Centre for Research on Ageing Health and Wellbeing, The Australian National University, Canberra, ACT, Australia.
Gerontology. 2017;63(5):469-478. doi: 10.1159/000475594. Epub 2017 Jun 9.
Subtle age-related cognitive decline may be associated with the capacity to remain engaged in mental, physical, and social activities. Informant reports of cognitive decline potentially provide additional information to psychometric tests on change in everyday cognitive function relevant to activity engagement.
To investigate relations between decline in everyday cognitive function as assessed by informant report and activity engagement in community-dwelling older adults.
A sample of cognitively normal older adults was drawn from the 2 latest waves of the PATH Through Life Study (n = 1,391; mean age 74.5 ± 1.5, 48.4% female). PATH is a 16-year longitudinal cohort study set in the Canberra/Queanbeyan district, Australia. Assessments were carried out at baseline, and at 3 subsequent time-points 4 years apart. At wave-4, the IQCODE, an informant measure of 4-year cognitive decline was provided by a spouse, family member, or friend of each participant. Activity engagement was assessed by the abbreviated RIASEC Mental Activity List, self-reported frequency and duration of physical activity (Whitehall Questionnaire) and the Lubben Social Network Scale that assessed interaction with family/friends. Participants provided demographic information, self-reported health status (SF-12), and responses to the Goldberg Depression Scale. The Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test (CVLT) were used to measure objective 4-year cognitive change. Those with MMSE score of ≤27 were excluded.
IQCODE score predicted disengagement from mental activities over 4 years in cognitively healthy adults (β = -0.056, standard error [SE] = 0.019, p = 0.004). This association was robust to covariate control and change on the SDMT which was also significantly related to mental activity disengagement. In models adjusted for change scores on the SDMT and the CVLT, the IQCODE was associated with less physical (β = -0.692, SE = 0.24, p = 0.004) and social engagement (β -0.046, SE = 0.021, p = 0.032), but relationships were attenuated with the inclusion of covariates.
Informant-reported cognitive decline in a non-clinical sample was linked to activities that support cognitive health. Associations were robust to adjustment for cognitive change scores. Utilising informant reports prior to the manifestation of clinically relevant decline may identify those who would benefit most from personalised activity interventions.
与保持参与心理、身体和社会活动的能力相关的是微妙的与年龄相关的认知能力下降。认知能力下降的知情者报告可能会提供与活动参与相关的日常认知功能变化的心理测试之外的其他信息。
研究社区居住的老年人中，日常认知功能下降的评估与知情者报告的认知下降与活动参与之间的关系。
从 PATH Through Life 研究的最近 2 个波次中抽取认知正常的老年人样本（n=1391；平均年龄 74.5±1.5，48.4%为女性）。PATH 是一项在澳大利亚堪培拉/昆比恩地区进行的 16 年纵向队列研究。基线时进行评估，并在 4 年后的 3 个后续时间点进行评估。在第 4 波次时，由每位参与者的配偶、家庭成员或朋友提供 IQCODE，这是一种知情者评估 4 年认知下降的指标。活动参与度通过缩短的 RIASEC 心理活动清单、自我报告的身体活动频率和持续时间（Whitehall 问卷）以及评估与家人/朋友互动的 Lubben 社会网络量表进行评估。参与者提供了人口统计学信息、自我报告的健康状况（SF-12）和对 Goldberg 抑郁量表的回答。符号数字模态测试（SDMT）和加利福尼亚语言学习测试（CVLT）用于测量 4 年内的客观认知变化。排除 MMSE 评分≤27 的人。
在认知健康的成年人中，IQCODE 评分预测了 4 年内从心理活动中脱离（β=-0.056，标准误差[SE]=0.019，p=0.004）。该关联在控制协变量和 SDMT 的变化后仍然稳健，SDMT 的变化也与心理活动脱离显著相关。在调整了 SDMT 和 CVLT 的变化分数后的模型中，IQCODE 与较少的身体（β=-0.692，SE=0.24，p=0.004）和社会参与（β=-0.046，SE=0.021，p=0.032）相关，但纳入协变量后，相关性减弱。
在非临床样本中，知情者报告的认知下降与支持认知健康的活动有关。关联在调整认知变化分数后仍然稳健。在出现临床相关下降之前利用知情者报告可能会识别出最受益于个性化活动干预的人群。
