Department of Psychiatry, University of Rochester School of Medicine and Dentistry, 300 Crittenden Boulevard, Rochester, NY, 14642, USA,
Soc Psychiatry Psychiatr Epidemiol. 2014 Mar;49(3):477-85. doi: 10.1007/s00127-013-0712-0. Epub 2013 May 26.
Many older adults in the USA live in public housing facilities and have characteristics that may place them at risk for cognitive impairment. Cognitive impairment has been largely unexamined in this socioeconomically disadvantaged population, however. We therefore aim to characterize its prevalence and correlates, which may help determine which residents could benefit from additional assistance to optimize their ability to function independently.
We interviewed 190 English-speaking public housing residents aged 60 years and older in Rochester, a city in Western New York, to assess socio-demographics, mental health, physical health and disability, coping strategies and social support, and service utilization. The Mini-Cog dementia screen evaluated cognitive status.
Twenty-seven percent of residents screened positive for cognitive impairment. In bivariate analyses, older age, less education, greater duration of residence, worse health, less reliance on adaptive coping strategies, and greater utilization of health services were associated with cognitive impairment; age and worse health remained correlated with cognitive impairment in multivariable analyses. Anxiety, depression, and history of substance misuse were not associated with cognitive impairment.
The high level of cognitive impairment in public housing could threaten residents' continued ability to live independently. Further examination is needed on how such threats to their independence are best accommodated so that public housing residents at risk for needing higher levels of care can successfully age in place.
美国有许多老年人居住在公共住房设施中,他们的特征可能使他们面临认知障碍的风险。然而,在这个社会经济处于不利地位的人群中,认知障碍在很大程度上尚未得到研究。因此,我们旨在描述其普遍性及其相关因素,这有助于确定哪些居民可以从额外的援助中受益,以优化他们独立生活的能力。
我们在纽约州西部的罗彻斯特市对 190 名 60 岁及以上的讲英语的公共住房居民进行了访谈,以评估社会人口统计学、心理健康、身体健康和残疾、应对策略和社会支持以及服务利用情况。使用迷你认知障碍筛查评估认知状况。
27%的居民认知障碍筛查呈阳性。在单变量分析中,年龄较大、受教育程度较低、居住时间较长、健康状况较差、较少依赖适应性应对策略以及更多地利用卫生服务与认知障碍相关;在多变量分析中,年龄和健康状况较差仍然与认知障碍相关。焦虑、抑郁和物质滥用史与认知障碍无关。
公共住房中认知障碍的高发生率可能威胁到居民继续独立生活的能力。需要进一步研究如何最好地适应这些对其独立性的威胁,以便有更高护理需求风险的公共住房居民能够成功地就地养老。