Jang Yuri, Choi Eunyoung, Rhee Min-Kyoung, Yoon Hyunwoo, Park Nan Sook, Chiriboga David A
Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
Aging Ment Health. 2021 May;25(5):807-813. doi: 10.1080/13607863.2020.1720596. Epub 2020 Jan 31.
The present study examined the associations between immigration-related factors and objective and subjective cognitive status with older Korean Americans' concern about developing Alzheimer's Disease (AD). It was hypothesized that (1) AD concern would be associated with immigration-related factors and (2) self-rated cognitive status would mediate the relationship between cognitive performance (Mini Mental State Examination (MMSE) scores) and concern about AD. Using data from the Study of Older Korean Americans ( = 2061, mean age = 73.2; 66.8% female), the direct and indirect effect models were tested. Korean American immigrants with a higher level of acculturation had better cognitive performance, more positive self-ratings of cognitive status, and a lower level of concern about AD. Both poor cognitive performance and negative self-ratings of cognitive status were associated with increased concern about AD. Supporting the mediation hypothesis, the indirect effect of cognitive performance on AD concern through self-rated cognitive status was significant (bias corrected 95% confidence interval for the indirect effect = -.012, -.003). The mediation model not only helps us better understand the psychological mechanisms that underlie the link between cognitive status and AD concern but also highlights the potential importance of subjective perceptions about cognitive status as an avenue for interventions.
本研究考察了与移民相关的因素、客观和主观认知状态与韩裔美国老年人对患阿尔茨海默病（AD）的担忧之间的关联。研究假设如下：（1）对AD的担忧与移民相关因素有关；（2）自我评定的认知状态将介导认知表现（简易精神状态检查表（MMSE）得分）与对AD的担忧之间的关系。利用来自韩裔美国老年人研究的数据（n = 2061，平均年龄 = 73.2岁；66.8%为女性），对直接效应模型和间接效应模型进行了检验。文化适应程度较高的韩裔美国移民具有更好的认知表现、对认知状态更积极的自我评定以及对AD更低的担忧程度。认知表现差和对认知状态的消极自我评定均与对AD的担忧增加有关。支持中介假设的是，认知表现通过自我评定的认知状态对AD担忧的间接效应显著（间接效应的偏差校正95%置信区间 = -.012，-.003）。该中介模型不仅有助于我们更好地理解认知状态与对AD的担忧之间联系背后的心理机制，还凸显了关于认知状态的主观认知作为干预途径的潜在重要性。
