Vitaliano Peter P, Zhang Jianping, Young Heather M, Caswell Lisa W, Scanlan James M, Echeverria Diana
Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA.
Gerontologist. 2009 Feb;49(1):12-22. doi: 10.1093/geront/gnp004. Epub 2009 Mar 18.
Very few studies have examined cognitive decline in caregivers versus noncaregivers, and only 1 study has examined mediators of such decline. We evaluated the relationship between caregiver status and decline on the digit symbol test (DST; a measure of processing speed, attention, cognitive-motor translation, and visual scanning) and whether this relationship was mediated by depressed mood.
Caregivers for spouses with Alzheimer's disease (n = 122) were compared with demographically similar noncaregiver spouses (n = 117) at study entry (Time 1 = T1), T2 (1 year later), and T3 (2 years after T1).
Caregivers had lower DST scores and higher Hamilton depression scores at T1, T2, and T3 than noncaregivers (all p < .05). Hierarchical linear modeling revealed that although caregivers started well below noncaregivers, they experienced a more rapid rate of decline than noncaregivers (p = .047). Caregivers declined 4.5 times faster than noncaregivers. Greater depressed mood at T1 (p < .01) and T2 (p < .01) predicted DST decline and mediated DST decline in caregivers vs. noncaregivers.
Depressed mood in caregivers relative to noncaregivers may influence their greater risk for DST decline. This is important because the DST predicts problem solving and everyday functions necessary for independent living and the potential well-being of their care recipients.
极少有研究对比过照料者与非照料者的认知衰退情况,仅有一项研究探究了这种衰退的中介因素。我们评估了照料者状态与数字符号测验(DST;一种用于测量加工速度、注意力、认知-运动转换和视觉扫描的测试)得分下降之间的关系,以及这种关系是否由抑郁情绪介导。
在研究开始时(时间1 = T1)、T2(1年后)和T3(T1后2年),将阿尔茨海默病患者配偶的照料者(n = 122)与人口统计学特征相似的非照料者配偶(n = 117)进行比较。
在T1、T2和T3时,照料者的DST得分低于非照料者,汉密尔顿抑郁得分高于非照料者(所有p < .05)。分层线性模型显示,尽管照料者一开始的得分远低于非照料者,但他们的衰退速度比非照料者更快(p = .047)。照料者的衰退速度比非照料者快4.5倍。T1(p < .01)和T2(p < .01)时更严重的抑郁情绪预示着照料者与非照料者相比DST得分下降,并介导了这种下降。
与非照料者相比,照料者的抑郁情绪可能会增加他们DST得分下降的风险。这很重要,因为DST可预测解决问题的能力以及独立生活所需的日常功能和其照料对象的潜在幸福感。