Florida State University College of Medicine, Tallahassee, FL, USA.
University of Montpellier, Montpellier, France.
J Alzheimers Dis. 2018;65(3):1041-1050. doi: 10.3233/JAD-180119.
Depressive symptoms and a history of mental disorders are associated with increased risk for dementia. Less is known about whether other aspects of psychological distress and negative self-beliefs also increase risk. The purpose of this research is to examine 1) whether eight aspects of psychological distress and self-beliefs (anxiety, negative affect, hostility, anger-in, anger-out, hopelessness, pessimism, perceived constraints) are associated with risk of incident dementia and cognitive impairment not dementia (CIND), 2) whether the associations are independent of depressive symptoms and history of a mental health diagnosis, and 3) whether the associations are also independent of behavioral, clinical, and genetic risk factors. A total of 9,913 participants (60% female) from the Health and Retirement Study completed the baseline measures, scored in the non-impaired range of cognition at baseline, and had cognitive status assessed across the 6-8-year follow-up. Baseline measures included eight aspects of psychological distress and self-beliefs, cognitive performance, depressive symptoms, and genetic, clinical, and behavioral risk factors. Participants who scored higher on anxiety, negative affect, hostility, pessimism, hopelessness, and perceived constraints were at a 20-30% increased risk of dementia and a 10-20% increased risk of CIND. The associations held controlling for baseline depressive symptoms, history of a mental health diagnosis, clinical and behavioral risk factors, and genetic risk. Anger-in and anger-out were unrelated to risk of either dementia or CIND. Independent of the core experience of depressed affect, other aspects of negative emotionality and self-beliefs increase risk of mild and severe cognitive impairment, which suggests additional targets of intervention.
抑郁症状和精神障碍病史与痴呆风险增加有关。然而，其他心理困扰和消极自我信念方面是否也会增加风险则知之甚少。本研究旨在探讨以下三个问题：1）焦虑、负性情绪、敌意、愤怒内隐、愤怒外显、绝望、悲观、感知限制这八个心理困扰和自我信念方面是否与痴呆和认知障碍但非痴呆（CIND）的发病风险相关；2）这些关联是否独立于抑郁症状和精神健康诊断史；3）这些关联是否也独立于行为、临床和遗传风险因素。共有 9913 名（60%为女性）来自健康与退休研究的参与者完成了基线测量，在基线时认知功能处于未受损范围内，并且在 6-8 年的随访中评估了认知状况。基线测量包括八个心理困扰和自我信念方面、认知表现、抑郁症状以及遗传、临床和行为风险因素。在焦虑、负性情绪、敌意、悲观、绝望和感知限制方面得分较高的参与者患痴呆的风险增加了 20-30%，患 CIND 的风险增加了 10-20%。在控制基线抑郁症状、精神健康诊断史、临床和行为风险因素以及遗传风险后，这些关联仍然存在。愤怒内隐和愤怒外显与痴呆或 CIND 的风险无关。除了抑郁情绪的核心体验之外，消极情绪和自我信念的其他方面也会增加轻度和重度认知障碍的风险，这表明有额外的干预目标。
