Department of Sociology, Purdue University, West Lafayette, Indiana, USA.
Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA.
Gerontologist. 2023 May 9;63(4):690-699. doi: 10.1093/geront/gnac086.
This study investigates whether subjective memory decline (SMD) in a racially diverse sample of older adults without cognitive impairment at baseline is associated with incident cognitive impairment during a 12-year follow-up period.
With panel data from a national sample (N = 9,244) of cognitively intact Black, White, and Hispanic Americans 65 years or older in 2004, we examine if SMD is associated with the loss of normal cognition by 2016. Cognitive status was assessed every 2 years with a modified version of the Telephone Interview for Cognitive Status to identify the transition from normal cognition to cognitive impairment.
Estimates from Weibull accelerated failure-time models reveal that SMD is associated with earlier incident cognitive impairment (time ratio = 0.96, p < .05). In subsequent models stratified by race-ethnicity, this association was evident among White respondents (time ratio = 0.95, p < .01) but not among Black, U.S.-born Hispanic, or foreign-born Hispanic respondents.
Given that the prognostic validity of SMD differs by race and ethnicity, caution is warranted when using it as a screening or clinical tool in diverse populations.
本研究调查了在基线时无认知障碍的、种族多样化的老年人群中,主观记忆减退(SMD)是否与 12 年随访期间发生的认知障碍有关。
利用来自一个全国性样本(N=9244)的面板数据,这些参与者是 2004 年时年龄在 65 岁及以上的认知正常的黑种人、白种人和西班牙裔美国人,我们研究了 SMD 是否与到 2016 年正常认知的丧失有关。使用电话认知状态测试的修改版,每两年评估一次认知状况,以确定从正常认知到认知障碍的转变。
Weibull 加速失效时间模型的估计表明,SMD 与更早发生的认知障碍有关(时间比=0.96,p<.05)。在按种族-族裔划分的后续模型中,这种关联在白种人受访者中是明显的(时间比=0.95,p<.01),但在黑种人、美国出生的西班牙裔或外国出生的西班牙裔受访者中则不明显。
鉴于 SMD 的预后有效性因种族和族裔而异,因此在不同人群中使用 SMD 作为筛查或临床工具时需要谨慎。