Yates Jennifer A, Clare Linda, Woods Robert T
Institute of Mental Health, University of Nottingham, Nottingham, UK.
Centre for Research in Ageing and Cognitive Health, School of Psychology, and PenCLAHRC, University of Exeter Medical School, Exeter, UK.
J Alzheimers Dis. 2017;55(3):1183-1193. doi: 10.3233/JAD-160611.
Mild cognitive impairment (MCI) often co-exists with mood problems, and both cognitive functioning and mood are known to be linked with health. This study aims to investigate how health, mood, and cognitive impairment interact. Health is often assessed using a single proxy measure, but the use of a range of measures can provide a more informative picture and allows for combination into a comprehensive measure of health. We report an analysis of data from the Cognitive Function and Ageing Study Wales (CFAS Wales, N = 3,173), in which structured interviews with older people captured measures of cognition, mood, and health. Each measure of health was assessed independently in relation to cognition and mood, and then all measures were combined to form a latent health variable and tested using structural equation modeling (SEM). SEM confirmed the association between health and cognition, with depression acting as a mediator. All measures of health were individually associated with levels of anxiety and depression. Participants reporting mood problems were less likely to engage in physical activity and more likely to report poor or fair health, have more comorbid health conditions, use more services, and experience difficulties with instrumental activities of daily living. Perceived health was associated with cognitive status; participants with MCI were more likely to report fair or poor health than participants who were cognitively unimpaired. Careful intervention and encouragement to maintain healthy lifestyles as people age could help to reduce the risk of both mood problems and cognitive decline.
轻度认知障碍(MCI)常与情绪问题并存,且认知功能和情绪都与健康相关。本研究旨在调查健康、情绪和认知障碍之间如何相互作用。健康状况通常通过单一替代指标进行评估,但使用一系列指标可以提供更丰富的信息,并能综合为一个全面的健康指标。我们报告了对威尔士认知功能与衰老研究(CFAS Wales,N = 3173)数据的分析,该研究通过对老年人进行结构化访谈,获取了认知、情绪和健康方面的指标。每项健康指标都分别针对认知和情绪进行评估,然后将所有指标合并形成一个潜在健康变量,并使用结构方程模型(SEM)进行检验。SEM证实了健康与认知之间的关联,其中抑郁起到了中介作用。所有健康指标都分别与焦虑和抑郁水平相关。报告有情绪问题的参与者进行体育活动的可能性较小,更有可能报告健康状况不佳或一般,患有更多合并症,使用更多服务,并且在日常生活的工具性活动方面存在困难。感知到的健康状况与认知状态相关;与认知未受损的参与者相比,患有MCI的参与者更有可能报告健康状况一般或不佳。随着人们年龄增长,进行仔细的干预并鼓励保持健康的生活方式,可能有助于降低情绪问题和认知衰退的风险。