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正念觉知与患有神经认知障碍的老年人焦虑和抑郁症状风险较低相关。

Mindfulness Awareness Is Associated With a Lower Risk of Anxiety and Depressive Symptoms in Older Adults With Neurocognitive Disorders.

作者信息

Lam Linda Chiu Wa, Lee Allen T C, Cheng Sheung Tak, Yip Benjamin H K, Chan Wai Chi, Fung Ada W T, Ma Suk Ling, Cheng Calvin P W, Kong Ryan, Chiu Henry T S, Lai Frank H Y, Wong Samuel Yeung Shan

机构信息

Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China.

Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, SAR China.

出版信息

Front Psychiatry. 2021 Oct 21;12:721583. doi: 10.3389/fpsyt.2021.721583. eCollection 2021.

Abstract

Apart from depressive disorders, there are great interests in adopting mindfulness based interventions (MBIs) for other mental health conditions. Depression and anxiety are common in people with neurocognitive disorders (NCD). The potential of MBIs as an adjuvant treatment in this cognitively at-risk group should be further explored. The current study explored the association between depression and anxiety symptoms with dispositional mindfulness in older adults, and if same association stays in the context of cognitive impairment. The Hong Kong Mental Morbidity Survey for Older People (MMSOP) is an ongoing epidemiology study of the prevalence of neurocognitive and mental disorders in adults aged 60 years or over in Hong Kong. MMSOP evaluated cognitive function, psychiatric symptoms (Clinical Interview Schedule-revised, CIS-R), chronic physical disease burden, psychosocial support, and resilience factors, including dispositional mindfulness as measured by the Mindful Attention Awareness Scale (MAAS). We analyzed the impact of MAAS on CIS-R and potential moderation effects of mindfulness. In March 2021, 1,218 community dwelling participants completed assessments. The mean age of the sample is 69.0 (SD 6.9) years. Eight hundred and two participants (65.7%) were not demented (CDR 0) and 391 (32%) and 25 (2%) were categorized as having mild NCD (CDR 0.5) and major NCD (CDR 1 or more), respectively. One hundred forty-three (11.7%) satisfied ICD-10 criteria for anxiety or depressive disorder as measured by CIS-R. Linear regression analysis showed that female gender, CIRS, and MAAS scores were significant factors associated with CIS-R scores. MAAS scores moderated and attenuated the impact CIRS on CIS-R (adjusted = 0.447, < 0.001). MAAS scores remained as significant moderator for CIRS in patients with NCD (CDR ≥ 0.5) (adjusted = 0.33, < 0.001). Interim findings of the MMSOP suggested that dispositional mindfulness is associated with lower level of mood symptoms in community dwelling older adults in Hong Kong. The interaction effects further suggested that high mindful awareness may reduce the adverse effects of chronic physical morbidity on mental health. The observation stayed in the participants with cognitive impairment. We should further explore MBIs as a non-pharmacological treatment for in older adults at-risk of physical morbidity and cognitive decline.

摘要

除了抑郁症之外,人们对将基于正念的干预措施(MBIs)应用于其他心理健康状况也有着浓厚的兴趣。抑郁和焦虑在神经认知障碍(NCD)患者中很常见。MBIs作为这种认知风险群体辅助治疗方法的潜力应该得到进一步探索。本研究探讨了老年人抑郁和焦虑症状与特质正念之间的关联,以及在认知障碍背景下这种关联是否依然存在。香港老年人精神疾病患病率调查(MMSOP)是一项正在进行的关于香港60岁及以上成年人神经认知和精神障碍患病率的流行病学研究。MMSOP评估了认知功能、精神症状(临床访谈时间表修订版,CIS-R)、慢性躯体疾病负担、社会心理支持以及复原力因素,包括用正念注意觉知量表(MAAS)测量的特质正念。我们分析了MAAS对CIS-R的影响以及正念的潜在调节作用。2021年3月,1218名社区居住参与者完成了评估。样本的平均年龄为69.0(标准差6.9)岁。802名参与者(65.7%)无痴呆(CDR 0),391名(32%)和25名(2%)分别被归类为患有轻度NCD(CDR 0.5)和重度NCD(CDR 1或更高)。143名(11.7%)符合CIS-R测量的ICD-10焦虑或抑郁障碍标准。线性回归分析表明,女性、CIRS和MAAS得分是与CIS-R得分相关的显著因素。MAAS得分调节并减弱了CIRS对CIS-R的影响(调整后β = 0.447,P < 0.001)。在NCD(CDR≥0.5)患者中,MAAS得分仍然是CIRS的显著调节因素(调整后β = 0.33,P < 0.001)。MMSOP的中期研究结果表明,特质正念与香港社区居住老年人较低水平的情绪症状相关。交互作用进一步表明,高正念意识可能会降低慢性躯体疾病对心理健康的不利影响。这一观察结果在有认知障碍的参与者中也成立。我们应该进一步探索将MBIs作为一种非药物治疗方法应用于有躯体疾病和认知衰退风险的老年人。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5120/8566433/aacb6af2f09a/fpsyt-12-721583-g0001.jpg

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