Depresyonu Olan Yaşlı Hastalarda Kalp Hızı Değişkenliğinde Oluşan Değişiklikler: Sistematik Bir Derleme

Öz

Depresyon, kişinin ruh halini ve günlük aktivitelerini etkileyen ve ciddi semptomlara neden olabilen yaygın bir duygudurum bozukluğudur. Depresyon yalnızca ruh halini etkilemekle kalmayıp aynı zamanda kişinin otonom sinir sisteminde işlev bozukluklarına da neden olabilir. Özellikle yaşlı bireylerde depresyon sıklıkla komplikedir ve yönetimi zorlaştırmaktadır. Depresyon tanısı alan bireylerde otonom sinir sisteminin değerlendirilmesi hastalığın seyri açısından büyük önem taşımaktadır. Otonom sinir sisteminin kantitatif değerlendirmesi için kullanılan invaziv olmayan yöntemlerden biri de kalp hızı değişkenliğinin (HRV) bilgisayarlı analizidir. Depresyon tanısı alan bireylerde HRV değişikliklerini inceleyen çalışmalarda farklı sonuçlar elde edilmiştir. Ayrıca yaşın HRV üzerinde etkili bir role sahip olduğu bilinmesine rağmen geriatrik yaş grubunda yeterli çalışmaya rastlanmamıştır. Bu sistematik derlemede depresyon tanısı almış ileri yaştaki bireylerdeki HRV değişimlerini incelemek amaçlanmıştır. Bu derlemeye; 2017 yılından10/09/2024 tarihine kadar Wiley, Web of Science, Springer Link, Scopus, Science Direct, PubMed, APA PsycArticles ve The Networked Digital Library of Theses and Dissertations (NDLTD) veritabanlarında taranan 688 çalışmadan, arama kriterlerini karşılayan 3 randomize kontrollü çalışma dâhil edildi. Sistematik incelememiz sonucunda yaşlı depresyon hastalarına uygulanan farklı meditasyon ve egzersiz programlarının otonom sinir sistemi ve HRV parametreleri üzerinde farklı etkileri olabileceği sonucuna ulaştık. Ancak derlememizin temel çıkış noktası olan yaşlı depresyon hastaları ile sağlıklı kontroller arasında HRV parametrelerindeki farklılıkları inceleyen bir çalışmaya rastlamadık. Çalışmamızdaki bu primer sınırlılık, aynı zamanda mevcut literatürdeki eksikliğin ciddiyetini açığa çıkarmaktadır. İleri yaşlarda depresyon oranının yüksek olduğu göz önüne alındığında bu konuda daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• Kalp Atış Hızı Değişkenliği
• Depresyon
• Yaşlı popülasyon

Heart Rate Variability Changes in Elderly Patients with Depression: A Systematic Review

Öz

Depression is a prevalent and serious mood disorder that affects a person's mood and daily activities, often leading to severe symptoms. Beyond its impact on mood, depression can also dysfunctions in the autonomic nervous system function, particularly in elderly individuals, where such dysfunctions often complicate management and outcomes. Evaluating the autonomic nervous system in those diagnosed with depression is crucial for understanding the disease’s progression. One non-invasive method for quantitatively assessing ANS is the computerized analysis of heart rate variability (HRV). Studies examining HRV changes in individuals with depression have yielded varied results. Although age is known to influence HRV, there is a lack of sufficient studies in the geriatric population. This systematic review aimed to examine HRV changes in elderly individuals diagnosed with depression. Among the 688 studies reviewed from databases including Wiley, Web of Science, Springer Link, Scopus, Science Direct, PubMed, APA PsycArticles and The Networked Digital Library of Theses and Dissertations (NDLTD) databases from 2017 to 10/09/2024, three randomized controlled studies met the inclusion criteria. Our systematic review found that different meditation and exercise programs applied to elderly depression patients may have varying effects on autonomic nervous system and HRV parameters. However, we did not find any study comparing HRV parameters between elderly depression patients and healthy controls, which was the primary focus of our review. This key limitation underscores the significant gap in the existing literature. Given the high prevalence of depression in older age groups, more research is needed in this area.

Anahtar Kelimeler

• : Heart Rate Variability
• Depression
• Geriatric Population

Kaynakça

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