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探索老年糖尿病患者的心理弹性 | 宾夕法尼亚大学护理学院

作者:NursingResearch护理研究前

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Studies suggest that exposure to the COVID-19 pandemic has been associated with a variety of different mental health consequences including reports of depression, loneliness, and insomnia. People who are more than 65 years of age and those with underlying medical conditions such as type 2 diabetes and obesity are particularly vulnerable to negative outcomes from COVID-19. Until now, few investigations have identified and separated the mental health consequences of exposure to the COVID-19 pandemic from preexisting factors in this age group. A new prospective study of a large cohort of older adults with type 2 diabetes and overweight/obesity from across the U.S. has explored this subject with surprising results.

The prospective study, published in the journal Diabetes Care, showed that from pre-COVID to during the COVID-19 pandemic, the prevalence of mild or greater symptoms of depression increased by 1.6 times (from 19.3% to 30.4% of participants), while loneliness rose by 1.8 times (from 12.3% to 22.1% of participants). Reports of insomnia remained stable in the cohort (at 33.3x% and 31.5%, respectively). More than half of the study participants remained free of clinically significant levels of adverse mental health conditions during the COVID-19 pandemic.

“Many older adults have demonstrated psychological resiliency amid the pandemic, but sex and race/ethnicity did play an important role in these outcomes,” says Ariana M. Chao, PhD, CRNP, Assistant Professor of Nursing at the University of Pennsylvania School of Nursing (Penn Nursing) and the lead author of the article. “Women, relative to men, had greater odds of depressive symptoms, anxiety, loneliness, and perceived COVID-19 threat. Compared with participants who were non-Hispanic White, those from underrepresented groups tended to report lower levels of depressive symptoms, loneliness, and insomnia. For example, 32.9% of women versus 26.1% of males reported symptoms of mild or greater depression during the pandemic.”

The article, “Changes in the Prevalence of Symptoms of Depression, Loneliness, and Insomnia in U.S. Older Adults with Type 2 Diabetes During the COVID-19 Pandemic: The Look AHEAD Study,” is available online. “We were fortunate,” said study co-author Thomas Wadden at the Perelman School of Medicine at the University of Pennsylvania, “to have been evaluating these more than 2800 participants in the Look AHEAD study for nearly 20 years, thus giving us a clear picture of their mental health and other functioning before and after the COVID-19 pandemic.” Other study authors included: Jeanne M. Clark of the Johns Hopkins University School of Medicine; Kathleen M. Hayden, Marjorie J. Howard, and Lynne E. Wagenknecht, all of the Wake Forest School of Medicine; Karen C. Johnson of the University of Tennessee Health Science Center; Blandine Laferrere of the Columbia University Irving Medical Center; Jeanne M. McCaffery of the University of Connecticut; Rena R. Wing of the Warren Alpert Medical School of Brown University; Susan Z. Yanovski of the National Institute of Diabetes and Digestive and Kidney Diseases; and the Look AHEAD Research Group.

This study was funded by the National Institutes of Health through cooperative agreements with the National Institute on Aging (AG058571) and National Institute of Diabetes and Digestive and Kidney Diseases (DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178).

diabetes

全文翻译(仅供参考)

研究表明,接触 COVID-19 大流行与各种不同的心理健康后果有关,包括抑郁、孤独和失眠的报告。65 岁以上的人以及患有 2 型糖尿病和肥胖症等基础疾病的人特别容易受到 COVID-19 的负面影响。到目前为止,很少有调查已经确定并将暴露于 COVID-19 大流行的心理健康后果与该年龄组的先前存在的因素区分开来。一项针对来自美国各地的大型 2 型糖尿病和超重/肥胖老年人群的新前瞻性研究探索了这一主题,并取得了令人惊讶的结果。

发表在Diabetes Care杂志上的这项前瞻性研究表明,从 COVID-19 大流行之前到 COVID-19 大流行期间,轻度或重度抑郁症状的患病率增加了 1.6 倍(从参与者的 19.3% 增加到 30.4%),而孤独感增加了 1.8 倍(从参与者的 12.3% 增加到 22.1%)。该队列的失眠报告保持稳定(分别为 33.3% 和 31.5%)。在 COVID-19 大流行期间,超过一半的研究参与者没有出现临床上显着的不良心理健康状况。

“许多老年人在大流行期间表现出心理弹性,但性别和种族/民族确实在这些结果中发挥了重要作用,”宾夕法尼亚大学护理学院护理学助理教授Ariana M. Chao 博士说(Penn Nursing) 和文章的主要作者。“与男性相比,女性出现抑郁症状、焦虑、孤独和感知到 COVID-19 威胁的可能性更大。与非西班牙裔白人的参与者相比,来自代表性不足的群体的参与者往往报告的抑郁症状、孤独感和失眠程度较低。例如,在大流行期间,32.9% 的女性和 26.1% 的男性报告了轻度或重度抑郁症的症状。”

文章“在 COVID-19 大流行期间美国 2 型糖尿病老年人抑郁、孤独和失眠症状流行率的变化:展望未来研究”可在线获取. “我们很幸运,”宾夕法尼亚大学佩雷尔曼医学院的研究合著者 Thomas Wadden 说,“近 20 年来一直在对 Look AHEAD 研究中的 2800 多名参与者进行评估,从而为我们提供了一个清晰的信息。在 COVID-19 大流行之前和之后,他们的心理健康和其他功能的照片。” 其他研究作者包括:约翰霍普金斯大学医学院的 Jeanne M. Clark;维克森林医学院的 Kathleen M. Hayden、Marjorie J. Howard 和 Lynne E. Wagenknecht;田纳西大学健康科学中心的 Karen C. Johnson;哥伦比亚大学欧文医学中心的 Blandine Laferrere;康涅狄格大学的 Jeanne M. McCaffery;布朗大学沃伦阿尔珀特医学院的 Rena R. Wing;苏珊 Z。国家糖尿病、消化和肾脏疾病研究所的亚诺夫斯基;和 Look AHEAD 研究小组。

原文链接:

https://www.nursing.upenn.edu/details/news.php?id=2053

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