Ward L, Mathias J L, Hitchings S E
School of Psychology, University of Adelaide, Adelaide, Australia.
Gerontology. 2007;53(6):362-72. doi: 10.1159/000104787. Epub 2007 Jun 29.
Bereavement is often associated with increased levels of depression, anxiety, and stress. The question of whether grief is associated with cognitive deficits in older adults remains largely unanswered. Although Xavier and coworkers (see text) found preliminary evidence that grief, in the absence of depression, impacted on memory in a sample of the oldest-old in Brazil, the impact of bereavement on cognitive functioning, independent of the effects of mood, has not been adequately examined.
To replicate and expand on the work of Xavier and colleagues to examine whether there is an association between bereavement due to spousal loss and performance in a range of cognitive functioning domains in older adults, independent of the effects of depression, stress, and anxiety.
Samples of bereaved (n = 25) and non-bereaved (n = 25) participants, who were aged between 65 and 80 years and who were matched for age, gender, education, premorbid intellectual functioning, and general cognitive ability, were compared on a battery of tests designed to assess attention, verbal fluency, memory, and visuospatial ability. Depression, anxiety, and stress were also assessed, as were the presence of complicated grief and the adequacy of social support in the bereaved group. Cognitive tests that differed between the groups and correlated with depression, stress, or anxiety were analyzed using hierarchical multiple regression.
The bereaved groups were more depressed, anxious, and stressed, and performed more poorly on tests assessing attention, information-processing speed, and verbal fluency. With the exception of the attentional switching task, the cognitive measures on which the groups differed were correlated with mood. When mood was controlled statistically, the group differences in these cognitive tests disappeared. Twenty-eight percent of the bereaved group met the criteria for a diagnosis of complicated grief. This subgroup was younger than the other bereaved participants and had higher levels of stress.
The evidence suggests that grief associated with death of a spouse has limited associations with cognition beyond those that would be expected to occur as a result of depression, anxiety, and stress.
丧亲之痛往往与抑郁、焦虑和压力水平的升高有关。悲伤是否与老年人的认知缺陷相关这一问题在很大程度上仍未得到解答。尽管泽维尔及其同事（见正文）发现了初步证据，表明在巴西的高龄老人样本中，悲伤在没有抑郁的情况下会影响记忆，但丧亲之痛对认知功能的影响，独立于情绪影响之外，尚未得到充分研究。
重复并扩展泽维尔及其同事的研究工作，以检验配偶离世导致的丧亲之痛与老年人一系列认知功能领域的表现之间是否存在关联，独立于抑郁、压力和焦虑的影响。
比较了25名丧亲者和25名非丧亲者样本，他们年龄在65至80岁之间，在年龄、性别、教育程度、病前智力功能和一般认知能力方面相匹配，通过一系列旨在评估注意力、语言流畅性、记忆和视觉空间能力的测试进行比较。还评估了抑郁、焦虑和压力，以及丧亲组中复杂悲伤的存在情况和社会支持的充分性。使用分层多元回归分析了两组之间存在差异且与抑郁、压力或焦虑相关的认知测试。
丧亲组更抑郁、焦虑和有压力，在评估注意力、信息处理速度和语言流畅性的测试中表现更差。除了注意力转换任务外，两组存在差异的认知指标与情绪相关。当在统计上控制情绪时，这些认知测试中的组间差异消失。28%的丧亲组符合复杂悲伤诊断标准。这个亚组比其他丧亲参与者更年轻，压力水平更高。
证据表明，与配偶死亡相关的悲伤与认知的关联有限，超出了因抑郁、焦虑和压力而预期会出现的关联。
