Chapko Dorota, Staff Roger T, McNeil Christopher J, Whalley Lawrence J, Black Corri, Murray Alison D
Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK.
Nuclear Medicine, Aberdeen Royal Infirmary NHS-Grampian, Aberdeen, UK.
Age Ageing. 2016 Jul;45(4):486-93. doi: 10.1093/ageing/afw061. Epub 2016 Apr 13.
the 'triad of impairment' phenomenon describes the co-occurrence of age-related cognitive, emotional and physical functioning deficits. We investigated how occupational profile and childhood intelligence contribute to the triad of impairment in late life.
we analysed data of a subsample of the Aberdeen Birth Cohort of 1936 (n = 346). Data were collected on participants' childhood intelligence, late-life cognitive ability, physical functioning, depressive symptoms and main lifetime occupation. We summarised the various occupational and impairment measures into two latent variables, 'occupational profile' and the 'triad of impairment'. We used a series of data reduction approaches and structural equation models (SEMs) of increasing complexity to test both the validity of the models and to understand causal relationships between the life-course risks for the triad of impairment.
occupational profile had a significant effect on the triad of impairment independent of childhood intelligence. Childhood intelligence was the predominant influence on the triad of impairment and exerted its effect directly and indirectly via its influence on occupation. The direct effect of childhood intelligence exceeded the independent influence of the occupational profile on impairment by a factor of 1.7-1.8 and was greater by a factor of ∼4 from the indirect pathway (via occupation).
childhood intelligence was the predominant influence on the triad of impairment in late life, independently of the occupational profile. Efforts to reduce impairment in older adults should be informed by a life-course approach with special attention to the early-life environment.
“损伤三联征”现象描述了与年龄相关的认知、情感和身体功能缺陷的共同出现。我们研究了职业概况和童年智力如何导致晚年的损伤三联征。
我们分析了1936年阿伯丁出生队列的一个子样本的数据（n = 346）。收集了参与者童年智力、晚年认知能力、身体功能、抑郁症状和主要终身职业的数据。我们将各种职业和损伤测量归纳为两个潜在变量，即“职业概况”和“损伤三联征”。我们使用了一系列数据简化方法和复杂度不断增加的结构方程模型（SEM）来检验模型的有效性，并了解损伤三联征的生命历程风险之间的因果关系。
职业概况对损伤三联征有显著影响，且独立于童年智力。童年智力是对损伤三联征的主要影响因素，并通过其对职业的影响直接和间接地发挥作用。童年智力的直接影响比职业概况对损伤的独立影响高出1.7 - 1.8倍，从间接途径（通过职业）来看则高出约4倍。
童年智力是晚年损伤三联征的主要影响因素，独立于职业概况。减少老年人损伤的努力应以生命历程方法为依据，并特别关注早期生活环境。
