Lee Sunmin, Kawachi Ichiro, Grodstein Francine
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, USA.
J Nerv Ment Dis. 2004 Jan;192(1):51-7. doi: 10.1097/01.nmd.0000106000.02232.30.
Increasing numbers of women provide care to their ill spouses; however, no studies have examined possible effects of caregiving stress on cognitive function. We administered 6 tests of cognitive function to 13740 Nurses' Health Study participants aged 70-79 years. We collected information on caregiving and numerous potential confounding variables via biennial mailed questionnaires. After adjustment for potential confounders (age, education, mental health index, vitality index, use of antidepressants, and history of high blood pressure, diabetes, and heart disease), we found modest but significantly increased risks of low cognitive function on three of the cognitive tests among women who provided care to a disabled or ill spouse compared with women who did not provide any care. For example, on the TICS, a test of general cognition, the risk of a low score was 31% higher in women who provided care compared with women who did not (RR = 1.31, 95% CI 1.10, 1.56). We found a moderately increased risk of poor performance on several cognitive tests among women who provided care to their disabled or ill husbands.
越来越多的女性为生病的配偶提供照料;然而,尚无研究考察照料压力对认知功能可能产生的影响。我们对13740名年龄在70 - 79岁的护士健康研究参与者进行了6项认知功能测试。我们通过每两年邮寄一次的问卷收集了有关照料情况及众多潜在混杂变量的信息。在对潜在混杂因素(年龄、教育程度、心理健康指数、活力指数、抗抑郁药使用情况以及高血压、糖尿病和心脏病史)进行调整后,我们发现,与未提供任何照料的女性相比,为残疾或患病配偶提供照料的女性在三项认知测试中出现低认知功能的风险虽小但显著增加。例如,在作为一般认知测试的TICS测试中,提供照料的女性得分低的风险比未提供照料的女性高31%(风险比=1.31,95%置信区间1.10,1.56)。我们发现,为残疾或患病丈夫提供照料的女性在多项认知测试中表现不佳的风险适度增加。