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DOI: 10.1055/a-1089-3935
Führt eine Zunahme depressiver Symptome zu einer Zunahme funktioneller Einschränkungen oder vice versa? Ergebnisse der AgeCoDe/AgeQualiDe-Studie
Does an Increase in Depressive Symptoms Lead to an Increase in Functional Impairment or vice versa? Results of the AgeCoDe and AgeQualiDe StudyPublikationsverlauf
Publikationsdatum:
17. Januar 2020 (online)
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Zusammenfassung
Ziel der Studie Analyse der Beziehung zwischen depressiven Symptomen und funktionellen Beeinträchtigungen bei Hochaltrigen (85+) im Längsschnitt.
Methodik Drei Wellen der multizentrischen prospektiven Kohortenstudie AgeQualiDe wurden genutzt (n = 1272 Beobachtungen). Die Geriatrische Depressionsskala wurde zur Erfassung depressiver Symptome verwendet. Die Instrumental Activities of Daily Living von Lawton und Brody wurde zur Messung funktioneller Beeinträchtigungen eingesetzt.
Ergebnisse Anfängliche Steigerungen in depressiven Symptomen gehen mit späteren Steigerungen funktioneller Beeinträchtigungen einher. Hingegen hängen anfängliche Steigerungen funktioneller Beeinträchtigungen nicht mit späteren Steigerungen in depressiven Symptomen zusammen.
Schlussfolgerung Unsere Ergebnisse deuten darauf hin, dass anfängliche Steigerungen depressiver Symptome mit einer Zunahme funktioneller Beeinträchtigungen bei Hochaltrigen zusammenhängen.
Abstract
Objective To clarify the link between depressive symptoms and functional impairment among the oldest old longitudinally.
Methods Longitudinal data (n = 1,272) were taken from a multicenter prospective cohort study (“Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)” [AgeQualiDe]). Functional decline was assessed using the Lawton and Brody Instrumental Activities of Daily Living scale, and the Geriatric Depression Scale was used to measure depressive symptoms.
Results While initial increases in depressive symptoms were associated with subsequent increases in functional impairment, initial increases in functional impairment were not associated with subsequent increases in depressive symptoms.
Conclusions Our results stress the relevance of increases in depressive symptoms for upcoming functional decline among the oldest old. Further longitudinal studies are required to replicate our findings.
Schlüsselwörter
depressive Symptome - Aktivitäten des täglichen Lebens - Funktion - LängsschnittstudienKeywords
depressive symptoms - activities of daily living - functional impairment - longitudinal studies* Diese Autoren haben zu gleichen Teilen zu der Arbeit beigetragen.
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Literatur
- 1 Alexopoulos GS. Depression in the elderly. Lancet 2005; 365: 1961-1970
- 2 Hajek A, Luck T, Brettschneider C. et al. Factors affecting functional impairment among elderly Germans – Results of a longitudinal study. J Nutr Health Aging 2017; 21: 299-306
- 3 Hajek A, Brettschneider C, Lange C. et al. Longitudinal Predictors of Institutionalization in Old Age. PLOS ONE 2015; 10: e0144203
- 4 Chang M, Phillips C, Coppin AK. et al. An association between incident disability and depressive symptoms over 3 years of follow-up among older women: the Women’s Health and Aging Study. Aging Clin Exp Res 2009; 21: 191-197
- 5 Chao S-F. Functional disability and depressive symptoms: longitudinal effects of activity restriction, perceived stress, and social support. Aging Ment Health 2014; 18: 767-776
- 6 Brilman EI, Ormel J. Life events, difficulties and onset of depressive episodes in later life. Psychol Med 2001; 31: 859-869
- 7 Barry LC, Soulos PR, Murphy TE. et al. Association between indicators of disability burden and subsequent depression among older persons. J Gerontol A Biol Sci Med Sci 2012; 68: 286-292
