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75岁及以上墨西哥裔美国人的生活空间移动性与认知衰退

Life-Space Mobility and Cognitive Decline Among Mexican Americans Aged 75 Years and Older.

作者信息

Silberschmidt Seraina, Kumar Amit, Raji Mukaila M, Markides Kyriakos, Ottenbacher Kenneth J, Al Snih Soham

机构信息

Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas.

University of Geneva, Geneva, Switzerland.

出版信息

J Am Geriatr Soc. 2017 Jul;65(7):1514-1520. doi: 10.1111/jgs.14829. Epub 2017 Mar 9.

Abstract

OBJECTIVES

To examine the association between life-space mobility and cognitive decline over a five-year period among older Mexican Americans.

DESIGN

Longitudinal study.

SETTING

Hispanic Established Population for the Epidemiologic Study of the Elderly survey conducted in the southwestern of United States (Texas, Colorado, Arizona, New Mexico, and California).

PARTICIPANTS

Four hundred thirty-two Mexican Americans aged 75 and older with normal or high cognitive function at baseline.

MEASUREMENTS

Socio-demographic factors, living arrangement, type of household, social support, financial strain, self-reported medical conditions, Mini-Mental State Examination (MMSE), depressive symptoms, activities of daily living (ADLs), and Short Physical Performance Battery. Life-space assessment (LSA) during the past 4 weeks was assessed during in-home interview. Scores ranged from 0 (daily restriction to the bedroom) to 120 (daily trips outside of their own town without assistance) and categorized as 0 to 20, 21 to 40, 41 to 60, 61 to 80, and 81 to 120. Because of the small sample size in the category of 81 to 120, the two highest categories were combined into a single group.

RESULTS

The mean LSA score and MMSE score of participants at baseline was 44.6 (Standard Deviation [SD], 20.7) and 25.7 (SD, 3.2), respectively. Mixed Model analyses showed that participants in the highest life-space category (≥61) experienced slower rates of cognitive decline over time compared to participants in the lowest category (0 to 20) (β = 1.03, Standard Error [SE] = 0.29, P = 0.0004), after adjusting for all covariates.

CONCLUSION

Greater life-space mobility at baseline was predictor of slower rates of cognitive decline over 5 years in older Mexican Americans.

摘要

目的

研究墨西哥裔美国老年人在五年期间生活空间移动性与认知衰退之间的关联。

设计

纵向研究。

地点

在美国西南部(得克萨斯州、科罗拉多州、亚利桑那州、新墨西哥州和加利福尼亚州)进行的西班牙裔老年人流行病学研究既定人群调查。

参与者

432名75岁及以上基线认知功能正常或较高的墨西哥裔美国人。

测量指标

社会人口学因素、居住安排、家庭类型、社会支持、经济压力、自我报告的健康状况、简易精神状态检查表(MMSE)、抑郁症状、日常生活活动能力(ADL)以及简短体能状况量表。在入户访谈期间评估过去4周内的生活空间评估(LSA)。分数范围从0(每日限制在卧室)到120(无需协助每日前往自己城镇以外的地方),并分为0至20、21至40、41至60、61至80以及81至120。由于81至120类别中的样本量较小,将两个最高类别合并为一个组。

结果

参与者在基线时的平均LSA分数和MMSE分数分别为44.6(标准差[SD],20.7)和25.7(SD,3.2)。混合模型分析表明,在调整所有协变量后,生活空间类别最高(≥61)的参与者与最低类别(0至20)的参与者相比,随着时间推移认知衰退速度较慢(β = 1.03,标准误[SE] = 0.29,P = 0.0004)。

结论

基线时更大的生活空间移动性是墨西哥裔美国老年人五年内认知衰退速度较慢的预测因素。

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