symptoms (DS) are very frequent in elderly individuals and are associated with negative outcomes. This study was undertaken to evaluate whether DS predict physical disability in this population. Methods: A prospective, community-based cohort study, this work included 5,632 individuals aged 65–84 years, who were recruited from the demographic registries of eight Italian municipalities in 1992. The complete data of 3,256 subjects were collected and analyzed. DS were assessed using the Geriatric Depression Scale with a score ≥10/30 indicating DS. All traditional risk factors for disability established by questionnaires and physical examinations were assessed at baseline. The outcomes were self-reported disability on the activities of daily living (ADL) test and the performance-based physical function assessment (Physical Performance Tests, PPT). The contribution of the predictive variables to the outcomes evaluated after a mean follow-up of 3.5 ± 0.4 years was assessed using hierarchical logistic nested models. Results: Baseline DS was associated with higher rates of ADL disability (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.12–2.66) and PPT disability (OR = 1.83, 95% CI 1.17–2.85) in men and with ADL disability (OR = 1.81, 95% CI 1.28–2.55) in women. The independent predictors of PPT disability in women were arthritis (OR = 2.13, 95% CI 1.28–3.53) and age (OR = 1.09; 95% CI 1.03–1.15). Conclusions: This study provides evidence that older persons who report DS are at higher risk of subsequent physical decline. In women, arthritis is a more powerful predictor of preclinical disability, as measured by PPT. Depressive symptoms (DS) are very frequent in elderly individuals and are associated with negative outcomes. This study was undertaken to evaluate whether DS predict physical disability in this population. A prospective, community-based cohort study, this work included 5,632 individuals aged 65–84 years, who were recruited from the demographic registries of eight Italian municipalities in 1992. The complete data of 3,256 subjects were collected and analyzed. DS were assessed using the Geriatric Depression Scale with a score ≥10/30 indicating DS. All traditional risk factors for disability established by questionnaires and physical examinations were assessed at baseline. The outcomes were self-reported disability on the activities of daily living (ADL) test and the performance-based physical function assessment (Physical Performance Tests, PPT). The contribution of the predictive variables to the outcomes evaluated after a mean follow-up of 3.5 ± 0.4 years was assessed using hierarchical logistic nested models. Baseline DS was associated with higher rates of ADL disability (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.12–2.66) and PPT disability (OR = 1.83, 95% CI 1.17–2.85) in men and with ADL disability (OR = 1.81, 95% CI 1.28–2.55) in women. The independent predictors of PPT disability in women were arthritis (OR = 2.13, 95% CI 1.28–3.53) and age (OR = 1.09; 95% CI 1.03–1.15). This study provides evidence that older persons who report DS are at higher risk of subsequent physical decline. In women, arthritis is a more powerful predictor of preclinical disability, as measured by PPT.
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