在 ACTIVE 研究中，老年人的日常功能自我感知困难先于认知能力下降。
Self-perceived Difficulties in Everyday Function Precede Cognitive Decline among Older Adults in the ACTIVE Study.
机构信息
1Department of Neurology,University of California,Sacramento,California.
2Department of Psychology,Temple University,Philadelphia,Pennsylvania.
出版信息
J Int Neuropsychol Soc. 2018 Jan;24(1):104-112. doi: 10.1017/S1355617717000546. Epub 2017 Aug 11.
OBJECTIVES
Careful characterization of how functional decline co-evolves with cognitive decline in older adults has yet to be well described. Most models of neurodegenerative disease postulate that cognitive decline predates and potentially leads to declines in everyday functional abilities; however, there is mounting evidence that subtle decline in instrumental activities of daily living (IADLs) may be detectable in older individuals who are still cognitively normal.
METHODS
The present study examines how the relationship between change in cognition and change in IADLs are best characterized among older adults who participated in the ACTIVE trial. Neuropsychological and IADL data were analyzed for 2802 older adults who were cognitively normal at study baseline and followed for up to 10 years.
RESULTS
Findings demonstrate that subtle, self-perceived difficulties in performing IADLs preceded and predicted subsequent declines on cognitive tests of memory, reasoning, and speed of processing.
CONCLUSIONS
Findings are consistent with a growing body of literature suggesting that subjective changes in everyday abilities can be associated with more precipitous decline on objective cognitive measures and the development of mild cognitive impairment and dementia. (JINS, 2018, 24, 104-112).
目的
老年人的功能衰退与认知衰退如何共同演变尚未得到很好的描述。大多数神经退行性疾病模型假设认知衰退先于并可能导致日常功能能力下降；然而，越来越多的证据表明，在认知正常的老年人中，可能已经可以检测到工具性日常生活活动（IADLs）的细微下降。
方法
本研究通过参与 ACTIVE 试验的老年人来检验认知变化与 IADL 变化之间的关系如何得到最好的描述。对 2802 名在研究基线时认知正常且随访时间长达 10 年的老年人进行了神经心理学和 IADL 数据的分析。
结果
研究结果表明，在认知测试的记忆、推理和处理速度方面，进行 IADL 时出现的细微的、自我感知的困难先于并预测了随后的下降。
结论
这些发现与越来越多的文献一致，这些文献表明，日常能力的主观变化可能与客观认知测量上更急剧的下降以及轻度认知障碍和痴呆的发展有关。（JINS，2018，24，104-112）。
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