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积极情绪对老年墨西哥裔美国人认知障碍与残疾关系的调节作用:一项队列研究。

The modifying effect of positive emotion on the relationship between cognitive impairment and disability among older Mexican Americans: a cohort study.

机构信息

a Occupational Therapy , The University of Illinois at Chicago , Chicago , IL , USA.

b Rehabilitation Sciences , The University of Texas Medical Branch Galveston , Galveston , TX , USA.

出版信息

Disabil Rehabil. 2019 Jun;41(13):1491-1498. doi: 10.1080/09638288.2018.1432080. Epub 2018 Jan 30.

Abstract

OBJECTIVE

To determine if positive emotion modifies the relationship between cognitive impairment and activities of daily living disability status over 10 years in Mexican American adults aged 75 years and older.

METHODS

A retrospective cohort design using data from the Hispanic established populations for the epidemiologic studies of the elderly. About 2674 participants aged 75 years and older were included and followed over 10 years. Cognition was measured using the mini-mental state examination, positive emotion was measured using four questions from the Center for Epidemiologic Studies Depression Scale, and disability was measured using seven activities of daily living items. A series of generalized estimating equations models were used, with the initial analysis including those with disability at baseline and subsequent analyses excluding disability at baseline.

RESULTS

Positive emotion and cognitive impairment consistently decreased and increased risk for activities of daily living disability, respectively. Positive emotion was a significant modifier in the cross-sectional analysis, and was not a statistically significant modifier in the longitudinal or predictive series analysis.

CONCLUSIONS

Positive emotion and cognitive impairment differentially affect the risk of developing activities of daily living disability. Further research is needed to explore the interaction of positive emotion and cognitive impairment, and to identify appropriate interventions that address the specific cognitive and emotional needs of older Mexican Americans. Implications for rehabilitation Promoting emotional well-being may be protective against incident disability for older adults. Cognitive impairment significantly predicts incident disability in activities of daily living and should be considered an early indicator of impending disability for older adults.

摘要

目的

确定积极情绪是否能改变认知障碍与日常活动能力残疾状况之间的关系,这种关系在超过 10 年的时间里对 75 岁及以上的墨西哥裔美国成年人起作用。

方法

使用西班牙裔美国人建立的人口老龄化流行病学研究的现有数据,采用回顾性队列设计。共纳入约 2674 名年龄在 75 岁及以上的参与者,并随访 10 多年。认知功能采用简易精神状态检查进行测量,积极情绪采用来自流行病学研究中心抑郁量表的四个问题进行测量,残疾采用七个日常生活活动项目进行测量。采用一系列广义估计方程模型进行分析,初始分析包括基线时存在残疾的人群,随后的分析排除了基线时存在残疾的人群。

结果

积极情绪和认知障碍分别持续下降和增加,日常活动能力残疾的风险也随之增加。积极情绪是横断面分析中的一个重要调节因素,但在纵向或预测系列分析中并不是一个统计学上显著的调节因素。

结论

积极情绪和认知障碍对发展为日常活动能力残疾的风险有不同的影响。需要进一步研究,以探讨积极情绪和认知障碍之间的相互作用,并确定针对墨西哥裔美国老年人特定认知和情感需求的适当干预措施。

对康复的意义

促进情绪健康可能对老年人的新发残疾有保护作用。认知障碍显著预测日常活动能力的新发残疾,应被视为老年人即将残疾的早期指标。

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