Correlates for Depression in Nursing Home Elderly Residents with and without Dementia

護理之家失智症與非失智症老年住民的憂鬱相關因子

陳頌威(Sung-Wei Chen) ； 陳佩嬅(Pei-Hwa Chen) ； 林莉莉(Li-Li Lin) ； 林信男(Hsin-Nan Lin) ； 劉珣瑛(Shen-Ing Liu)

《台灣精神醫學》 22卷2期 (2008/06) Pp. 125-140

https://doi.org/10.29478/TJP.200806.0006

摘要

目的：護理之家住民較可能憂鬱。相較於西方護理之家憂鬱危險因子研究，生物危險因子少於臺灣提及。本研究目的為：(1)調查護理之家老年住民的憂鬱危險因子，著重生物因子如失智症、中風和各種疾病。(2)探究護理之家「失智症」與「非失智症」者在「心理社會」與「生物」憂鬱危險因子之相異型態。方法：在某護理之家作橫斷性研究，共91位老人，其中56位失智症。各因子在憂鬱與非憂鬱個案間進行雙變項分析與迴歸分析。然後樣本分為「失智症」與「非失智症」，各自進行憂鬱與非憂鬱個案間比較分析。結果：此樣本憂鬱盛行率為54.9%。在失智症，憂鬱危險因子為功能、中風、心臟病、糖尿病、營養不良、自覺疼痛、骨骼與眼部疾病。在非失智症者，憂鬱危險因子為護理之家滿意度、生活事件、社會網路、功能、自覺健康、中風、癌症與呼吸疾病。結論：護理之家失智症與非失智症者，在心理社會與生物憂鬱相關因子存有相異型態。宜對有無失智症者發展不同的憂鬱處遇策略。

關鍵字

憂鬱 ； 失智症 ； 老人 ； 護理之家

並列摘要

Objective: Nursing home residents are at increased risk of depression. In contrast to Western studies of risk factors for depression in aged care facilities of this type, the biological risk factors for depression have seldom been investigated in Taiwan. Thus, the aims of this study were: (1) to investigate the risk factors for depression in residents of a nursing home in Taiwan, especially focusing on biological factors such as dementia, cerebrovascular disease (CVD), and various medical conditions; (2) to distinguish the characteristic patterns of biological and psychosocial risk factors for depression between nursing home residents with and without dementia. Methods: The cross-sectional study was conducted in the nursing home of a medical center. A total of 91 residents were recruited: 56 with and 35 without dementia. The depressed and non-depressed subjects were compared using bivariate and regression analyses. The sample was then stratified according to dementia status for further analysis. Results: The prevalence of depression in our sample was 54.9%. In patients with dementia, signifi cant differences between the depressed and non-depressed subjects included functional status, CVD, diabetes, perceived pain, malnutrition, and heart, musculoskeletal and eye diseases. In patients without dementia, significant differences between depressed and non-depressed subjects included satisfaction with nursing home, life events, social networks, functional status, perceived health, CVD, neoplasm and respiratory diseases. Conclusion: There are distinct patterns of biological and psychosocial correlates for depression comparing nursing home residents with and without dementia. In psychiatric services to nursing homes, it appears reasonable to suggest that different strategies should be developed for the detection and management of depression in patients with and without dementia.

並列關鍵字

depression ； dementia ； elder ； nursing home

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