Department of Social Work, Faculty of Arts and Social Sciences, National University of Singapore, Singapore.
Department of Social Security, School of Public Administration, Hebei University of Economics and Business, Shijiazhuang, China.
Int J Geriatr Psychiatry. 2021 Aug;36(8):1284-1294. doi: 10.1002/gps.5523. Epub 2021 Mar 17.
Family caregivers are important to older adults' health, but few studies have examined how caregivers' mental health is associated with older adults' cognitive function. This study examined the trajectories of cognitive function of older adults and whether caregivers' depressive symptoms shape the pattern of cognitive function trajectories.
This 6-year longitudinal sample consisted 1188 older adults aged ≥75 years with deficits in activities of daily living (ADL) and their family caregivers in Shanghai, China (Rounds 1-3). Cognitive function trajectories were identified based on an enhanced group-based trajectory modeling that accounted for nonrandom attrition. Multinomial logistic regression tested the association between caregivers' depressive symptoms and older adults' cognitive function trajectory.
Three trajectory groups were identified: a "newly onset" group (50.4%) had an increased risk of being cognitive impaired during the 6-year period; a "never" group (46.2%) remained cognitive active; and a "chronic" group was largely persistently cognitive impaired (3.4%). Caregivers' depressive symptoms increased the relative risk of having the "onset" or "chronic" versus "never" trajectory. Among the four dimensions of depressive symptoms, only somatic complaints were associated with a higher risk of the "newly onset" trajectory in 6 years.
The progression of cognitive function among older adults with deficits in ADL followed three distinct trajectories during a 6-year period. Addressing the mental health of caregivers may prevent or delay progression of cognitive impairment among older adults.
家庭照顾者对老年人的健康至关重要，但很少有研究探讨照顾者的心理健康如何与老年人的认知功能相关。本研究考察了老年人认知功能的轨迹，以及照顾者的抑郁症状是否影响认知功能轨迹的模式。
本 6 年纵向样本包括 1188 名年龄≥75 岁、日常生活活动（ADL）能力受损且有其家庭照顾者的老年人，他们来自中国上海（第 1-3 轮）。基于考虑非随机缺失的增强型群组轨迹建模，确定认知功能轨迹。使用多项逻辑回归检验照顾者抑郁症状与老年人认知功能轨迹之间的关联。
确定了三个轨迹组：“新发病”组（50.4%）在 6 年内认知障碍的风险增加；“从未”组（46.2%）保持认知活跃；“慢性”组则主要持续认知受损（3.4%）。照顾者的抑郁症状增加了发生“发病”或“慢性”与“从未”轨迹的相对风险。在抑郁症状的四个维度中，只有躯体症状与 6 年内“新发病”轨迹的高风险相关。
ADL 能力受损的老年人的认知功能进展在 6 年内呈现出三种不同的轨迹。解决照顾者的心理健康问题可能有助于预防或延缓老年人认知障碍的进展。
