Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle.
Department of Psychology, University of Washington, Seattle.
Gerontologist. 2017 Aug 1;57(4):637-647. doi: 10.1093/geront/gnv690.
Caregivers (CGs) have been shown to do more poorly than non-caregivers (NCGs) on objective cognitive tests (Trails B and Digit Symbol Test, DST), but less is known about whether these groups differ in: (a) reports of subjective cognitive problems (SCPs, memory complaints, etc.) and (b) relationships of SCPs with objective cognitive tests, depression, and stress exposure. Such relationships are important because researchers/clinicians use SCPs as proxies for objective cognitive tests.
One hundred and twenty-two spouse CGs of persons with Alzheimer's disease and 117 demographically matched NCG spouses were compared on Trails B and DST at baseline (T1), 1 year later (T2), and 2 years later (T3) and on SCPs at T1.
Trails B was slower in CGs than NCGs and DST declined in CGs relative to NCGs. CGs reported more SCPs than NCGs. Depression mediated group differences in Trails and DST and was also associated with SCPs. Trails B and DST explained variance in SCPs in NCGs, but not in CGs. Hours of care explained variance in SCPs in CGs, but not in NCGs.
When using SCPs to make inferences about CG cognitive function, researchers/clinicians should consider the possible influence of stress exposures and depression. The lack of associations of objective and subjective cognitive measures may be a reflection of poorer self-monitoring among CGs, a potential new area of CG research.
研究表明,与非照护者(NCG)相比,照护者(CG)在客观认知测试(Trails B 和数字符号测试,DST)上的表现更差,但对于以下两个方面知之甚少:(a)报告主观认知问题(SCPs,记忆问题等)的差异,以及(b)SCPs 与客观认知测试、抑郁和应激暴露的关系。这些关系很重要,因为研究人员/临床医生将 SCPs 用作客观认知测试的替代指标。
在基线(T1)、1 年后(T2)和 2 年后(T3),比较了 122 名阿尔茨海默病患者的配偶 CG 和 117 名在人口统计学上匹配的 NCG 配偶在 Trails B 和 DST 上的表现,以及在 T1 时对 SCPs 的报告。
CG 比 NCG 完成 Trails B 的速度更慢,且 DST 在 CG 中相对于 NCG 下降。CG 比 NCG 报告更多的 SCPs。抑郁中介了 Trails 和 DST 中两组间的差异,并且与 SCPs 相关。Trails B 和 DST 解释了 NCG 中 SCPs 的差异,但在 CG 中则不然。CG 中的照护时间解释了 SCPs 的差异,但在 NCG 中则不然。
当使用 SCPs 来推断 CG 的认知功能时,研究人员/临床医生应该考虑应激暴露和抑郁的可能影响。客观和主观认知测量之间缺乏关联可能反映了 CG 自我监测能力较差,这是 CG 研究的一个新领域。