Depressive symptoms and functional dependence in near-centenarians and centenarians: a scoping review
摘要
The growing population of centenarians faces unique health challenges. Of particular interest may be the co-occurrence of depressive symptoms and functional dependence, requiring comprehensive exploration.
ObjectiveTo map and summarize existing literature on depressive symptoms and functional dependence in near-centenarians and centenarians, focusing on prevalence rates, screening instruments, and the relationship between these two conditions.
Inclusion criteriaStudies that explored depressive symptoms and functional dependence among individuals aged ≥ 95 years.
MethodsThis review was performed in accordance with the JBI Manual for Scoping Reviews. The PRISMA Extension for Scoping Reviews (PRISMA-ScR) standards were followed for reporting. The literature search was conducted in August 2023 in the following bibliographic databases: Embase.com, Medline ALL Ovid, CINAHL with Full Text, APA PsycInfo Ovid, Web of Science Core Collection, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials; including a grey literature search and citation tracking strategies.
ResultsFifty-three studies from 1994 to 2023 were included, with 28.3% conducted in the USA. Most studies were quantitative and cross-sectional. Depressive symptom prevalence ranged from 10.5% to 73% among studies reported individually; the GDS–15 was the most commonly used instrument. Total functional dependence ranged from 20.8% to 30.3% (ADLs) and 27.5% to 63% (IADLs); the OARS Multidimensional Functional Assessment Questionnaire and the Katz Index were the most frequently employed instruments. Only 30.2% of studies explored the association between depressive symptoms and functional dependence, with 56.3% finding a significant relationship.
ConclusionsThe findings revealed geographical research disparities and underscored the need for diverse research methodologies for deeper insights into the health trajectories of the very old. Additionally, centenarians may not inherently have higher depressive symptoms than ‘younger’ seniors, suggesting possible resilience mechanisms. The relationship between depressive symptoms and functional dependence highlighted their mutual influence and potential to increase the risk of adverse outcomes.
ImplicationsDiversifying research methodologies and expanding geographical scope are essential for a holistic understanding and international comparisons. Standardized guidelines for assessment instruments could facilitate consistent conclusions. Development and implementation of multifaceted interventions, such as preventive measures, professional competency enhancement, and caregiver support are central to addressing the needs of this population effectively.