Bipolar Disord:老年双相情感障碍的双相症状、身体功能受限的研究

2022-06-25 医路坦克 MedSci原创

有关老年双相情感障碍(OABD)的文献有限。这是首次对双相情感障碍数据库中的全球老龄化和老年实验(Gage-BD)进行的分析,调查了年龄、BD症状、共病和功能之间的关系。

从现在到2030年,60岁以上人口的增长速度将是普通人口的3.5倍。大约25%的双相情感障碍患者年龄在60岁或以上,这一比例可能会随着全球人口结构的变化而增加。不幸的是,缺乏关于双相情感障碍老年实验数据库(Gage-BD)项目的研究,该项目由国际双相情感障碍协会(ISBD)赞助,汇集了一些档案研究和临床数据集,以提供一个促进对老年BD(OABD)的认识的证据平台。Gage-BD项目合作的研究人员的主要目标是检查BD情绪轨迹与年龄的模式,BD症状、身体功能受限状态之间的关系。

随着年龄的增长,有许多人口统计学和背景变量可以预测BD患者的预后。性别和教育程度与情绪症状的严重程度和结局有关。例如,抑郁症状在年龄较大的妇女中可能更常见和更严重。教育水平是认知储备的有力预测因素,因此社会经济地位可能与结果和情绪症状的严重程度相关。由于较低的教育程度是晚年抑郁的风险因素,患有BD和教育程度较低的老年人特别可能出现抑郁症状。

这是有史以来第一次对Gage-BD进行分析。两个主要目标中的第一个是检查BD症状和年龄增长之间的联系。第二个目的是检查症状严重程度和身体功能受限对整个年龄段的功能的影响。预计这些发现将为Gage-BD项目中的未来分析以及专注于OABD的其他研究提供信息。

方法:这项分析使用了来自19项国际研究(N=1377)的协调、基线、横断面数据。标准化测量包括青年躁狂症评定量表(YMRS)、汉密尔顿抑郁量表(HAM-D)、蒙哥马利-阿斯伯格抑郁量表(MADRS)和全球功能评估(GAF)。

结果:样本平均年龄为60.8岁(标准差为12.2岁),女性占55%,BD I占72%。情绪症状严重程度低:YMRS总分平均为4.3(SD 5.4),中至重度抑郁仅占22%。控制样本效应,躁狂和抑郁症状严重程度在老年人中都较低(p‘s<0.0001)。年龄较大与症状严重程度之间的负关系在不同性别之间相似,但在教育水平较低的人中更强。GAF轻度受损(平均值=62.0,SD=13.3),身体功能受限较重(平均值=2.42,SD=1.97)。共病负担与GAF无关。然而,较高的抑郁(p<0.0001)和躁狂(p<0.0001)症状与较低的GAF相关,尤其是在老年人中。

结论:研究结果表明,尽管存在广泛的身体功能受限,但OABD患者的BD症状有所减轻。抑郁症状的严重程度与老年人的身体功能恶化密切相关,这突显了有效治疗老年人BD抑郁症的必要性。这一国际合作为更好地了解BD的衰老奠定了道路。

文献来源:Sajatovic M,  Dols A,  Rej S,Bipolar symptoms, somatic burden, and functioning in older-age bipolar disorder: Analyses from the Global Aging & Geriatric Experiments in Bipolar Disorder Database project.Bipolar Disord 2022 Mar;24(2)

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    2022-11-25 晴朗天空 来自广东省

    谢谢分享!感恩

    0

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    2022-06-15 dzx0922892
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