Noonan Devon, Silva Nikolas J, McClintock Shawn M, Silva Susan G
J Addict Nurs. 2021;32(4):249-254. doi: 10.1097/JAN.0000000000000436.
Rural older adults are an underserved population with high rates of smoking and related morbidity and mortality. Age-related executive function deficits are common in older smokers; however, the association of depression and nicotine dependence on executive function has not been explored. This study addressed whether depression and nicotine dependence are related to executive dysfunction in rural older adult smokers.
The sample included 40 rural older adults recruited from two primary care clinics in North Carolina. Executive function was evaluated with the Behavioral Regulation Index (BRI), Metacognition Index, and Global Executive Composite (GEC) T scores from the Behavior Rating Inventory of Executive Function-Adult. Nicotine dependence and depression symptoms were assessed using the Fagerstrom Test and Center for Epidemiologic Depression Scale-10, respectively. Analysis of variance was used to explore whether depression and/or nicotine dependence influences executive function. Nondirectional tests were performed with significance set at .10.
Smokers who screened positive for depression had significantly greater executive dysfunction than those who did not (BRI: p = .0003, Metacognition Index: p < .0001, GEC: p < .0001), and moderate/high dependence was associated with greater executive function deficits compared with those with mild dependence (BRI: p = .0942). Together, depression and nicotine dependence explained 50% of the variability of the GEC overall scores.
Executive dysfunction is common in rural older adult smokers and associated with depression and nicotine dependence severity. Futures studies should test the relationship of executive function and smoking cessation in the older adult population as it may have implications for cessation in this population.
农村老年人群是服务不足的群体，吸烟率以及与吸烟相关的发病率和死亡率都很高。与年龄相关的执行功能缺陷在老年吸烟者中很常见；然而，抑郁症和尼古丁依赖与执行功能之间的关联尚未得到探讨。本研究探讨了抑郁症和尼古丁依赖是否与农村老年吸烟者的执行功能障碍有关。
样本包括从北卡罗来纳州的两家初级保健诊所招募的40名农村老年人。使用执行功能行为评定量表-成人版的行为调节指数（BRI）、元认知指数和整体执行综合得分（GEC）T分数来评估执行功能。分别使用法格斯特龙测试和流行病学研究中心抑郁量表-10来评估尼古丁依赖和抑郁症状。采用方差分析来探讨抑郁症和/或尼古丁依赖是否会影响执行功能。进行了非定向检验，显著性水平设定为0.10。
抑郁症筛查呈阳性的吸烟者的执行功能障碍明显比未筛查出抑郁症的吸烟者更严重（BRI：p = 0.0003，元认知指数：p < 0.0001，GEC：p < 0.0001），与轻度依赖者相比，中度/高度依赖与更严重的执行功能缺陷相关（BRI：p = 0.0942）。抑郁症和尼古丁依赖共同解释了GEC总分变异性的50%。
执行功能障碍在农村老年吸烟者中很常见，并且与抑郁症和尼古丁依赖的严重程度相关。未来的研究应该测试老年人群中执行功能与戒烟之间的关系，因为这可能对该人群的戒烟有影响。
