大屠杀经历与冠心病男性的晚年认知表现。

Holocaust exposure and late-life cognitive performance in men with coronary heart disease.

机构信息

School of Public Health, University of Haifa, Haifa, Israel.

The Israel Center for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

J Psychiatr Res. 2021 Feb;134:1-7. doi: 10.1016/j.jpsychires.2020.12.044. Epub 2020 Dec 19.

DOI:10.1016/j.jpsychires.2020.12.044

PMID:33360219

Abstract

BACKGROUND

Holocaust victims experienced extreme physical and mental stress that could lead to prolonged deficits in psychological and physiological well-being. We aimed to examine whether exposure to Holocaust conditions is associated with cognitive function and decline in a sample of old male adults with coronary heart disease (CHD).

METHODS

The sample included 346 individuals with CHD who participated in a clinical trial in 1990-1997 (mean age 56.7 ± 6.5 y). During 2004-2008 (mean age 71.8 ± 6.5 y) and 2011-2013 (mean age 77.1 ± 6.4 y) participants underwent computerized cognitive assessments. Exposure to Holocaust conditions was based on self-report at the second assessment. Linear regression and mixed-effect models were conducted to evaluate the associations between Holocaust survivorship and subsequent cognitive performance and rate of cognitive decline.

RESULTS

Forty-Three participants (12%) survived concentration camps/ghettos, 69 (20%) were Holocaust survivors who escaped concentration camps/ghettos, and 234 (68%) were not Holocaust survivors. After adjustment for potential confounders, concentration camp/ghetto survivors had poorer global cognitive performance and poorer attention (β = -3.90; 95%CI: 7.11;-0.68 and β = -4.11; 95%CI: 7.83;-0.38, respectively) compared to individuals who were not exposed to Holocaust conditions. Additionally, participants who reported being at concentration camps/ghettoes had increased cognitive decline in global performance and executive function (β = -0.19; 95%CI: 0.37;-0.008 and β = -0.29; 95%CI: 0.53;-0.06, respectively) compared to participants who were not Holocaust survivors. Lastly, those who were Holocaust survivors but not in concentration camps/ghettos had greater decline in attention (β = -0.11; 95%CI: 0.21;-0.01).

DISCUSSION

Exposure to Holocaust conditions in early-life may be linked with poorer cognitive function and greater cognitive decline decades later in old-adults with CHD.

摘要

背景

大屠杀受害者经历了极端的身心压力，这可能导致他们在心理和生理健康方面长期存在缺陷。我们旨在研究在患有冠心病（CHD）的老年男性样本中，暴露于大屠杀环境是否与认知功能和下降有关。

方法

该样本包括 346 名参加 1990-1997 年临床试验的 CHD 患者（平均年龄 56.7±6.5 岁）。在 2004-2008 年（平均年龄 71.8±6.5 岁）和 2011-2013 年（平均年龄 77.1±6.4 岁）期间，参与者接受了计算机认知评估。在第二次评估时，根据自我报告确定暴露于大屠杀环境的情况。进行线性回归和混合效应模型分析，以评估大屠杀幸存者身份与随后的认知表现和认知衰退率之间的关联。

结果

43 名参与者（12%）幸存于集中营/聚居区，69 名参与者（20%）是逃离集中营/聚居区的大屠杀幸存者，而 234 名参与者（68%）不是大屠杀幸存者。在调整了潜在混杂因素后，集中营/聚居区幸存者的整体认知表现和注意力较差（β=-3.90；95%CI：7.11；-0.68 和 β=-4.11；95%CI：7.83；-0.38），与未暴露于大屠杀环境的个体相比。此外，报告处于集中营/聚居区的参与者在整体表现和执行功能方面的认知衰退速度更快（β=-0.19；95%CI：0.37；-0.008 和 β=-0.29；95%CI：0.53；-0.06），与非大屠杀幸存者相比。最后，那些曾经是大屠杀幸存者但没有在集中营/聚居区的人注意力下降更明显（β=-0.11；95%CI：0.21；-0.01）。