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老年人主观认知下降、客观认知与抑郁在接受记忆障碍筛查的西班牙裔人群中的研究

Subjective Cognitive Decline, Objective Cognition, and Depression in Older Hispanics Screened for Memory Impairment.

机构信息

Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

出版信息

J Alzheimers Dis. 2018;63(3):949-956. doi: 10.3233/JAD-170865.

Abstract

Subjective cognitive decline (SCD) is common in older adults and may be an early marker of future cognitive decline. Research suggest that SCD is more closely related to concurrent symptoms of depression than to objective cognitive performance in non-Hispanic Whites, but it is unknown whether the associations of SCD, cognition, and depression manifest differently in Hispanic older adults. We examined if SCD is associated with objective cognitive performance or with depression symptoms in 145 Hispanic individuals ages 60 or older referred by community health clinics for screening of cognitive complaints. All participants lived near the U.S.-Mexico border, spoke Spanish only, or were Spanish-English bilingual. Memory-only and global cognitive composites were created from scores on Spanish versions of several neuropsychological tests. The Geriatric Depression Scale (GDS) and a five-item SCD questionnaire developed by our group were also completed. Multiple regression analyses showed no significant associations between SCD and memory or global cognitive composite scores after adjusting for age, sex, education, and GDS score. In contrast, there was a significant association between GDS and SCD after adjusting for age, sex, education, global and memory composite scores. Findings suggest that SCD does not accurately reflect current cognitive status in older Hispanics who present to their primary care physician with cognitive complaints. Clinicians should interpret SCD in this population within the context of information about symptoms of depression. Longitudinal research is needed in older Hispanics to better characterize SCD in this population and to determine if it can predict future cognitive decline.

摘要

主观认知衰退(SCD)在老年人中很常见,可能是未来认知能力下降的早期标志物。研究表明,在非西班牙裔白种人中,SCD 与当前的抑郁症状更为密切相关,而与客观认知表现的关系则不太密切,但尚不清楚 SCD、认知和抑郁之间的关联在西班牙裔老年人中是否表现不同。我们研究了 SCD 是否与客观认知表现或抑郁症状有关,参与者为 145 名年龄在 60 岁或以上的西班牙裔个体,他们因认知问题到社区健康诊所接受筛查。所有参与者都居住在美国-墨西哥边境附近,只会说西班牙语,或为西班牙语-英语双语者。从几项神经心理学测试的西班牙语版本的得分中创建了记忆和整体认知综合评分。还完成了老年抑郁量表(GDS)和我们小组开发的五分量表 SCD 问卷。多变量回归分析显示,在调整年龄、性别、教育程度和 GDS 评分后,SCD 与记忆或整体认知综合评分之间没有显著关联。相比之下,在调整年龄、性别、教育程度、整体和记忆综合评分后,GDS 与 SCD 之间存在显著关联。研究结果表明,在因认知问题到初级保健医生就诊的西班牙裔老年人中,SCD 不能准确反映当前的认知状况。临床医生应在了解抑郁症状信息的情况下,在该人群中解释 SCD。需要对西班牙裔老年人进行纵向研究,以更好地描述该人群中的 SCD,并确定其是否可以预测未来的认知能力下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1c1/5988433/8e95f4e922fd/nihms965817f1.jpg

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