美国老年人感知的阿尔茨海默病和相关痴呆风险与认知功能之间的关系。
Association between perceived risk of Alzheimer's disease and related dementias and cognitive function among U.S. older adults.
机构信息
Department of Public Health Sciences, School of Medicine, UC-Davis, CA, United States of America.
Department of Family Medicine and Community Health, Duke University, Durham, NC, United States of America; Duke University School of Nursing, Duke University, Durham, NC, United States of America; Center for the Study of Aging and Human Development, Duke University, Durham, NC, United States of America.
出版信息
Arch Gerontol Geriatr. 2023 Dec;115:105126. doi: 10.1016/j.archger.2023.105126. Epub 2023 Jul 13.
INTRODUCTION
The aim of the study was to assess factors associated with the perceived risk of developing Alzheimer's disease and related dementias (ADRD) and how the perceived risk of ADRD was related to cognitive function.
METHODS
We conducted a retrospective cohort study using 5 waves of data from the Health and Retirement Study (2012-2022) that included adults aged 65 years or older with no previous diagnosis of ADRD at baseline. Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7's test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range = 0-35). Perceived risk of developing ADRD was categorized at baseline as "definitely not" (0% probability), "unlikely" (1-49%), "uncertain" (50%), and "more than likely" (>50-100%). Additional baseline measures included participants' sociodemographic background, psychosocial resources, health behaviors, physiological status, and healthcare utilization.
RESULTS
Of 1457 respondents (median age 74 [IQR = 69-80] and 59.8% women), individuals who perceived that they were "more than likely" to develop ADRD had more depressive symptoms and were more likely to be hospitalized in the past two years than individuals who indicated that it was "unlikely" they would develop ADRD. Alternatively, respondnets who perceived that they would "definitely not" develop ADRD were more likely to be non-Hispanic Black, less educated, and have lower income than individuals who indicated it was "unlikely" they would develop ADRD. Respondents who reported their risks of developing ADRD as "more than likely" (β = -2.10, P < 0.001) and "definitely not" (β = -1.50, P < 0.001) had the lowest levels of cognitive function; and the associations were explained in part by their socioeconomic, psychosocial, and health status.
CONCLUSIONS
Perceived risk of developing ADRD is associated with cognitive function. The (dis)concordance between individuals' perceived risk of ADRD and their cognitive function has important implications for increasing public awareness and developing interventions to prevent ADRD.
简介
本研究旨在评估与阿尔茨海默病和相关痴呆症（ADRD）发病风险感知相关的因素，以及感知到的 ADRD 发病风险与认知功能的关系。
方法
我们使用健康与退休研究（2012-2022 年）的 5 波数据进行了回顾性队列研究，该研究纳入了基线时无 ADRD 既往诊断的 65 岁及以上成年人。使用包括即时/延迟单词回忆、7 连测试、客观命名测试、倒数计数、回忆当前日期和命名总统/副总统（范围为 0-35）的综合评分来测量基线和随时间推移的认知功能。基线时感知到的 ADRD 发病风险分为“肯定不会”（0%概率）、“不太可能”（1-49%）、“不确定”（50%）和“更有可能”（>50-100%）。其他基线测量包括参与者的社会人口统计学背景、心理社会资源、健康行为、生理状况和医疗保健利用情况。
结果
在 1457 名受访者中（中位数年龄 74[IQR=69-80]，59.8%为女性），与表示“不太可能”会发展为 ADRD 的个体相比，认为自己“更有可能”患上 ADRD 的个体抑郁症状更严重，且在过去两年中更有可能住院。相反，认为自己“肯定不会”患上 ADRD 的个体更有可能是非西班牙裔黑人，受教育程度较低，收入较低，与表示“不太可能”患上 ADRD 的个体相比。报告 ADRD 发病风险为“更有可能”（β=-2.10，P<0.001）和“肯定不会”（β=-1.50，P<0.001）的个体认知功能水平最低；这些关联部分可以通过他们的社会经济、心理社会和健康状况来解释。
结论
对 ADRD 发病风险的感知与认知功能相关。个体对 ADRD 发病风险的感知与其认知功能之间的（不）一致对提高公众意识和制定预防 ADRD 的干预措施具有重要意义。
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