400038 重庆,陆军军医大学(第三军医大学)军事预防医学系卫生统计学教研室
Received:05 August 2018,
Revised:2018-10-08,
Published:28 February 2019
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Qiuyue SONG, Dong YI, Yazhou WU. Factors contributing to depression in the elderly: a longitudinal data analysis based on linear mixed effect[J]. Journal of Third Military Medical University, 2019, 41(4): 384-387.
Qiuyue SONG, Dong YI, Yazhou WU. Factors contributing to depression in the elderly: a longitudinal data analysis based on linear mixed effect[J]. Journal of Third Military Medical University, 2019, 41(4): 384-387. DOI: 10.16016/j.1000-5404.201808025.
目的
2
应用线性混合效应(linear mixed effect,LME)模型对老年抑郁量表得分情况进行拟合分析,探讨老年人抑郁情况及其影响因素。
方法
2
数据来源于美国国家阿尔茨海默合作中心(National Alzheimer’s Coordinating Center,NACC),采用简版老年人抑郁量表对老年人抑郁情绪进行调查,从2011年进行首次调查的1 345人中筛选出连续随访4年共计230人;根据赤池信息准则(Akaike information criterion,AIC)、贝叶斯信息准则(Bayesian information criterions,BIC)值最小化原则,选择合适的方差-协方差结构(UN)对该数据进行拟合和模型参数估计,利用SAS软件中的MIXED模块对该纵向数据进行建模与分析。
结果
2
LME模型结果显示,受教育年限越长(β=-0.103,
P
=0.016),简版老年抑郁量表(Geriatric Depression Scale,GDS)得分越低;离婚的老年人相比于在婚状态的老年人GDS得分高(β=0.742,
P
=0.025),独居的老年人比在婚状态的GDS得分高(β=1.495,
P
=0.024);复杂活动需要帮助的老年人相比于完全能自理的老年人GDS得分更高(β=0.420,
P
=0.036);近2年经常感到沮丧的老年人GDS得分更高(β=1.176,
P
<
0.0001);痴呆状态的老年人比正常认知老年人GDS得分高(β=1.068,
P
=0.003),MCI状态的老年人也比正常状态的老年人GDS得分高(β=1.020,
P
=0.001)。
结论
2
线性混合效应模型能有效地处理纵向数据;低文化水平、低自理能力、低认知状态、离婚是造成老年抑郁的重要因素。
Objective
2
To investigate the prevalence of depression in the elderly and identify the contributing factors by fitting the Geriatric Depression Scale (GDS) scores using a linear mixed effect (LME) model.
Methods
2
The data were obtained from a longitudinal study by the United States National Alzheimer's Coordinating Center (NACC). Starting from 2011
this study investigated the prevalence of depression using Short GDS initially among 1 345 elderly subjects
from whom 230 were followed up continuously for 4 years. According to the minimization principle of the values of Akaike information criterion (AIC) and Bayesian Information Criteria (BIC)
a variance-covariance structure was chosen to fit the data and estimate the model
and the MIXED module in SAS software was used to model and analyze the longitudinal data.
Results
2
Analysis of the LME model showed that a longer education time was associated with a lower GDS score (β=-0.103
P
=0.016). The elderly who divorced (β=0.742
P
=0.025) and those who lived alone (β=1.495
P
=0.024) were more likely to have a higher GDS score than those in marriage. The elderly who required assistance for complex activities had higher GDS scores than those who were completely independent (β=0.420
P
=0.036). The elderly reporting frequent depressive feelings in the past 2 years had higher GDS scores (β=1.176
P
<
0.000 1). The elderly patients with dementia (β=1.068
P
=0.003) and those with mild cognitive impairment (β=1.020
P
=0.001) had higher GDS scores than the elderly with normal cognitive function.
Conclusion
2
The LME model allows efficient analysis of the longitudinal data from this elderly cohort. A lower level of education
a lowered self-care ability
cognitive impairment and divorce are all important factors contributing to depression in the elderly.
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