高齡者靜態行為與憂鬱症狀之文獻回顧

Review of Sedentary Behaviors and Depressive Symptoms in Older Adults

憂鬱症是常見的心理問題，不僅是失能的主因，也是增加全球疾病負擔的重要因素。憂鬱症對高齡者會造成死亡與罹病風險提高的嚴重影響。因此，如何找出能預防或延緩其發生的相關因子如：可調整的生活型態行為，實有其必要。靜態行為如：看電視、閱讀、使用手機與電腦、久坐聊天、乘坐交通工具等，是老年生活常見的行為。不幸的是，靜態行為已逐漸被認為是影響許多健康層面如：全因死亡率、心血管代謝症候群、肥胖等的獨立因素，但有關靜態行為與老年憂鬱症狀的關係則尚未有完整的文獻探討。本文旨在提供綜論，分析高齡者靜態行為與憂鬱症狀的前瞻性世代研究等流行病學證據。故此，本文針對以下議題逐一探討，以釐清二者的複雜關係：（1）高齡者憂鬱症狀的盛行率與相關因子；（2）靜態行為定義與高齡者靜態行為現況；（3）靜態行為的測量議題；（4）靜態行為對不同健康層面的影響；（5）高齡者靜態行為與憂鬱症狀之前瞻性世代研究；（6）提出文獻缺口並加以討論。依據目前有限的證據顯示高齡者靜態行為與憂鬱症狀有顯著相關。未來研究建議透過大型前瞻性研究且具多波資料收集，並兼採問卷與加速規等主客觀測量，以釐清不同型態靜態行為與憂鬱症狀的雙向關係及作用機轉。

Depression is a common mental problem and is also a leading cause of disability, which serves as an important contributor to the overall global burden of disease. It may lead to serious consequences including increased risk of morbidity and mortality. This warrants the need to identify correlates such as modifiable lifestyle behaviors that can prevent or delay the onset of depressive symptoms in aging populations. Sedentary behaviors such as TV viewing, reading, mobile phone/computer use, social chatting, and passive transport etc. are prevalent among older adults. Unfortunately, sedentary behaviors have been increasingly recognized as an independent risk factor for different health outcomes. Although the link between sedentary behaviors and several geriatric health outcomes including allcause mortality, cardio-metabolic diseases and obesity in later life has been established, the associations of sedentary behaviors with depressive symptoms have not been comprehensively investigated. Therefore, this study aimed to provide a narrative review by scrutinizing the recent epidemiologic evidence for prospective cohort studies of sedentary behaviors and depressive symptoms in older adults. To fulfill the aim, the following issues were raised and analyzed in an effort to disentangle the complex relationships between late-life sedentary behaviors and depressive symptoms. First, the prevalence and correlates of geriatric depressive symptoms were presented and discussed. Second, the definition of sedentary behaviors and the prevalence of late-life sedentary behaviors were described. Third, the relevant issues of measuring sedentary behaviors were addressed. Fourth, the effects of sedentary behaviors on various health outcomes were identified. Fifth, the prospective studies regarding sedentary behaviors and depressive symptoms in older adults were examined based on epidemiological perspectives. Sixth, based on the preceding information, research gaps in the literature were identified and discussed. Conclusions and suggestions for future research on this topic were proposed. Based on limited evidence, late-life sedentary behaviors are associated with higher risk of depressive symptoms. Future studies on the current topic are recommended to conduct large-scale prospective cohort studies with multiple waves of data collection employs a combination of subjective and objective measures of sedentary behaviors, such as a questionnaire and accelerometry, by which studies could explore the bi-directional relationships of different types of sedentary behaviors with depressive symptoms in older adults and the mechanism between them.