Wang Kun, Marbut Alexander R, Suntai Zainab, Zheng Dianhan, Chen Xiayu
School of Social Work, University of Alabama, Tuscaloosa, AL, USA, 35401; Department of Social Work, Binghamton University, Binghamton, NY, 13902, USA.
Department of Management, University of Alabama, Tuscaloosa, AL, USA, 35401.
Soc Sci Med. 2022 Oct;311:115297. doi: 10.1016/j.socscimed.2022.115297. Epub 2022 Aug 21.
Previous studies have linked levels of perceived chronic stress to older adults' cognitive functioning, but few have focused on the impact of chronic stressor types. Thus, this study aimed to (1) identify patterns of chronic stressor types and (2) examine the effects of these patterns on cognitive functioning trajectories among older adults.
Two longitudinal studies were conducted separately to test the study aims and ensure replicability across samples and time points. Both used three timepoints (Study 1: 2006, 2008, and 2010, n = 6974; Study 2: 2012, 2014, and 2016, n = 6604) collected from older Americans in the Health and Retirement Study. Participants did not overlap between the two studies. Latent class analyses were conducted to identify chronic stressor-type patterns. Latent growth curve models were used to test the effects of chronic stressor-type patterns on cognitive functioning trajectories.
Three latent classes of stressor types were identified in both studies: egocentric (4.56%; 5.85%), nonegocentric (8.58%; 10.03%), and low stressor (86.86%; 84.12%). In both studies, compared to the low stressor class, the egocentric stressor class had significantly lower initial cognitive scores (B = -0.72, ρ < 0.001; B = -0.46, ρ < 0.05), while the nonegocentric stressor class did not have significantly different initial scores, with covariates controlled. Additionally, in Study 1, the nonegocentric stressor class had significantly slower cognitive decline rates than the low stressor class (B = 0.11, ρ < 0.05).
Findings suggested that nonegocentric stressors are an important stressor source in late adulthood but are less detrimental to cognitive functioning than egocentric stressors. Health management interventions may reduce older adults' cognitive health disparities caused by self-health and financial stressors. More support, including financial subsidies, caregiver stress management training, or support groups, should be provided to older caregivers, especially those with few resources.
以往研究已将感知到的慢性应激水平与老年人的认知功能联系起来，但很少有研究关注慢性应激源类型的影响。因此，本研究旨在：（1）识别慢性应激源类型的模式；（2）检验这些模式对老年人认知功能轨迹的影响。
分别进行了两项纵向研究以检验研究目的，并确保跨样本和时间点的可重复性。两项研究均使用了三个时间点（研究1：2006年、2008年和2010年，n = 6974；研究2：2012年、2014年和2016年，n = 6604），数据来自健康与退休研究中的美国老年人。两项研究的参与者没有重叠。进行潜在类别分析以识别慢性应激源类型的模式。使用潜在增长曲线模型来检验慢性应激源类型模式对认知功能轨迹的影响。
两项研究均识别出三类潜在的应激源类型：以自我为中心型（4.56%；5.85%）、非以自我为中心型（8.58%；10.03%）和低应激源型（86.86%；84.12%）。在两项研究中，与低应激源类别相比，以自我为中心的应激源类别初始认知得分显著更低（B = -0.72，ρ < 0.001；B = -0.46，ρ < 0.05），而非以自我为中心的应激源类别在控制协变量后初始得分无显著差异。此外，在研究1中，非以自我为中心的应激源类别认知衰退率显著慢于低应激源类别（B = 0.11，ρ < 0.05）。
研究结果表明，非以自我为中心的应激源是成年晚期重要的应激源，但对认知功能的损害小于以自我为中心的应激源。健康管理干预措施可能会减少由自身健康和经济应激源导致的老年人认知健康差异。应向老年照料者，尤其是资源较少的照料者提供更多支持措施，包括经济补贴、照料者压力管理培训或支持小组等。
