Age-specific risk factors of depression among the oldest-old - evidence from the multicenter AgeCoDe-AgeQualiDe study

M. Luppa, A. Pabst, M. Löbner, Tina Mallon, Christian Brettschneider, A. Hajek, K. Heser, L. Kleineidam, Siegfried Weyerer, Jochen Werle, Michael Pentzek, D. Weeg, Edelgard Mösch, B. Wiese, A. Oey, M. Wagner, Wolfgang Maier, Martin Scherer, Hans-Helmut König, S. Riedel-Heller
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Abstract

The present study aimed to investigate age-group-specific incidence rates and risk factors for depressive symptoms in the highest age groups.Data were derived from a prospective multicenter cohort study conducted in primary care – the AgeCoDe/AgeQualiDe study. In total, 2,436 patients 75 years and older were followed from baseline to ninth follow-up. To assess depressive symptoms, the short version of the Geriatric Depression Scale (GDS-15, cutoff score 6) was used. Age-specific competing risk regressions were performed to analyze risk factors for incident depressive symptoms in different age groups (75 to 79, 80 to 84, 85+ years), taking into account the accumulated mortality.The age-specific incidence rate of depression was 33 (95% CI 29-38), 46 (95% CI 40-52) and 63 (95% CI 45-87) per 1,000 person years for the initial age groups 75 to 79, 80 to 84 and 85+ years, respectively. In competing risk regression models, female sex, mobility as well as vision impairment, and subjective cognitive decline (SCD) were found to be risk factors for incident depression for age group 75 to 79, female sex, single/separated marital status, mobility as well as hearing impairment, and SCD for age group 80 to 84, and mobility impairment for age group 85+.Depressive symptoms in latest life are common and the incidence increases with increasing age. Modifiable and differing risk factors across the highest age groups open up the possibility of specifically tailored prevention concepts.
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老年人患抑郁症的特定年龄风险因素--来自多中心 AgeCoDe-AgeQualiDe 研究的证据
本研究旨在调查高年龄组抑郁症状的特定年龄组发病率和风险因素。数据来源于一项在初级保健领域开展的前瞻性多中心队列研究--AgeCoDe/AgeQualiDe 研究。共有 2436 名 75 岁及以上的患者接受了从基线到第九次随访的跟踪调查。在评估抑郁症状时,采用了老年抑郁量表(GDS-15,截断分数为 6 分)的简易版。考虑到累积死亡率,对不同年龄组(75 至 79 岁、80 至 84 岁、85 岁以上)的抑郁症发病风险因素进行了年龄特异性竞争风险回归分析。在 75 至 79 岁、80 至 84 岁和 85 岁以上的初始年龄组中,抑郁症的年龄特异性发病率分别为每千人年 33 例(95% CI 29-38)、46 例(95% CI 40-52)和 63 例(95% CI 45-87)。在竞争风险回归模型中发现,女性性别、行动能力以及视力障碍和主观认知能力下降(SCD)是 75 至 79 岁年龄组中抑郁症发病的风险因素,女性性别、单身/分居婚姻状况、行动能力以及听力障碍和 SCD 是 80 至 84 岁年龄组中抑郁症发病的风险因素,而行动能力障碍则是 85 岁以上年龄组中抑郁症发病的风险因素。最高年龄组中可改变的和不同的风险因素为专门定制预防概念提供了可能性。
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