Rush University Medical Center, Chicago, Illinois, USA.
J Am Geriatr Soc. 2010 Dec;58(12):2292-9. doi: 10.1111/j.1532-5415.2010.03156.x.
To examine the longitudinal association between decline in cognitive function and risk of elder self-neglect in a community-dwelling population.
Prospective population-based study.
Geographically defined community in Chicago.
Community-dwelling subjects reported to the social services agency from 1993 to 2005 for self-neglect who also participated in the Chicago Health Aging Project (CHAP). Of the 5,519 participants in CHAP, 1,017 were reported to social services agency for suspected elder self-neglect from 1993 to 2005.
Social services agency identified reported elder self-neglect. The primary predictor was decline in cognitive function assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (Executive Function), and immediate and delayed recall of the East Boston Memory Test (Episodic Memory). An index of global cognitive function scores was derived by averaging z-scores of all tests. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these longitudinal associations.
After adjusting for potential confounding factors, decline in global cognitive function, MMSE score, and episodic memory were not independently associated with greater risk of reported and confirmed elder self-neglect. Decline in executive function was associated with greater risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with greater risk of greater self-neglect severity (parameter estimate=0.76, standard error=0.31, P=.01).
Decline in executive function was associated with risk of reported and confirmed elder self-neglect. Decline in global cognitive function was associated with risk of greater self-neglect severity.
在一个社区居民群体中，研究认知功能下降与老年自我忽视风险之间的纵向关联。
前瞻性基于人群的研究。
芝加哥的一个地理定义社区。
1993 年至 2005 年因自我忽视而向社会服务机构报告的居住在社区中的受试者，他们也参加了芝加哥健康老龄化项目（CHAP）。在 CHAP 的 5519 名参与者中，1993 年至 2005 年期间有 1017 名因涉嫌老年自我忽视而向社会服务机构报告。
社会服务机构确定了报告的老年自我忽视。主要预测指标是使用简易精神状态检查（MMSE）、符号数字模态测试（执行功能）和东波士顿记忆测试（情景记忆）即时和延迟回忆评估的认知功能下降。通过平均所有测试的 z 分数得出全球认知功能评分指数。感兴趣的结果是老年自我忽视。使用逻辑和线性回归模型评估这些纵向关联。
在调整了潜在的混杂因素后，全球认知功能、MMSE 评分和情景记忆下降与报告和确诊的老年自我忽视风险增加无关。执行功能下降与报告和确诊的老年自我忽视风险增加有关。全球认知功能下降与报告的自我忽视严重程度增加有关（参数估计值=0.76，标准误差=0.31，P=.01）。
执行功能下降与报告和确诊的老年自我忽视风险增加有关。全球认知功能下降与自我忽视严重程度增加有关。
