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健康因素作为孤独感对一般认知能力的纵向影响的潜在中介。

Health Factors as Potential Mediators of the Longitudinal Effect of Loneliness on General Cognitive Ability.

机构信息

University of Southern California (AJK, CRB), Los Angeles, CA.

University of Southern California (AJK, CRB), Los Angeles, CA.

出版信息

Am J Geriatr Psychiatry. 2020 Dec;28(12):1272-1283. doi: 10.1016/j.jagp.2020.07.017. Epub 2020 Aug 11.

DOI:10.1016/j.jagp.2020.07.017
PMID:32900580
Abstract

OBJECTIVE

Higher levels of loneliness in older adulthood predict cognitive decline, but research on mediating mechanisms is sparse. We examine multisystemic physiological risk, functional ability, self-rated health, depressive symptoms, and social participation as mediating processes for the association between loneliness and general cognitive ability over a 10-year follow-up in an older adult sample.

METHODS

Three waves of data from 3,005 individuals (mean intake age: 69.30 (SD: 7.85) years; female = 51.61%) recruited during Wave 1 of the National Social Life, Health, and Aging Project were used to test whether hypothesized mediators collected at the 5-year follow-up explained effects of baseline loneliness on 10-year general cognitive ability.

RESULTS

The relationship between baseline loneliness and 10-year general cognitive ability was not mediated by multisystemic physiological risk. Functional ability (b = -0.24, SE = 0.05, p <0.001), self-rated health (b = -0.08, SE = 0.02, p <0.001), depressive symptoms (b= -0.20, SE = 0.05, p <0.001), and social participation (b = -0.03, SE = 0.01, p = 0.016) significantly mediated effects. Indirect effects remained significant after adjusting for demographic covariates and 5-year general cognitive ability, except social participation.

DISCUSSION

Loneliness may influence cognitive ability indirectly, signaling waning physical and psychiatric health more proximally correlated with cognitive ability. These mechanisms may serve as targets of intervention for cognitive maintenance in lonely older adults.

摘要

目的

老年人的孤独感水平较高预示着认知能力下降,但关于中介机制的研究却很少。我们研究了多系统生理风险、功能能力、自我评估健康状况、抑郁症状和社会参与度,以作为孤独感与老年人群体在 10 年随访期间一般认知能力之间关联的中介过程。

方法

使用来自“国家社会生活、健康和老龄化项目”第 1 波中招募的 3005 名个体(平均入组年龄:69.30(SD:7.85)岁;女性=51.61%)的 3 次数据,来检验在 5 年随访中收集的假设中介变量是否可以解释基线孤独感对 10 年一般认知能力的影响。

结果

基线孤独感与 10 年一般认知能力之间的关系并未通过多系统生理风险来中介。功能能力(b=-0.24,SE=0.05,p<0.001)、自我评估健康状况(b=-0.08,SE=0.02,p<0.001)、抑郁症状(b=-0.20,SE=0.05,p<0.001)和社会参与度(b=-0.03,SE=0.01,p=0.016)显著中介了影响。在调整人口统计学协变量和 5 年一般认知能力后,间接效应仍然显著,除了社会参与度。

讨论

孤独感可能会通过与认知能力更密切相关的身体和精神健康状况的下降来间接影响认知能力。这些机制可能成为孤独老年人群认知维持的干预目标。

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