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应对方式与老年人认知功能的关系。

Coping patterns associations with cognitive function in older adults.

机构信息

Department of Psychology, University of Maine, Orono, ME, USA.

出版信息

J Int Neuropsychol Soc. 2024 Oct;30(8):738-745. doi: 10.1017/S1355617724000377. Epub 2024 Sep 18.

Abstract

OBJECTIVE

Cognitive function may contribute to variability in older adults' ability to cope with chronic stress; however, limited research has evaluated this relationship. This study investigated the relationship between theoretically derived coping domains and cognitive function in 165 middle-to-older adults during the Omicron stage of COVID-19.

METHOD

Participants completed a clinical interview and self-report measures of health. The National Alzheimer's Coordinating Center Uniform Data Set neuropsychological battery was used to evaluate memory, language, executive function/speed, and working memory. Structural equation modeling evaluated the underlying factor structure of the Brief COPE adapted for COVID-19.

RESULTS

The data supported the proposed second-order Approach factor comprised of Problem-Solving and Emotion Regulation (ER) strategies and a first-order Avoidance factor. Higher Avoidance was associated with greater depression symptoms, lower income and worse memory, executive function, working memory, and verbal fluency performance. Higher Problem-Solving was associated with better verbal fluency performance. ER strategies were not significantly associated with cognitive function. The use of Problem-Solving was not associated with less Avoidance. Greater use of Problem-Solving, ER, and Avoidance were all associated with higher levels of stress. Post-hoc analyses found that higher Acceptance was the only coping strategy associated with less stress.

CONCLUSIONS

These findings demonstrate that older adults with worse cognitive function were more likely to use Avoidance during the pandemic, which could result in prolonged stress and adverse health consequences. Future research is warranted to investigate whether acceptance-based interventions reduce the avoidance and impact of stress on health in vulnerable older adults.

摘要

目的

认知功能可能是导致老年人应对慢性压力能力存在差异的因素之一;然而,相关研究有限。本研究在新冠病毒奥密克戎变异株流行期间,调查了 165 名中老年参与者中理论上推导的应对领域与认知功能之间的关系。

方法

参与者完成了临床访谈和自我报告的健康评估。采用国立阿尔茨海默病协调中心统一数据集中的神经心理学测试包评估记忆、语言、执行功能/速度和工作记忆。结构方程模型评估了为新冠疫情改编的Brief COPE 的潜在因子结构。

结果

数据支持了包含问题解决和情绪调节(ER)策略的二阶趋近因子以及一阶回避因子的假设。较高的回避与更多的抑郁症状、较低的收入以及更差的记忆、执行功能、工作记忆和语言流畅性表现相关。较高的问题解决与更好的语言流畅性表现相关。ER 策略与认知功能没有显著相关。问题解决的使用与回避的减少无关。更多地使用问题解决、ER 和回避均与更高水平的压力相关。事后分析发现,更高的接纳是唯一与压力水平降低相关的应对策略。

结论

这些发现表明,认知功能较差的老年人在大流行期间更有可能使用回避策略,这可能导致压力持续存在和健康状况恶化。有必要开展未来研究,以调查基于接纳的干预措施是否可以减少脆弱的老年人的回避行为以及压力对健康的影响。

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