Xiao Qiu, Ziyao Xu, Cassandra L Hua, Na Sun, James Scott Brown
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引用次数: 0
Abstract
Objectives: This study examined the relationship between polypharmacy and depressive symptoms among U.S. community-dwelling older adults and whether it varied by gender.
Methods: We conducted a retrospective population-based analysis of 3,354 adults aged 65 and older using data from the 2009 Health and Retirement Study Health and Well-Being Study. Polypharmacy was defined as the use of five or more prescription medications. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale (CESD-8). Negative binomial regression models assessed associations between polypharmacy and depressive symptoms and whether the relationship varied by gender.
Results: Over 40% of participants reported polypharmacy. In unadjusted models, polypharmacy was positively related to depressive symptoms (Incidence Rate Ratio [IRR] = 1.44, p < .01). In models adjusting for demographic and health characteristics, there was no statistically significant relationship between polypharmacy and depressive symptoms (Adjusted Incidence Rate Ratio [AIRR] = 0.99, p > .05). There were no significant gender differences in unadjusted or adjusted models in the relationship between polypharmacy and depressive symptoms.
Conclusions: Polypharmacy was not related to depressive symptoms among older women or men.
Clinical implications: Interventions to address physical health may be more salient to depression management than polypharmacy regardless of gender.
目的:本研究考察了在美国社区居住的老年人中使用多种药物与抑郁症状之间的关系,以及这种关系是否因性别而异。方法:我们对3354名65岁及以上的成年人进行了基于人群的回顾性分析,使用了2009年健康与退休研究健康与幸福研究的数据。多重用药被定义为使用五种或五种以上的处方药。采用8项流行病学研究中心抑郁量表(CESD-8)测量抑郁症状。负二项回归模型评估了多药与抑郁症状之间的关联,以及这种关系是否因性别而异。结果:超过40%的参与者报告了多药。在未调整的模型中,多药与抑郁症状呈正相关(发病率比[IRR] = 1.44, p p > .05)。在未调整和调整的模型中,多药与抑郁症状的关系没有显著的性别差异。结论:多药治疗与老年女性或男性抑郁症状无关。临床意义:无论性别如何,针对身体健康的干预措施在抑郁症管理中可能比综合用药更为突出。
期刊介绍:
Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including:
-adjustments to changing roles-
issues related to diversity and aging-
family caregiving-
spirituality-
cognitive and psychosocial assessment-
depression, anxiety, and PTSD-
Alzheimer’s disease and other neurocognitive disorders-
long term care-
behavioral medicine in aging-
rehabilitation and education for older adults.
Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.