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衰老过程中心理健康改善的矛盾趋势:一项针对1546名年龄在21至100岁成年人的社区研究

Paradoxical Trend for Improvement in Mental Health With Aging: A Community-Based Study of 1,546 Adults Aged 21-100 Years.

作者信息

Thomas Michael L, Kaufmann Christopher N, Palmer Barton W, Depp Colin A, Martin Averria Sirkin, Glorioso Danielle K, Thompson Wesley K, Jeste Dilip V

机构信息

Departments of Psychiatry and bNeurosciences and cSam and Rose Stein Institute for Research on Aging, University of California, San Diego, La Jolla.

Veterans Affairs San Diego Healthcare System, San Diego, California, USA.

出版信息

J Clin Psychiatry. 2016 Aug;77(8):e1019-25. doi: 10.4088/JCP.16m10671.

Abstract

OBJECTIVE

Studies of aging usually focus on trajectories of physical and cognitive function, with far less emphasis on overall mental health, despite its impact on general health and mortality. This study examined linear and nonlinear trends of physical, cognitive, and mental health over the entire adult lifespan.

METHODS

Cross-sectional data were obtained from 1,546 individuals aged 21-100 years, selected using random digit dialing for the Successful AGing Evaluation (SAGE) study, a structured multicohort investigation that included telephone interviews and in-home surveys of community-based adults without dementia. Data were collected from 1/26/2010 to 10/07/2011 targeting participants aged 50-100 years and from 6/25/2012 to 7/15/2013 targeting participants aged 21-100 years with an emphasis on adding younger individuals. Data included self-report measures of physical health, measures of both positive and negative attributes of mental health, and a phone interview-based measure of cognition.

RESULTS

Comparison of age cohorts using polynomial regression suggested a possible accelerated deterioration in physical and cognitive functioning, averaging 1.5 to 2 standard deviations over the adult lifespan. In contrast, there appeared to be a linear improvement of about 1 standard deviation in various attributes of mental health over the same life period.

CONCLUSIONS

These cross-sectional findings suggest the possibility of a linear improvement in mental health beginning in young adulthood rather than a U-shaped curve reported in some prior studies. Lifespan research combining psychosocial and biological markers may improve our understanding of resilience to mental disability in older age and lead to broad-based interventions promoting mental health in all age groups.

摘要

目的

衰老研究通常聚焦于身体和认知功能的轨迹,尽管整体心理健康对总体健康和死亡率有影响,但对其关注却少得多。本研究考察了整个成年期身体、认知和心理健康的线性及非线性趋势。

方法

横断面数据来自1546名年龄在21至100岁之间的个体,这些个体通过随机数字拨号选取,用于成功衰老评估(SAGE)研究,这是一项结构化的多队列调查,包括电话访谈和对无痴呆的社区成年居民的家庭调查。数据收集时间为2010年1月26日至2011年10月7日,针对50至100岁的参与者;以及2012年6月25日至2013年7月15日,针对21至100岁的参与者,重点是纳入更年轻的个体。数据包括身体健康的自我报告测量、心理健康的积极和消极属性测量,以及基于电话访谈的认知测量。

结果

使用多项式回归对不同年龄队列进行比较表明,身体和认知功能可能加速衰退,在整个成年期平均衰退1.5至2个标准差。相比之下,在同一时期,心理健康的各种属性似乎有大约1个标准差的线性改善。

结论

这些横断面研究结果表明,心理健康从青年期开始可能呈线性改善,而非一些先前研究中报道的U形曲线。结合心理社会和生物学标志物的寿命研究可能会增进我们对老年人心理残疾恢复力的理解,并导致促进所有年龄组心理健康的广泛干预措施。

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