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不同老年人群体的婚姻状况、脑健康与认知储备

Marital status, brain health, and cognitive reserve among diverse older adults.

作者信息

Lee Ji Hyun, Scambray Kiana A, Morris Emily P, Sol Ketlyne, Palms Jordan D, Zaheed Afsara B, Martinez Michelle N, Schupf Nicole, Manly Jennifer J, Brickman Adam M, Zahodne Laura B

机构信息

Department of Human Development and Community Health, Montana State University, Bozeman, MT, USA.

Department of Psychology, University of Michigan, Ann Arbor, MI, USA.

出版信息

J Int Neuropsychol Soc. 2025 Jan;31(1):1-10. doi: 10.1017/S1355617724000638. Epub 2024 Nov 26.

Abstract

OBJECTIVE

Being married may protect late-life cognition. Less is known about living arrangement among unmarried adults and mechanisms such as brain health (BH) and cognitive reserve (CR) across race and ethnicity or sex/gender. The current study examines (1) associations between marital status, BH, and CR among diverse older adults and (2) whether one's living arrangement is linked to BH and CR among unmarried adults.

METHOD

Cross-sectional data come from the Washington Heights-Inwood Columbia Aging Project ( = 778, 41% Hispanic, 33% non-Hispanic Black, 25% non-Hispanic White; 64% women). Magnetic resonance imaging (MRI) markers of BH included cortical thickness in Alzheimer's disease signature regions and hippocampal, gray matter, and white matter hyperintensity volumes. CR was residual variance in an episodic memory composite after partialing out MRI markers. Exploratory analyses stratified by race and ethnicity and sex/gender and included potential mediators.

RESULTS

Marital status was associated with CR, but not BH. Compared to married individuals, those who were previously married (i.e., divorced, widowed, and separated) had lower CR than their married counterparts in the full sample, among White and Hispanic subgroups, and among women. Never married women also had lower CR than married women. These findings were independent of age, education, physical health, and household income. Among never married individuals, living with others was negatively linked to BH.

CONCLUSIONS

Marriage may protect late-life cognition via CR. Findings also highlight differential effects across race and ethnicity and sex/gender. Marital status could be considered when assessing the risk of cognitive impairment during routine screenings.

摘要

目的

已婚状态可能对晚年认知起到保护作用。对于未婚成年人的生活安排以及跨种族和族裔或性别在大脑健康(BH)和认知储备(CR)等机制方面的了解较少。本研究调查了(1)不同老年成年人的婚姻状况、大脑健康和认知储备之间的关联,以及(2)未婚成年人的生活安排是否与大脑健康和认知储备相关。

方法

横断面数据来自华盛顿高地 - 因伍德哥伦比亚衰老项目(n = 778,41%为西班牙裔,33%为非西班牙裔黑人,25%为非西班牙裔白人;64%为女性)。大脑健康的磁共振成像(MRI)指标包括阿尔茨海默病特征区域的皮质厚度以及海马体、灰质和白质高信号体积。认知储备是在排除MRI指标后情景记忆综合指标中的剩余方差。按种族和族裔以及性别进行分层的探索性分析,并纳入了潜在的中介因素。

结果

婚姻状况与认知储备相关,但与大脑健康无关。在全样本、白人和西班牙裔亚组以及女性中,与已婚个体相比,那些曾经结婚(即离婚、丧偶和分居)的人的认知储备低于已婚者。从未结婚的女性的认知储备也低于已婚女性。这些发现独立于年龄、教育程度、身体健康和家庭收入。在从未结婚的个体中,与他人同住与大脑健康呈负相关。

结论

婚姻可能通过认知储备保护晚年认知。研究结果还突出了跨种族和族裔以及性别之间的差异效应。在常规筛查认知障碍风险时可考虑婚姻状况。

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