Healthy Brain Ageing Program, The University of Sydney, Camperdown, NSW, Australia.
School of Psychology, The University of Sydney, Camperdown, NSW, Australia.
Int Psychogeriatr. 2019 Nov;31(11):1611-1625. doi: 10.1017/S1041610218002144. Epub 2019 Feb 4.
Disability in older adults is associated with a need for support in work, education, and community activities, reduced independence, and poorer quality of life. This study examines potential determinants of disability in a clinical sample of older adults across the continuum of cognitive decline, including sociodemographic, medical, psychiatric, and cognitive factors.
This is a cross-sectional study.
Participants were recruited from a specialty clinic for adults "at risk" of or with early dementia (including subjective cognitive complaints, mild cognitive impairment, and early dementia).
Four hundred forty-two older adults (mean age = 67.11, SD = 9.33) underwent comprehensive medical, neuropsychological, and mood assessments.
Disability was assessed via the self-report World Health Organization Disability Assessment Schedule 2.0. A stepwise (forward) linear regression model was computed to determine factors that contribute to disability within this group.
Depressive symptoms were the largest predictor, uniquely explaining 31.8% of the variance. Other contributing factors in the model included younger age, medical burden, and sleep quality, with all factors together accounting for a total of 50.4% of the variance in disability. Cognitive variables did not contribute to the model.
Depressive symptoms account for a significant portion of the variance in disability, but other factors such as age, medical burden and sleep quality are also important contributors in older adults across the continuum of cognitive decline. The relative association of these variables with disability appears to differ for older (≥65 years) relative to younger (<65 years) participants. Given the relationship between disability and these risk factors, an integrative and multidisciplinary approach to risk reduction will likely be most effective, with potential carry over effects for physical and mental health.
老年人的残疾与工作、教育和社区活动中的支持需求、独立性降低以及生活质量较差有关。本研究考察了认知能力下降连续体中的老年临床样本中残疾的潜在决定因素，包括社会人口学、医学、精神病学和认知因素。
这是一项横断面研究。
参与者从专门的成人诊所招募，这些诊所针对的是有认知障碍风险或有早期痴呆的成年人（包括主观认知抱怨、轻度认知障碍和早期痴呆）。
442 名老年人（平均年龄=67.11，标准差=9.33）接受了全面的医学、神经心理学和情绪评估。
残疾通过自我报告的世界卫生组织残疾评估表 2.0 进行评估。使用逐步（向前）线性回归模型来确定该组中导致残疾的因素。
抑郁症状是最大的预测因素，独特地解释了 31.8%的方差。模型中的其他贡献因素包括年龄较小、医疗负担和睡眠质量，所有因素共解释了残疾总方差的 50.4%。认知变量对模型没有贡献。
抑郁症状占残疾方差的很大一部分，但其他因素，如年龄、医疗负担和睡眠质量，在认知能力下降连续体中的老年人中也是重要的贡献因素。这些变量与残疾的相对关联似乎因年龄较大（≥65 岁）和年龄较小（<65 岁）的参与者而有所不同。鉴于残疾与这些风险因素之间的关系，综合和多学科的风险降低方法可能是最有效的，可能对身体和心理健康产生后续影响。
