中年和老年西班牙裔/拉丁裔成年人中的焦虑抑郁与神经认知：西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）结果。
Anxious Depression and Neurocognition among Middle-Aged and Older Hispanic/Latino Adults: Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Results.
机构信息
Departments of Psychiatry, Family Medicine, and Public Health, University of California San Diego, San Diego, CA.
Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI.
出版信息
Am J Geriatr Psychiatry. 2018 Feb;26(2):238-249. doi: 10.1016/j.jagp.2017.06.002. Epub 2017 Jul 3.
OBJECTIVE
The purpose of this study is to examine the association between verbal learning, fluency, and processing speed with anxious depression symptomatology (ADS) among diverse Hispanics. We hypothesized an inverse association of anxious depression with neurocognition among Hispanics of different heritage.
DESIGN
Data are from the Hispanic Community Health Study/Study of Latinos. The sample included 9,311participants aged 45-74 years (mean: 56.5 years). A latent class analysis of items from the Center for Epidemiological Studies for Depression scale and the Spielberger Trait Anxiety Inventory was used to derive an anxious depression construct. Neurocognitive measures included scores on the Brief Spanish English Verbal Learning Test (B-SEVLT, learning and recall trials), Word Fluency (WF), Digit Symbol Substitution (DSS) test, and a Global Cognitive Score (GCS). We fit survey linear regression models to test the associations between anxious depression symptomatology and cognitive function. We tested for effect modification by sex, Hispanic heritage, and age groups.
RESULTS
Among men, 71.6% reported low, 23.3% moderate, and 5.1% high ADS. Among women, 55.1% reported low, 33.2% moderate, and 11.8% high ADS. After controlling for age, sex, sociodemographic characteristics, cardiovascular risk factors and disease, and antidepressant use, we found significant inverse associations between moderate and high anxious depression (ref:low) with B-SEVLT learning and recall, DSS and GCS. Moderate, but not high, anxious depression was inversely associated with WF. Associations were not modified by sex, Hispanic heritage, or age.
CONCLUSIONS
Increased anxious depression symptomatology is associated with decreased neurocognitive function among Hispanics. Longitudinal studies are needed to establish temporality and infer if negative emotional symptoms precede cognitive deficits.
目的
本研究旨在探讨不同西班牙裔人群的言语学习、流畅性和处理速度与焦虑抑郁症状（ADS）之间的关系。我们假设，在具有不同文化背景的西班牙裔人群中，焦虑抑郁与神经认知呈负相关。
设计
数据来自西班牙裔社区健康研究/拉丁裔研究。该样本包括 9311 名年龄在 45-74 岁（平均年龄：56.5 岁）的参与者。使用来自抑郁流行病学研究中心量表和特质焦虑量表的项目进行潜在类别分析，以得出焦虑抑郁的结构。神经认知测量包括简短西班牙-英语言语学习测验（B-SEVLT，学习和回忆试验）、词汇流畅性（WF）、数字符号替代测验（DSS）和总体认知评分（GCS）的得分。我们拟合了调查线性回归模型，以检验焦虑抑郁症状与认知功能之间的关系。我们检验了性别、西班牙裔背景和年龄组的效应修饰作用。
结果
在男性中，71.6%报告低、23.3%报告中、5.1%报告高 ADS。在女性中，55.1%报告低、33.2%报告中、11.8%报告高 ADS。在控制年龄、性别、社会人口统计学特征、心血管危险因素和疾病以及抗抑郁药使用后，我们发现中度和高度焦虑抑郁（参照低）与 B-SEVLT 学习和回忆、DSS 和 GCS 呈显著负相关。中度但不是高度的焦虑抑郁与 WF 呈负相关。这些关联不受性别、西班牙裔背景或年龄的影响。
结论
在西班牙裔人群中，焦虑抑郁症状的增加与神经认知功能下降有关。需要进行纵向研究以确定时间关系，并推断负面情绪症状是否先于认知缺陷。
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