- 8 Hajek A, Brettschneider C, Eisele M. et al. Disentangling the complex relation of disability and depressive symptoms in old age – findings of a multicenter prospective cohort study in Germany. Int Psychogeriatr 2017; 29: 885-895
- 9 Xue Q-L, Fried LP, Glass TA. et al. Life-space constriction, development of frailty, and the competing risk of mortality: the Womenʼs Health And Aging Study I. Am J Epidemiol 2007; 167: 240-248
- 10 Bock J-O, Hajek A, Lühmann D. et al. Unterschiede in Kognition, Depressivität und gesundheitsbezogener Lebensqualität zwischen Versicherten der GKV und PKV im hohen Alter. Psychiat Prax 2018; 45: 148-153
- 11 Eisele M, Kaduszkiewicz H, König H-H. et al. Determinants of health-related quality of life in older primary care patients: results of the longitudinal observational AgeCoDe Study. Br J Gen Pract 2015; 65: e716-e723
- 12 Yesavage JA, Sheikh JI. 9/Geriatric Depression Scale (GDS) recent evidence and development of a shorter violence. Clin Gerontol 1986; 5: 165-173
- 13 Lawton MP, Brody EM. Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. Gerontologist 1969; 9: 179-186
- 14 Graf C. The Lawton instrumental activities of daily living scale. Am J Nurs 2008; 108: 52-62
- 15 Lubben J, Blozik E, Gillmann G. et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontologist 2006; 46: 503-513
- 16 Reisberg B, Ferris SH, de Leon MJ. et al. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139: 1136-1139
- 17 Brauns H, Steinmann S. Educational reform in France, West-Germany and the United Kingdom: updating the CASMIN educational classification. ZUMA Nachrichten 1999; 23: 7-44
- 18 Stock JH, Watson MW. Vector autoregressions. J Econ Perspect 2001; 15: 101-115
- 19 Hajek A, Brettschneider C, Ernst A. et al. Complex coevolution of depression and health-related quality of life in old age. Qual Life Res 2015; 24: 2713-2722
- 20 Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1: 385-401
- 21 Katz S, Ford AB, Moskowitz RW. et al. Studies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963; 185: 914-919
- 22 Pfeiffer E. A short psychiatric evaluation schedule: a new 15-item monotonic scale indicative of functional psychiatric disorder. In: Brain function in old age. Berlin: Springer; 1979: 228-236
- 23 Yang Y, George LK. Functional disability, disability transitions, and depressive symptoms in late life. J Aging Health 2005; 17: 263-292
- 24 Bacon KL, Heeren T, Keysor JJ. et al. Longitudinal and reciprocal relationships between depression and disability in older women caregivers and noncaregivers. Gerontologist 2015; 56: 723-732
- 25 Demakakos P, Cooper R, Hamer M. et al. The bidirectional association between depressive symptoms and gait speed: evidence from the English Longitudinal Study of Ageing (ELSA). PLOS ONE 2013; 8: e68632
- 26 Gurland BJ, Wilder DE, Berkman C. Depression and disability in the elderly: reciprocal relations and changes with age. Int J Geriatr Psychiatr 1988; 3: 163-179
- 27 Turner RJ, Noh S. Physical disability and depression: A longitudinal analysis. J Health Soc Behav 1988; 29: 23-37
- 28 Bruce ML. Depression and disability in late life: directions for future research. Am J Geriatr Psychiatry 2001; 9: 102-112
- 29 Ormel J, Rijsdijk FV, Sullivan M. et al. Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life. J Gerontol B Psychol Sci Soc Sci 2002; 57: P338-P347
- 30 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361-370
- 31 Cameron AC, Trivedi PK. Microeconometrics: methods and applications. Cambridge: Cambridge University Press; 2005
- 32 Chen CM, Mullan J, Su YY. et al. The Longitudinal Relationship Between Depressive Symptoms and Disability for Older Adults: A Population-Based Study. J Gerontol A Biol Sci Med Sci 2012; 67: 1059-1067