School of Nursing, University of Maryland, Baltimore, Maryland, USA.
College of Nursing, Research Institue of Nursing Science, Pusan National University, Yangsan, Korea (the Republic of)
BMJ Open. 2023 Aug 24;13(8):e072236. doi: 10.1136/bmjopen-2023-072236.
Subjective cognitive decline, self-perceived cognitive deterioration without objective impairment, is becoming a vital health indicator, especially due to its intermediate stage between normal function and mild cognitive impairment. Cognitive decline often coexists with various symptoms that may interact with each other, serve as prognostic indicators and influence the progression of cognitive decline. This study aims to identify symptom clusters among individuals with subjective cognitive decline, using latent class analysis, and to identify factors affecting these symptom clusters, offering insights into understanding and potentially preventing cognitive decline progression.
A secondary data analysis of the nationally representative cross-sectional data obtained from the 2019 Korea Community Health Survey.
We performed latent class analysis using six symptoms (pain, sleep deprivation, depression, fatigue, restlessness and apathy) to determine the distinct symptom clusters. After selecting the best latent class model, we identified factors influencing those symptom clusters using multinomial logistic regression analyses.
We found that a three-latent-class model best fitted the data: a low symptom-burden group (39.9%), a moderate symptom-burden group (44.8%) and a high symptom-burden group (15.3%). Male gender, higher age, higher perceived health status and lower perceived stress status, were strongly associated with lesser odds of being in the moderate (OR: 0.37 (95% CI: 0.33 to 0.41)) to OR: 2.20 (95% CI: 2.03 to 2.39)) and high symptom-burden groups (OR: 0.18 (95% CI: 0.15 to 0.21)) to OR: 8.53 (95% CI: 7.68 to 9.49)) as compared with being in the low symptom-burden group.
Findings may contribute to improving clinical practitioners' understanding of the unique symptom patterns experienced by people with subjective cognitive decline and their influencing factors. Furthermore, we recommend that formal caregivers screen and manage prevalent symptoms considering the factors affecting the symptoms of people with subjective cognitive decline in clinical practice.
主观认知衰退是一种认知功能下降的主观感觉,而没有客观损害,它正成为一个重要的健康指标,尤其是因为它处于正常功能和轻度认知障碍之间的中间阶段。认知衰退常伴有各种症状,这些症状可能相互作用,作为预后指标,并影响认知衰退的进展。本研究旨在使用潜在类别分析确定主观认知衰退个体的症状群,并确定影响这些症状群的因素,从而深入了解并可能预防认知衰退的进展。
这是一项对 2019 年全国代表性横断面韩国社区健康调查获得的代表性数据进行的二次数据分析。
我们使用六个症状(疼痛、睡眠剥夺、抑郁、疲劳、不安和冷漠)进行潜在类别分析,以确定不同的症状群。在选择最佳潜在类别模型后,我们使用多项逻辑回归分析确定了影响这些症状群的因素。
研究结果表明,一个三潜在类别模型最适合数据:低症状负担组(39.9%)、中症状负担组(44.8%)和高症状负担组(15.3%)。男性、较高的年龄、较高的自我感知健康状况和较低的自我感知压力状况与中(比值比:0.37(95%置信区间:0.33 至 0.41))到比值比:2.20(95%置信区间:2.03 至 2.39))和高症状负担组(比值比:0.18(95%置信区间:0.15 至 0.21))到比值比:8.53(95%置信区间:7.68 至 9.49))的可能性降低有关。
研究结果可能有助于提高临床医生对主观认知衰退患者所经历的独特症状模式及其影响因素的理解。此外,我们建议在临床实践中,正式的护理人员应根据影响主观认知衰退患者症状的因素,对常见症状进行筛查和管理。