Journal of the American Medical Directors Association · 2015
Combined Effect of Slow Gait Speed and Depressive Symptoms on Incident Disability in Older Adults.
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Tsutsumimoto Kota, Doi Takehiko, Shimada Hiroyuki, Makizako Hyuma, Hotta Ryo, Nakakubo Sho, Suzuki Takao
Аннотация
OBJECTIVES: To elucidate whether a combination of slow gait speed and depressive symptoms result in higher risk of incident disability in older adults than either symptom individually.
DESIGN: Prospective cohort study.
SETTING: Obu City, Aichi Prefecture, Japan.
PARTICIPANTS: Participants were 4038 older adults (48.7% male, mean age = 71 years) who met the study inclusion criteria.
MEASUREMENTS: Longitudinal data on incident disability were collected up to 33 months [median 31 months (interquartile range 29-32 months)] after baseline. We monitored monthly incident disability, defined as Japanese long-term care insurance certification for personal support or care. Baseline measurements included covariates for incident disability, gait speed, and the Geriatric Depression Scale for assessing depressive symptoms. The associations between slow gait, depressive symptoms, or their co-occurrence, and incident disability were examined.
RESULTS: Control participants were the reference in an adjusted Cox proportional hazard regression model. Participants with co-occurring slow gait and depressive symptoms showed a greater risk of incident disability [hazard ratio (HR) 3.08, confidence interval (CI) 95% 2.00-4.75]. Greater risk was also found for participants with slow gait speed alone (HR 2.44, CI 95% 1.71-3.47) and depressive symptoms alone (HR 1.60, CI 95% 1.01-2.53).
CONCLUSIONS: Older adults with both risk factors may require early detection and physical and psychological intervention.
DESIGN: Prospective cohort study.
SETTING: Obu City, Aichi Prefecture, Japan.
PARTICIPANTS: Participants were 4038 older adults (48.7% male, mean age = 71 years) who met the study inclusion criteria.
MEASUREMENTS: Longitudinal data on incident disability were collected up to 33 months [median 31 months (interquartile range 29-32 months)] after baseline. We monitored monthly incident disability, defined as Japanese long-term care insurance certification for personal support or care. Baseline measurements included covariates for incident disability, gait speed, and the Geriatric Depression Scale for assessing depressive symptoms. The associations between slow gait, depressive symptoms, or their co-occurrence, and incident disability were examined.
RESULTS: Control participants were the reference in an adjusted Cox proportional hazard regression model. Participants with co-occurring slow gait and depressive symptoms showed a greater risk of incident disability [hazard ratio (HR) 3.08, confidence interval (CI) 95% 2.00-4.75]. Greater risk was also found for participants with slow gait speed alone (HR 2.44, CI 95% 1.71-3.47) and depressive symptoms alone (HR 1.60, CI 95% 1.01-2.53).
CONCLUSIONS: Older adults with both risk factors may require early detection and physical and psychological intervention.