Psychology Department, VA Boston Healthcare System, Boston.
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center.
Alzheimer Dis Assoc Disord. 2023;37(3):184-188. doi: 10.1097/WAD.0000000000000571. Epub 2023 Jul 31.
Disparities in Alzheimer disease (AD) and differences in help seeking (HS) across sociodemographic groups warrant public health concern. Research addressing such disparities must shift toward the earliest clinical manifestations of AD to optimize diagnosis, intervention and care planning. Subjective cognitive decline (SCD), a risk state for AD, provides an important context in which to examine sociodemographic-related disparities in HS.
One hundred sixty-seven cognitively healthy older adults (M age =73, M education =16) (26.4% Black, Asian, or "Other") completed SCD questionnaire, HS questions, and mood measures (depression and anxiety). Binary logistic adjusted regressions examined: (a) the association between SCD and HS; and (b) the extent to which education moderated the relationship between SCD and HS. SCD [b = 0.06, SE=0.13, P <0.001, odds ratio=1.06, 95% CI (1.03, 1.08)] and education [b=0.32, SE=0.09, P <0.001, odds ratio=1.37, 95% CI (1.15, 1.64)] were independently associated with HS, with significant interaction between education and SCD on HS [b=0.2, SE=0.01, P =0.01, odds ratio=1.02, 95% CI (1.00, 1.03)].
Findings elucidate the importance of tailoring SCD-related psychoeducational resources depending on educational background as a preliminary stepping-stone in encouraging HS among older adults who may be at particular risk for developing dementia.
阿尔茨海默病(AD)在不同社会人口群体中的差异和寻求帮助(HS)的差异引起了公共卫生关注。解决这些差异的研究必须转向 AD 的最早临床表现,以优化诊断、干预和护理计划。主观认知衰退(SCD)是 AD 的一个风险状态,为检查 HS 中与社会人口相关的差异提供了一个重要的背景。
167 名认知健康的老年人(平均年龄=73 岁,平均受教育年限=16 年)(26.4%为黑人、亚洲人或“其他”)完成了 SCD 问卷、HS 问题和情绪测量(抑郁和焦虑)。二元逻辑回归分析考察了:(a)SCD 与 HS 之间的关联;以及(b)教育在多大程度上调节了 SCD 与 HS 之间的关系。SCD [b=0.06,SE=0.13,P<0.001,优势比=1.06,95%CI(1.03,1.08)]和教育 [b=0.32,SE=0.09,P<0.001,优势比=1.37,95%CI(1.15,1.64)]与 HS 独立相关,教育与 SCD 对 HS 的交互作用显著 [b=0.2,SE=0.01,P=0.01,优势比=1.02,95%CI(1.00,1.03)]。
这些发现阐明了根据教育背景定制与 SCD 相关的心理教育资源的重要性,这是鼓励可能有发展为痴呆症风险的老年人寻求帮助的初步步骤。