DEPRESSION, DISABILITY & REHAB IN VISION IMPAIRED ELDERS

抑郁、残疾

• 批准号: 2867431
• 负责人: AMY HOROWITZ
• 金额: $ 28.74万
• 依托单位: LIGHTHOUSE INTERNATIONAL
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-30 至 2003-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2867431
• 关键词: aging; behavioral /social science research tag; clinical research; comorbidity; depression; disease /disorder etiology; functional ability; gender difference; health care service utilization; human old age (65+); human subject; longitudinal human study; mental health epidemiology; person with disability; rehabilitation; vision disorders

The proposed study builds upon current research addressing the inter- relationships among chronic impairment, disability and depression in later life and will make several unique contributions. The study's focus is on subgroup of elders experiencing an extremely common age- related disability, vision impairment, in which the rates of both functional disability and depression are particularly high, but which has received relatively little systematic research attention. The longitudinal design will permit an in-depth examination of the course of depression over time, utilizing a stress and coping conceptual model which incorporates key personal and social resources as mediators of the relationship between disability and depression. Most importantly, the focus on a sample seeking rehabilitation permits us to empirically challenge the assumption of inevitable, reciprocal decline in functional and depressive status. By following the natural course of both depression and rehabilitation service use, a primary long-term goal is to examine the extent to which, and mechanisms by which, this non- psychiatric intervention may influence depression status among disabled elders. This knowledge will provide a foundation for future intervention studies. The specific study aims are: 1. to document the prevalence, course, and severity of depression among visually impaired elders over time. 2. to examine the influence of depression on utilization of vision rehabilitation services. 3. to examine the mechanisms by which vision rehabilitation services may affect the severity and course of depression. 4. to test a longitudinal model explicating the interrelationships among vision impairment severity, co- morbid health conditions, functional disability, rehabilitation service utilization and depression, and how such relationships are mediated by personal and social resources. 5. to examine gender differences relative to aims 1-4 above. 600 elders (300 of each gender) will be sampled from applicants, age 65+, of a vision rehabilitation agency. Subjects will be assessed 4 times (at baseline, 6, 12 and 18 months) in order to examine both short and long-term causal relationships among key variables. Analyses address concurrent associations (cross-sectional) and prospective relationships (longitudinal) using regression and structural equation modeling (SEM) techniques.

拟议的研究基于目前的研究，以解决 慢性障碍，残疾和抑郁之间的关系 以后的生活将做出一些独特的贡献。 研究是 重点是长者亚组，经历了极为普遍的年龄 - 相关的残疾，视力障碍，其中两者的比率 功能残疾和抑郁症特别高，但 受到相对较少的系统研究关注。 这 纵向设计将允许对课程进行深入检查 随着时间的流逝，抑郁症，利用压力和应对概念模型 将关键的个人和社会资源作为调解员 残疾与抑郁之间的关系。 最重要的是 专注于寻求康复的样本允许我们经验 挑战功能不可避免的，互惠下降的假设 和抑郁状态。 通过遵循两者的自然过程 抑郁和康复服务的使用，主要的长期目标是 检查该非 - 精神病干预可能会影响残疾人的抑郁状况 长者。 这些知识将为未来提供基础 干预研究。 具体研究的目的是：1。记录 视力障碍的抑郁症的患病率，过程和严重程度 长老会随着时间的流逝。 2。检查抑郁症对 视力康复服务的利用。 3。检查 视力康复服务可能会影响的机制 严重性和抑郁症的过程。 4。测试纵向模型 阐明视力障碍严重程度之间的相互关系，共同 病态的健康状况，功能残疾，康复服务 利用和沮丧以及这种关系的方式 由个人和社会资源介导。 5。检查性别 相对于目标1-4的差异。 600名长老（每个性别的300个）将从申请人中取样，年龄 65岁以上，是一家视觉康复机构。 受试者将进行评估4 时间（基线，6、12和18个月），以便检查两个短片 关键变量之间的长期因果关系。 分析 地址并发协会（横截面）和预期 使用回归和结构方程的关系（纵向） 建模（SEM）技术。