Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.
Department of Neurological Sciences, Rush Medical College, Chicago, Illinois, USA.
Int J Geriatr Psychiatry. 2021 Jun;36(6):901-908. doi: 10.1002/gps.5491. Epub 2021 Jan 23.
Exposure to negative life events (NLEs) and neuroticism are associated with dementia. It is unknown whether neuroticism explains or modifies the association of NLEs with dementia in older Black and White Brazilians.
A total of 1747 decedents 65 years and older White and Black (11% Black and 23% Mixed) Brazilians, 53% women, were included in the analyses. Data were obtained in a face-to-face interview with an informant (71% their children) who knew the decedents for 47 years on average. Dementia was classified using the Clinical Dementia Rating. NLEs were assessed with a 10-item scale involving common problems (e.g., death, illness, alcoholism, and financial). Neuroticism was assessed with a 6-item neuroticism scale adapted from the NEO Five-Factor Inventory. Models adjusted for age, sex, and education. Black and mixed-race were combined in the analyses.
NLEs (median of 2) were more common in Blacks than Whites (2.04 vs. 1.82, p = 0.007). More NLEs increased the odds of dementia (OR = 1.112, β = 0.106, p = 0.002), similarly in Blacks and Whites (β = 0.046, p = 0.526). More NLEs were also associated with higher neuroticism (β = 0.071, p < 0.0001), in Whites but not in Blacks (β = -0.048, p = 0.006). Neuroticism was associated with higher odds of dementia (OR = 1.658, β = 0.506, p=<0.001), in Whites but not in Blacks (β = -0.420, p = 0.040). Overall, 34% of the effect of NLEs on dementia was associated with the underlying neuroticism trait in Whites (65%, Indirect OR = 1.060, p < 0.001) but no association was evident in Blacks (6%, Indirect OR = 1.008, p = 0.326). Neuroticism did not moderate the association of NLEs with dementia (OR = 0.979, β = -0.021, p = 0.717).
The association of NLEs and dementia is partially explained by neuroticism in older White but not in Blacks Brazilians.
负面生活事件（NLEs）和神经质与痴呆有关。目前尚不清楚神经质是否可以解释或改变 NLEs 与老年黑人和白人巴西人痴呆之间的关联。
共有 1747 名年龄在 65 岁及以上的白人（11%为黑人，23%为混血儿）和黑人巴西死者参与了本研究，其中 53%为女性。分析数据是通过对平均与死者相识 47 年的知情者（71%为其子女）进行面对面访谈获得的。使用临床痴呆评定量表对痴呆进行分类。采用涉及常见问题（如死亡、疾病、酗酒和财务问题）的 10 项量表评估 NLEs。神经质采用从 NEO 五因素量表改编的 6 项神经质量表进行评估。模型调整了年龄、性别和教育因素。黑人与混血儿在分析中合并。
与白人相比，黑人 NLEs（中位数为 2）更为常见（2.04 比 1.82，p=0.007）。NLEs 越多，痴呆的几率越高（OR=1.112，β=0.106，p=0.002），黑人和白人之间的情况类似（β=0.046，p=0.526）。NLEs 也与更高的神经质相关（β=0.071，p<0.0001），这在白人中存在，但在黑人中不存在（β=-0.048，p=0.006）。神经质与痴呆的几率增加相关（OR=1.658，β=0.506，p<0.001），在白人中存在，但在黑人中不存在（β=-0.420，p=0.040）。总的来说，在白人中，NLEs 对痴呆的影响有 34%与潜在的神经质特质有关（间接 OR=1.060，p<0.001），但在黑人中没有关联（6%，间接 OR=1.008，p=0.326）。神经质不能调节 NLEs 与痴呆之间的关联（OR=0.979，β=-0.021，p=0.717）。
在老年白人巴西人中，NLEs 与痴呆之间的关联部分可以通过神经质来解释，但在黑人巴西人中并非如此。
