Depression and quality of life in Brazilian and Portuguese community elderly: association and risk analysis

We aimed to analyze the association and risk of depression on aspects of Quality of Life (QL) in elderly users of Primary Health Care (PHC) residing in Brazil and Portugal. This is an observational, cross-sectional, comparative study with a quantitative approach carried out in PHC in Brazil and Portugal, in which we obtained a non-random sample of participants who were 65 years of age or older and consisted of 150 participants (100 Brazilians and 50 Portuguese). For data collection, a questionnaire with sociodemographic and health data, the Medical Outcomes Short-Form Health QoL (SF-36) questionnaire and the Beck Inventory were used. In the analysis of the association between QoL and depression, we observed that most aspects of QoL had a higher median score (> 50.0) within the categorical variables of depression “Absent” and “Mild”. The Emotional role functioning, Physical role functioning, Physical functioning, Mental Health, Total Score and summary measures Mental Health and Physical health domains stood out with this behavior, which in turn, presented correlation values inversely proportional with the Beck Inventory, which indicated lower levels of depression in the face of higher SF-36 scores. In general, their correlation strengths were more relevant in Portugal, where we found that most of them had moderate to strong correlation (⍴> 0.400). Greater risks of depression were observed on the QoL of Portugal when compared to Brazil. Among its most expressive risks was for the worst assessment of QOL (SF-36 < 50.0) in the Physical role functioning (OR= 4.776; 95% CI: 2.41-9.43), Physical functioning (OR= 3.037; 95% CI: 3.037) domains , Vitality (OR= 6,000; 95% CI: 1.56-23.07), Total Score (OR= 3.727; 95% CI: 2.24-6.17) and the Summary Measure Mental Health (OR= 3.870; 95% CI: 2.13-7.02) . Among the aspects, those related to the emotional, physical, functional and mental health components stood out. Both the association, the correlation and the risk of depression were more expressive in Portugal compared to Brazil, although it also presented similar results, but with less relevance.

本研究旨在探究居住于巴西及葡萄牙的基层医疗（Primary Health Care, PHC）老年使用者群体中，抑郁症与生活质量（Quality of Life, QL）各维度的关联，以及抑郁症对生活质量的风险效应。本研究为一项采用定量研究方法的观察性横断面对比研究，在巴西与葡萄牙的基层医疗场景中开展，纳入了150名65岁及以上的非随机抽样参与者（其中巴西籍100人，葡萄牙籍50人）。数据收集阶段，本研究采用了包含社会人口学与健康相关信息的问卷、简明健康生活质量调查问卷（Medical Outcomes Short-Form Health QoL, SF-36）以及贝克量表（Beck Inventory）。在分析生活质量与抑郁症的关联时，我们发现，在抑郁症分类变量为「无」与「轻度」的群体中，多数生活质量维度的中位数得分高于50.0。情感职能、躯体职能、躯体功能、精神健康、总得分以及心理健康与躯体健康领域的综合评分均呈现出该特征，即其与贝克量表得分呈负相关关系，提示SF-36得分越高，抑郁程度越低。总体而言，相关强度在葡萄牙群体中更为显著，研究发现该群体多数指标的相关系数⍴>0.400，处于中等至强相关水平。与巴西群体相比，葡萄牙群体的生活质量受抑郁症影响的风险更高。其中最具代表性的风险包括：躯体职能领域（比值比OR=4.776；95%置信区间CI:2.41-9.43）、躯体功能领域（OR=3.037；95%CI:3.037）、活力维度（OR=6.000；95%CI:1.56-23.07）、总得分（OR=3.727；95%CI:2.24-6.17）以及心理健康综合评分（OR=3.870；95%CI:2.13-7.02）对应的生活质量评分最差（SF-36<50.0）的情况。在各维度中，与情感、躯体、功能及精神健康相关的指标尤为突出。总体而言，相较于巴西群体，葡萄牙群体中抑郁症与生活质量的关联、相关关系及风险效应均更为显著，尽管巴西群体也呈现出相似的结果，但相关性强度相对较弱。