45岁及以上人群抑郁对日常活动能力影响的meta分析

A meta-analysis of effect of depression on activities of daily living among people aged 45 years and over

目的:探索45岁及以上人群抑郁与日常活动能力的相关性。方法:检索公开发表的45岁及以上人群中抑郁影响日常活动能力的队列研究。检索数据库包含CochraneLibrary、PubMed、EMbase、PsycINFO、WebofScience、中国生物医学文献服务系统(CBM)、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方科技期刊全文数据库。采用NOS量表评价所纳入研究的质量,对<6分的文献予以剔除,利用meta分析方法计算纳入文献的合并OR和RR和HR值及95%CI值。结果:最终纳入8篇文献,共15342例45岁及以上人群。Meta分析结果显示,抑郁是非抑郁人群发生日常活动能力受损约2.5倍(OR=2.42,95%CI=1.43~4.09)。亚组分析显示,较高年龄(OR=1.99,95%CI=1.12~3.54)、男性(OR=1.76,95%CI=1.47~2.12)、抑郁症(OR=3.30,95%CI=1.35~8.11)、欧美地区(OR=3.05,95%CI=1.87~4.97)、研究跟踪时长较长(OR=1.71,95%CI=1.44~2.03)均与日常活动能力相关。结论:本研究显示,抑郁是日常活动能力的危险因素。

Objective:To explore the association between depression and activities of daily living among peo­ple 45-yea old and over.Methods:Databases including Cochrane Library,PubMed,EMbase,PsycINFO,Web of Science,CBM,CNK,VIP,WanFang were included.The Newcastle-Ottawa Scale(NOS)was used to evaluate qualities of included studies and those lower than 6 scores would be removed.The odds ratio(OR),risk ratio(RR)and hazard ratio(HR)and 95%confidence interval(CI)were utilized.Results:Eight studies involving 15342 population were included.The pooled studies showed that people with depression had about 2.5 times the risk of suffering activities of daily living decline(OR=2.42,95%CI:1.43-4.09).Subgroup analysis presented that older age(OR=1.99,95%Cl:1.12-3.54),male(OR=1.76,95%Cl:1.47-2.12),depression(OR=3.30,95%Cl:1.35-8.11),Europe and America(OR=3.05,95%Cl:1.87-4.97),longer follow-up duration(OR=1.71,95%Cl:1.44-2.03)were significantly associated with activities of daily living.Conclusion:It suggests that de­pression may be a risk factor of activities of daily living decline.