Abstract

Background

Depression in older adults is becoming an increasing concern. As depressive symptoms change over time, it is important to understand the determinants of change in depressive symptoms. The aim of our study is to use a longitudinal study design to explore the predictors of change, remission and incident depression in older patients with multimorbidity.

Methods

Data from the MultiCare cohort study were used. The cohort studied 3,189 multimorbid general practice patients aged 65-85. Data were collected during personal interviews. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS-15). Predictors of change in depressive symptoms were determined using multivariate linear regression, while multivariate logistic regression was used to analyze predictors of remission and incident depression. Models included depressive symptoms at baseline and follow-up, socio-demographics and data on health status and social support.

Results

Overall, 2,746 participants with complete follow-up data were analyzed. Mean age was 74.2 years, 59.2% were female, and 11.3% were classified as depressed at baseline. Burden of multimorbidity and social support were statistically significant predictors in all regression analyses. Further predictors of change in depressive symptoms were: income, pain, nursing grade, self-rated health and self-efficacy.

Limitations

The sample size for prediction of remission limited statistical certainty. Assessment of depressive symptoms using GDS-15 differs from routine clinical diagnoses of depression.

Conclusions

Predictors of change in depressive symptoms in older multimorbid patients are similar to those predicting remission and incident depression, and do not seem to differ significantly from other older patient populations with depressive symptoms.

中文翻译：

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老年和多病患者抑郁症状变化的预测因子：多护理队列的纵向分析

摘要

背景

老年人的抑郁症越来越受到关注。随着抑郁症状随着时间的推移而变化，了解抑郁症状变化的决定因素非常重要。我们研究的目的是使用纵向研究设计来探索患有多种疾病的老年患者的变化、缓解和抑郁事件的预测因素。

方法

使用了来自 MultiCare 队列研究的数据。该队列研究了 3,189 名 65-85 岁的多病全科患者。数据是在个人访谈期间收集的。使用老年抑郁量表 (GDS-15) 评估抑郁症状。使用多变量线性回归确定抑郁症状变化的预测因子，而多变量逻辑回归用于分析缓解和抑郁症事件的预测因子。模型包括基线和随访时的抑郁症状、社会人口统计数据以及健康状况和社会支持数据。

结果

总体而言，对 2,746 名具有完整随访数据的参与者进行了分析。平均年龄为 74.2 岁，59.2% 为女性，11.3% 在基线时被归类为抑郁症。在所有回归分析中，多重疾病负担和社会支持是具有统计学意义的预测因子。抑郁症状变化的进一步预测因素是：收入、疼痛、护理等级、自评健康和自我效能。

限制

用于预测缓解的样本量限制了统计确定性。使用 GDS-15 评估抑郁症状与抑郁症的常规临床诊断不同。

结论

老年多病患者抑郁症状变化的预测因子与预测缓解和抑郁发作的预测因子相似，并且似乎与其他有抑郁症状的老年患者群体没有显着差异。