School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.
J Alzheimers Dis. 2021;80(2):895-904. doi: 10.3233/JAD-201349.
Health-related quality of life (HRQoL) has been shown to predict adverse health outcome in the general population.
We examined the cross-sectional association between HRQoL and cognitive performance at baseline. Next, we explored whether baseline HRQoL predicted 5-year incident cognitive decline and dementia and whether there were gender differences.
19,106 community-dwelling participants from the ASPirin in Reducing Events in the Elderly (ASPREE) trial, aged 65-98 years, free of major cognitive impairments, and completed the HRQoL 12-item short-form (SF-12) at baseline (2010-2014), were followed until June 2017. The physical (PCS) and mental component scores (MCS) of SF-12 were calculated. The cognitive tests were assessed at baseline, year 1, 3, 5, and 7 or close-out visit. Cognitive decline was defined as > 1.5 SD drop from baseline on any of the cognitive tests. Dementia was adjudicated according to DSM-IV criteria. Linear and Cox proportional-hazards regressions were used to examine the cross-sectional and longitudinal associations respectively.
At baseline, higher PCS and MCS were associated with better cognition. Over a median 4.7-year follow-up, higher MCS was associated with a reduced risk of cognitive decline and dementia (12% and 15% respectively, per 10-unit increase) and a 10-unit higher PCS was associated with a 6% decreased risk of cognitive decline. PCS did not predict dementia incidence. Findings were not different by gender.
Our study found that higher HRQoL, in particular MCS, predicted a reduced risk of cognitive decline and dementia over time in community-dwelling older people.
健康相关生活质量（HRQoL）已被证明可预测一般人群的不良健康结局。
我们检查了基线时 HRQoL 与认知表现之间的横断面关联。接下来，我们探讨了基线 HRQoL 是否预测了 5 年的认知衰退和痴呆的发生率，以及是否存在性别差异。
来自阿司匹林减少老年人事件（ASPREE）试验的 19,106 名居住在社区的参与者，年龄在 65-98 岁之间，无严重认知障碍，并且在基线（2010-2014 年）完成了健康相关生活质量 12 项短表（SF-12）。SF-12 的身体（PCS）和心理成分评分（MCS）进行了计算。认知测试在基线、第 1、3、5 年和 7 年或接近结束时进行评估。认知衰退定义为任何认知测试的基线值下降>1.5 个标准差。痴呆根据 DSM-IV 标准进行裁决。线性和 Cox 比例风险回归分别用于检查横断面和纵向关联。
在基线时，较高的 PCS 和 MCS 与更好的认知相关。在中位随访 4.7 年后，较高的 MCS 与认知衰退和痴呆的风险降低相关（分别为每增加 10 个单位分别降低 12%和 15%），较高的 PCS 与认知衰退的风险降低 6%相关。PCS 与痴呆的发生率无关。性别差异不明显。
我们的研究发现，在社区居住的老年人中，较高的 HRQoL，特别是 MCS，随着时间的推移可预测认知衰退和痴呆的风险降低。
