健康幸福感作为认知能力下降和痴呆症的保护因素：文献综述与未来研究方向。
Well-Being as a Protective Factor Against Cognitive Decline and Dementia: A Review of the Literature and Directions for Future Research.
机构信息
Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
出版信息
J Gerontol B Psychol Sci Soc Sci. 2023 May 11;78(5):765-776. doi: 10.1093/geronb/gbad020.
OBJECTIVES
Treatments that target the biological causes of dementia remain limited, making prevention critically important. Well-being-defined broadly as living in accordance with one's potential and experiencing one's life as enjoyable and satisfying-is a promising avenue for prevention. It can be targeted by large-scale, noninvasive interventions and has been linked with better cognitive health and lower dementia risk. In the current review, we begin by summarizing empirical evidence linking well-being to cognitive functioning, cognitive decline, dementia diagnosis, and dementia-related neuropathology. Then, we highlight 3 key areas for future research.
METHODS
We searched the literature on wellbeing, cognitive decline, and dementia, focusing on prospective and longitidinal evidence.
RESULTS
The research reviewed here provides consistent evidence for associations of well-being with cognitive decline, dementia risk, and cognitive resilience to neuropathology. However, several open questions remain regarding (1) causality and mechanism(s), (2) specificity versus generalizability of associations, and (3) timing.
DISCUSSION
To inform potential intervention efforts, the field must address complex open questions about whether, how, when, and for whom well-being influences dementia risk. The majority of existing research on well-being and cognitive health is correlational, and few studies have tested potential mechanisms that may explain those associations. Further, relatively little is known about the generalizability of associations across different aspects of well-being and for different sociocultural groups. Finally, we do not yet understand when in the life span and on what timescale well-being might influence cognitive health. We discuss challenges and opportunities for addressing each of these open questions, including concrete recommendations for research designs and use of open science practices.
目的
针对痴呆症的生物学病因的治疗方法仍然有限，因此预防变得至关重要。幸福感被广泛定义为按照自己的潜力生活，并体验到生活的乐趣和满足，这是预防痴呆症的一个很有前途的途径。它可以通过大规模的、非侵入性的干预措施来实现，并且与更好的认知健康和更低的痴呆症风险有关。在目前的综述中，我们首先总结了将幸福感与认知功能、认知衰退、痴呆诊断和与痴呆相关的神经病理学联系起来的实证证据。然后，我们强调了未来研究的 3 个关键领域。
方法
我们搜索了关于幸福感、认知衰退和痴呆的文献，重点是前瞻性和纵向证据。
结果
这里回顾的研究为幸福感与认知衰退、痴呆风险以及对神经病理学的认知弹性之间的关联提供了一致的证据。然而，关于（1）因果关系和机制、（2）关联的特异性与普遍性，以及（3）时间性，仍有几个悬而未决的问题。
讨论
为了为潜在的干预措施提供信息，该领域必须解决关于幸福感是否、如何、何时以及对谁影响痴呆风险的复杂开放性问题。关于幸福感和认知健康的大多数现有研究都是相关的，很少有研究测试过可能解释这些关联的潜在机制。此外，关于幸福感在不同方面和不同社会文化群体中的普遍性知之甚少。最后，我们还不知道幸福感何时以及在什么时间尺度上会影响认知健康。我们讨论了应对这些开放性问题的挑战和机遇，包括对研究设计和开放科学实践的具体建议。
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