Gawronski Katerina A B, Kim Eric S, Langa Kenneth M, Kubzansky Laura D
From the College of Literature, Science, and the Arts, University of Michigan (Gawronski), Ann Arbor, Michigan; Department of Genetics, Perelman School of Medicine (Gawronski), University of Pennsylvania, Philadelphia, Pennsylvania; Department of Social and Behavioral Sciences (Kim, Kubzansky), Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of General Medicine (Langa), University of Michigan Medical School, Ann Arbor, Michigan; Veterans Affairs, Ann Arbor Center for Clinical Management Research (Langa), Ann Arbor, Michigan; and Institutes for Healthcare Policy and Innovation (Langa) and Social Research (Langa), University of Michigan, Ann Arbor, Michigan.
Psychosom Med. 2016 Sep;78(7):819-28. doi: 10.1097/PSY.0000000000000345.
Higher levels of optimism have been linked with positive health behaviors, biological processes, and health conditions that are potentially protective against cognitive impairment in older adults. However, the association between optimism and cognitive impairment has not been directly investigated. We examined whether optimism is associated with incident cognitive impairment in older adults.
Data are from the Health and Retirement Study. Optimism was measured by using the Life Orientation Test-R and cognitive impairment with a modified version of the Telephone Interview for Cognitive Status derived from the Mini-Mental State Examination. Using multiple logistic regression models, we prospectively assessed whether optimism was associated with incident cognitive impairment in 4624 adults 65 years and older during a 4-year period.
Among participants, 312 women and 190 men developed cognitive impairment during the 4-year follow-up. Higher optimism was associated with decreased risk of incident cognitive impairment. When adjusted for sociodemographic factors, each standard deviation increase in optimism was associated with reduced odds (odds ratio [OR] = 0.70, 95% confidence interval [CI] = 0.61-0.81) of becoming cognitively impaired. A dose-response relationship was observed. Compared with those with the lowest levels of optimism, people with moderate levels had somewhat reduced odds of cognitive impairment (OR = 0.78, 95% CI = 0.59-1.03), whereas people with the highest levels had the lowest odds of cognitive impairment (OR = 0.52, 95% CI = 0.36-0.74). These associations remained after adjusting for health behaviors, biological factors, and psychological covariates that could either confound the association of interest or serve on the pathway.
Optimism was prospectively associated with a reduced likelihood of becoming cognitively impaired. If these results are replicated, the data suggest that potentially modifiable aspects of positive psychological functioning such as optimism play an important role in maintaining cognitive functioning.
较高水平的乐观情绪与积极的健康行为、生物过程以及健康状况相关联，这些因素可能对老年人的认知障碍具有潜在的保护作用。然而，乐观与认知障碍之间的关联尚未得到直接研究。我们调查了乐观情绪是否与老年人的新发认知障碍有关。
数据来自健康与退休研究。乐观情绪通过生活取向测试修订版进行测量，认知障碍则使用源自简易精神状态检查表的认知状况电话访谈修改版进行评估。我们使用多个逻辑回归模型，前瞻性地评估了在4年期间，乐观情绪是否与4624名65岁及以上成年人的新发认知障碍有关。
在参与者中，312名女性和190名男性在4年随访期间出现了认知障碍。较高的乐观情绪与新发认知障碍风险降低相关。在对社会人口学因素进行调整后，乐观情绪每增加一个标准差，认知障碍的几率就会降低（优势比[OR]=0.70，95%置信区间[CI]=0.61-0.81）。观察到了剂量反应关系。与乐观情绪水平最低的人相比，中等水平的人认知障碍几率有所降低（OR=0.78，95%CI=0.59-1.03），而乐观情绪水平最高的人认知障碍几率最低（OR=0.52，95%CI=0.36-0.74）。在对可能混淆感兴趣关联或处于该关联路径上的健康行为、生物因素和心理协变量进行调整后，这些关联仍然存在。
乐观情绪与认知障碍发生可能性降低前瞻性相关。如果这些结果得到重复验证，数据表明积极心理功能中潜在可改变的方面，如乐观情绪，在维持认知功能方面发挥着重要作用。
