Alzheimer's Disease and Healthy Aging Program, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA.
Int Psychogeriatr. 2021 Jul;33(7):689-702. doi: 10.1017/S1041610220001635. Epub 2020 Sep 4.
To estimate the prevalence of unmet needs for assistance among middle-aged and older adults with subjective cognitive decline (SCD) in the US and to evaluate whether unmet needs were associated with health-related quality of life (HRQOL).
Cross-sectional.
US - 50 states, District of Columbia, and Puerto Rico.
Community-dwelling adults aged 45 years and older who completed the Cognitive Decline module on the 2015--2018 Behavioral Risk Factor Surveillance System reported experiencing SCD and always, usually, or sometimes needed assistance with day-to-day activities because of SCD (n = 6,568).
We defined SCD as confusion or memory loss that was happening more often or getting worse over the past 12 months. Respondents with SCD were considered to have an unmet need for assistance if they sometimes, rarely, or never got the help they needed with day-to-day activities. We measured three domains of HRQOL: (1) mental (frequent mental distress, ≥14 days of poor mental health in the past 30 days), (2) physical (frequent physical distress, ≥14 days of poor physical health in the past 30 days), and (3) social (SCD always, usually, or sometimes interfered with the ability to work, volunteer, or engage in social activities outside the home). We used log-binomial regression models to estimate prevalence ratios (PRs). All estimates were weighted.
In total, 40.2% of people who needed SCD-related assistance reported an unmet need. Among respondents without depression, an unmet need was associated with a higher prevalence of frequent mental distress (PR = 1.55, 95% CI: 1.12-2.13, p = 0.007). Frequent physical distress and social limitations did not differ between people with met and unmet needs.
Middle-aged and older adults with SCD-related needs for assistance frequently did not have those needs met, which could negatively impact their mental health. Interventions to identify and meet the unmet needs among people with SCD may improve HRQOL.
估计美国有主观认知下降 (SCD) 的中老年成年人未得到满足的援助需求的流行率，并评估这些需求是否与健康相关的生活质量 (HRQOL) 相关。
横断面研究。
美国 - 50 个州、哥伦比亚特区和波多黎各。
完成了 2015-2018 年行为风险因素监测系统认知下降模块的 45 岁及以上、居住在社区的成年人，他们报告说经历了 SCD，并且由于 SCD，他们总是、通常或有时需要帮助日常生活活动（n = 6568）。
我们将 SCD 定义为过去 12 个月中经常或更频繁发生的混乱或记忆丧失。如果 SCD 患者有时、很少或从未得到日常生活活动所需的帮助，则认为他们有未满足的援助需求。我们测量了 HRQOL 的三个领域：（1）心理（频繁的精神困扰，过去 30 天内有 14 天以上的心理健康不佳），（2）身体（频繁的身体困扰，过去 30 天内有 14 天以上的身体健康不佳），（3）社会（SCD 总是、通常或有时干扰在家外工作、志愿或参与社交活动的能力）。我们使用对数二项式回归模型估计患病率比 (PR)。所有估计均进行了加权。
共有 40.2%需要 SCD 相关援助的人报告未得到满足的需求。在没有抑郁症的受访者中，未满足的需求与更高的频繁精神困扰患病率相关（PR = 1.55，95%CI：1.12-2.13，p = 0.007）。有满足和未满足需求的人的频繁身体困扰和社会限制没有差异。
有 SCD 相关援助需求的中老年成年人经常得不到满足，这可能会对他们的心理健康产生负面影响。识别和满足 SCD 患者的未满足需求的干预措施可能会改善 HRQOL。
