老年住院患者抑郁症状与衰弱状况关系的研究

Correlation between depressive symptoms and frailty in elderly inpatients

目的探讨老年住院患者抑郁症状与衰弱状况的关系,为老年住院患者抑郁症状的预防和改善提供依据。方法2015年12月至2017年2月对吉林大学第一医院干部病房符合标准的248例老年住院患者通过老年综合评估(CGA)进行横断面调查,其中通过老年抑郁量表(GDS-5)评估抑郁症状,通过衰弱表型法对衰弱状况进行划分。结果调查对象中有抑郁症状者为50例(20.2%),衰弱前期和衰弱期的患者分别为93例(37.5%)、39例(15.7%)。衰弱程度以及握力低、步行速度缓慢、活动量低下、疲乏、虚弱5个衰弱指标均与老年住院患者抑郁症状呈正相关(r分别为0.441、0.315、0.426、0.316、0.395、0.151,均P<0.05)。在Logistic回归分析中发现,衰弱程度越严重,抑郁症状发生的风险越高(OR=2.608,P<0.05),步行速度缓慢和疲乏也会增加抑郁症状发生的风险(OR分别为2.801、3.484,均P<0.05)。结论衰弱程度及步行速度缓慢、疲乏2个衰弱指标均会导致老年抑郁症状发生风险增加,可以通过对衰弱前期和衰弱的预防和干预来预防或改善老年住院患者的抑郁症状。

Objective To explore the correlation between depressive symptoms and frailty, in order to provide evidence for prevention and relief of depressive symptoms in elderly inpatients. Methods A cross-sectional survey and comprehensive geriatric assessment(CGA)were conducted with 248 eligible elderly inpatients from December 2015 to February 2017 in our hospital.Depressive symptoms were assessed by the 5-Item Geriatric Depression Scale(GDS-5), and frailty was identified by the frailty phenotype method. Results In all respondents, 50(20.2%)patients showed depressive symptoms, 93(37.5%)patients had pre-frailty and 39(15.7%)patients had frailty.Correlation analysis showed that frailty degree, low grip strength, slow gait speed, low physical activity, fatigue, and weakness were all positively correlated with depressive symptoms in elderly inpatients(r=0.441, 0.315, 0.426, 0.316, 0.395 and 0.151, respectively, P<0.05). Logistic regression analysis showed that patients who had more severe frailty faced a much higher risk of developing depressive symptoms(OR=2.608, P<0.05). Of the 5 indicators of frailty, slow gait speed and frailty also increased the risk of having depressive symptoms(OR=2.801 and 3.484, P<0.05). Conclusions Frailty degree, gait speed and fatigue are associated with increased risk of depression in the elderly.Depressive symptoms can be reduced in elderly inpatients with prevention and intervention of pre-frailty and frailty.