台灣中老年人憂鬱與行動功能關聯性之探討

The Impact of Depressive Symptoms on Functional Ability of Older Taiwanese

許美秀(HSU.MEI HSIU)

指導教授 ： 蔡仲弘

亞洲大學/健康學院/長期照護研究所在職專班/碩士(2011年)

摘要

背景—憂鬱與行動失能都是老年人健康衰退的主要影響因子，但其兩者間的關聯並不清礎。
目的—本研究目的在探討台灣中老年人憂鬱與行動功能的關聯。
研究方法—資料來源為「中老年身心社會生活狀態長期追蹤調查」資料庫，分析2003年憂鬱對2007年的行動功能的影響。以2003年時57歲以上3,772名個案為對象。但經排除2007年未完訪及2003年已失能者(ADL一項以上失能)，實際有效個案為2,739名。以SPSS 12.0軟體進行統計分析。以描述性統計分析基本資料，以卡方檢定檢測各因子與行動功能的關聯。以邏吉斯迴歸分析檢測2003年憂鬱狀況及四年間憂鬱惡化，在控制人口學、社會、經濟、衛生行為、健康及疾病狀況等變項下，對2007年行動功能及四年間行動功能惡化的關聯。
研究結果—在控制人口學、社會、經濟、衛生行為、健康及疾病狀況下，2003年的憂鬱狀況顯著預測四年後ADL失能的風險及憂鬱惡化與ADL惡化亦呈顯著關聯。2003年輕度憂鬱者，其四年後ADL失能風險為正常人的1.51倍，中度憂鬱者為3.16 倍，重度憂鬱者為4.08倍。四年間憂鬱有惡化者其四年後ADL惡化為無惡化的1.971倍。
結論與建議—本研究分析縱貫性資料，結果顯示中老年人憂鬱與行動失能有顯著關聯，具有預測失能風險的功能。憂鬱確實是中老人行動失能的重要影響因子之一，故建議將憂鬱檢測列為中老年人健康檢查項目之一，並提供適時的介入措施，以減低老年人行動失能的風險。

關鍵字

中老年人 ； 憂鬱 ； 日常生活活動(ADL) ； 失能

並列摘要

Background: Depression and functional disability are the main factors contribute to declining health in the elderly. But the relationship between the two is not clearly known.
Purpose: This study was to determine the impact of depression on functional ability in elderly Taiwanese.
Methods: Data for this analysis were the 2003 and 2007 datasets of the Survey of the Health and Living Status of the Elderly (SHLSET) which was conducted by the Bureau of Health Promotion of Taiwan. Study subjects were 2739 men and women who were without functional (ADL) disability and aged 57 years or older in 2003. SPSS 12.0 software was used for all statistical analyses. Logistic Regression analysis was used to examine the association between baseline (2003) depression status and functional status four years later adjusted for demographic, socioeconomic, health behavioral, health and disease-related variables.
Results: Results showed that depression significantly increased the risk of future functional ability in older Taiwanese. Compared to those who had no depressive symptoms, those who had mild depressive symptoms had 1.51 times of the risk of depression, those who had moderate symptoms had 3.16 times the risk, whereas those who had severe depression had 4.08 times the risk four years later. A worsening of depressive symptoms during the four-year period was also accompanied by worsening functional decline.
Conclusions: Depression significantly impacts functional ability in the elderly and is one of the leading factors contribute to functional disability in this age group. The risk of depression in older adults should be routinely monitored and those who are identified at risk of depression should be given proper intervention.

並列關鍵字

Elderly ； Depression ； Activities of Daily Living (ADL) ； Functional impairment

參考文獻

Morris PL, Raphael B, Robinson RG. Clinical depression is associated with impaired recovery from stroke. Med J Aust. 1992; 157(4):239-242.

Armenian HK, Pratt LA, Gallo J, Eaton WW. Psychopathology as a predictor of disability: a population-based follow-up study in Baltimore, Maryland. Am J Epidemiol. 1998; 148:269-275.

Barry LC, Allore HG, Bruce ML, Gill TM. Longitudinal association between depressive symptoms and disability burden among older persons. J Gerontol A Biol Sci Med Sci. 2009; 64(12):1325-32. Epub 2009 Sep 23.

Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003; 58(3):249-265.

Broadhead WE, Blazer DG, George LK, Tse CK. Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA. 1990; 264:2524-2528.