Fankhauser Sonja, Drobetz Reinhard, Mortby Moyra, Maercker Andreas, Forstmeier Simon
Department of Psychology, University of Zurich, Zurich, Switzerland.
Center for Psychiatry and Psychotherapy, Private Clinic Meiringen, Station "au soleil", c/o Rehaklinik Hasliberg, 6083 Hasliberg-Hohfluh, Switzerland.
Eur J Ageing. 2014 Mar 15;11(4):321-332. doi: 10.1007/s10433-014-0311-2. eCollection 2014 Dec.
This study investigates the role of a motivational process based on a composite of four subcomponents (self-efficacy, decision regulation, activation regulation and motivation regulation), as a mediator of the relationship between social support and depression assessed with the Geriatric Depression Scale in cognitively impaired and unimpaired individuals. Participants were 229 adults with a mean age of 74 years (range: 52-94 years). The sample comprised 64 participants diagnosed with mild cognitive impairment (MCI), 47 participants diagnosed with early-stage Alzheimer's disease (AD), and a group of 118 participants without any cognitive impairment. In this cross-sectional study, bivariate correlations and linear regression models were used to assess the association between the predictor variables and depression. Linear regression models were controlled for age, gender, education, cognitive status, cognitive impairment and activities. In the total sample, social support ( = -0.15, < 0.05) and motivational processes ( = -0.41, < 0.001) were significantly associated with depression; the impact of social support was mediated by motivational processes. While motivational processes were associated with depression in all three groups (no impairment: = -0.61, < 0.001; MCI: = -0.28, < 0.05; early AD: = -0.30, < 0.06), social support lost significance (no impairment: = -0.36, < 0.001; MCI: = 0.07, = 0.59; early AD: = -0.08, = 0.62). Based on these findings, it can be argued that the impact of social support on depressive symptoms is attenuated by cerebral deterioration in cognitively impaired individuals, while motivational processes remain relevant.
本研究调查了一种基于四个子成分（自我效能感、决策调节、激活调节和动机调节）组合的动机过程的作用，该过程作为社会支持与使用老年抑郁量表评估的抑郁之间关系的中介变量，研究对象为认知功能受损和未受损的个体。参与者为229名成年人，平均年龄74岁（范围：52 - 94岁）。样本包括64名被诊断为轻度认知障碍（MCI）的参与者、47名被诊断为早期阿尔茨海默病（AD）的参与者以及118名无任何认知障碍的参与者。在这项横断面研究中，使用双变量相关性和线性回归模型来评估预测变量与抑郁之间的关联。线性回归模型对年龄、性别、教育程度、认知状态、认知障碍和活动进行了控制。在总样本中，社会支持（β = -0.15，p < 0.05）和动机过程（β = -0.41，p < 0.001）与抑郁显著相关；社会支持的影响通过动机过程介导。虽然动机过程在所有三组中均与抑郁相关（无损伤组：β = -0.61，p < 0.001；MCI组：β = -0.28，p < 0.05；早期AD组：β = -0.30，p < 0.06）），但社会支持失去了显著性（无损伤组：β = -0.36，p < 0.001；MCI组：β = 0.07，p = 0.59；早期AD组：β = -0.08，p = 0.62）。基于这些发现，可以认为在认知功能受损的个体中，社会支持对抑郁症状的影响因脑功能衰退而减弱，而动机过程仍然具有相关性。
