Departments of Neurology.
Department of Neurology, Montefiore Medical Center.
Alzheimer Dis Assoc Disord. 2019 Jul-Sep;33(3):240-245. doi: 10.1097/WAD.0000000000000324.
We hypothesized that higher quality of life would be associated with better cognitive function and a reduced risk of incident all cause dementia and Alzheimer disease (AD) in older adults.
Participants included 1183 older adults with an average age of 78.2 (SD=5.3) from Einstein Aging Study. The 36-Item Short-Form Health Survey was used to measure health-related quality of life (HRQoL). We investigated baseline associations between the cognitive domains of memory, executive function, and general fluid ability with 8 subscales of the 36-Item Short-Form Health Survey (physical functioning, role limitations due to physical problems, bodily pain, general health perceptions, social functioning, role limitations due to emotional problems, vitality, and general mental health) and the 2 component summary scores of physical component summary (PCS) and mental component summary (MCS). Next, we used Cox proportional hazard models to assess the predictive validity of HRQoL subscales for the onset of incident dementia and incident AD.
At baseline, higher scores (better HRQoL) on MCS and its 4 subscales (social functioning, role limitations due to emotional problems, vitality, and general mental health) were associated with higher performance on both memory and executive function domains. Higher scores in role limitation due to physical problems, role limitation due to emotional problems, and general mental health subscales were associated with reduced risk of incident dementia. Higher MCS, but not PCS, predicted a reduced incident of all-cause dementia and AD.
These findings suggest that diminution of HRQoL precedes the onset of diagnosable dementia and may be useful in the prediction of dementia onset.
我们假设更高的生活质量与更好的认知功能以及降低老年人群中全因痴呆和阿尔茨海默病（AD）的发病风险相关。
参与者包括来自爱因斯坦老龄化研究的 1183 名平均年龄为 78.2 岁（标准差=5.3）的老年人。使用 36 项简短健康调查来衡量与健康相关的生活质量（HRQoL）。我们调查了认知领域的记忆、执行功能和一般流体能力与 36 项简短健康调查的 8 个亚量表（身体功能、因身体问题导致的角色限制、身体疼痛、一般健康感知、社会功能、因情绪问题导致的角色限制、活力和一般心理健康）以及身体成分综合评分（PCS）和心理成分综合评分（MCS）的两个组成部分综合评分之间的基线关联。接下来，我们使用 Cox 比例风险模型来评估 HRQoL 亚量表对新发痴呆和新发 AD 的预测效力。
在基线时，MCS 及其 4 个亚量表（社会功能、因情绪问题导致的角色限制、活力和一般心理健康）的得分较高（HRQoL 更好）与记忆和执行功能领域的表现较高相关。因身体问题导致的角色限制、因情绪问题导致的角色限制和一般心理健康亚量表的得分较高与新发痴呆的风险降低相关。更高的 MCS，但不是 PCS，预测了全因痴呆和 AD 的发生率降低。
这些发现表明，HRQoL 的降低先于可诊断痴呆的发生，并且可能对痴呆发生的预测有用。
