The aim of this study was to determine trajectories of depression in older adults and to identify predictors of membership in the different trajectory groups. A total of 3983 individuals aged 65 or older were included. Latent class growth models were used to identify trajectory groups. Of 3983 individuals, 2269 (57%) were females, with a mean baseline age of 72.4 years ( SD = 6 years). Four depression trajectories were identified across 8 years of follow-up: “low-flat” ( n = 3636; 86.6%), “low-to-middle” ( n = 214; 9.2%), “low-to-high” ( n = 31; 1.3%), and “high-stable” ( n = 102; 2.9%). Compared to the low-flat depression group, high-stable depression group members were more likely to be female, have three or more chronic diseases, and were more likely not to own a home. Our findings will assist health policy decision-makers in planning intervention programs targeting those most likely to experience persistent depression in order to improve psychological well-being in the elderly.
PurposeArthroscopic meniscectomy (APM) is the most common procedure in orthopedic surgery, despite increasing evidence questioning its benefit over conservative management for treatment of degenerative meniscal tears. The purpose of this study is to determine the epidemiology and trends of APM in Saskatchewan, a Canadian province, over a 20 year period.
MethodsPhysician billing codes were used to identify patients who underwent APM in Saskatchewan between January 1, 1998 and December 31, 2017. Records were obtained from eHealth Saskatchewan, a provincial health database. Data was analyzed for overall incidence and age‐specific trends of APM.
ResultsA total of 35,099 APMs were performed during the study period. The population of Saskatchewan ranged from 992,314 to 1,150,782 (median 1,017,368) during this time interval, with 81 orthopedic surgeons performing APM. Overall incidence rate of APM did not change significantly over time. No decrease was observed in patients presumed to have degenerative tears (≥ 50 years). The number of meniscectomies in patients ≥ 50 years was significantly greater during the second decade of study compared to the first (OR 1.48, p < 0.01). Conversely, the increase in incidence rate among older patients was not statistically significant (R2 = 0.125, n.s.).
ConclusionOverall incidence rate of APM in Saskatchewan has not decreased during the last 20 years. Furthermore, APM frequency increased over time for individuals ≥ 50 years. Several regional factors may have contributed to these findings, including the large proportion of Saskatchewan residents engaged in physically demanding work and barriers to accessing physiotherapy services. Given recent evidence disputing the benefit of APM over conservative measures, this study highlights the need for improved dissemination of evidence, as well as the importance of an individualized treatment plan to address patient‐specific factors.
Level of evidenceLevel IV
Background
Depression and anxiety are common mental health conditions in the older adult population. Understanding the trajectories of these will help implement treatments and interventions.
Aims
This study aims to identify depression and anxiety trajectories in older adults, evaluate the interrelationship of these conditions, and recognize trajectory-predicting characteristics.
Methods
Group-based dual trajectory modeling (GBDTM) was applied to the data of 3983 individuals, aged 65 years or older who participated in the Korean Health Panel Study between 2008 and 2015. Logistic regression was used to identify the association between characteristics and trajectory groups.
Results
Four trajectory groups from GBDTM were identified within both depression and anxiety outcomes. Depression outcome fell into “low-flat (87.0%)”, “low-to-middle (8.8%)”, “low-to-high (1.3%)” and “high-stable (2.8%)” trajectory groups. Anxiety outcome fell into “low-flat (92.5%)”, “low-to-middle (4.7%)”, “high-to-low (2.2%)” and “high-curve (0.6%)” trajectory groups. Interrelationships between depression and anxiety were identified. Members of the high-stable depression group were more likely to have “high-to-low” or “high-curved” anxiety trajectories. Female sex, the presence of more than three chronic diseases, and being engaged in income-generating activity were significant predictors for depression and anxiety.
Conclusions
Dual trajectory analysis of depression and anxiety in older adults shows that when one condition is present, the probability of the other is increased. Sex, having more than three chronic diseases, and not being involved in income-generating activity might increase risks for both depression and anxiety. Health policy decision-makers may use our findings to develop strategies for preventing both depression and anxiety in older adults.
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