美国老年人感知到的歧视与痴呆症的发生:社会关系的缓冲作用

Ning Hsieh, Hui Liu, Zhenmei Zhang
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摘要

研究目的 近期的研究发现,作为一种慢性压力源,感知到的歧视会导致认知健康状况变差。然而,很少有研究调查社会关系作为潜在的干预机制会如何减轻或加剧这种关联。本研究利用具有全国代表性的美国老年人样本,考察了伴侣、子女、其他家庭成员和朋友这四种关系的存在和质量如何改变感知到的歧视对痴呆症事件的影响。方法 我们使用具有竞争风险的离散时间事件历史模型分析了 2006-2016 年健康与退休研究(N=12,236)的数据。我们利用基线时感知到的歧视、社会关系及其相互作用来预测随访中痴呆症的发病风险。结果 在随访中,感知到的歧视可预测较高的痴呆症发病风险。虽然有无伴侣并不能改变这种关联,但伴侣的支持却能减轻歧视对痴呆症发病的负面影响。与子女、其他家庭成员或朋友之间是否存在关系以及关系的质量都不会改变这种关联。讨论 我们的研究结果表明,亲密伙伴关系在应对歧视方面起着关键作用,并因此影响老年人的认知健康。虽然感知到的歧视是痴呆症发病率的一个重要风险因素,但更好的伙伴关系质量可能会削弱这种关联。消除歧视的政策和加强亲密伙伴关系的干预措施可能有助于改善晚年认知健康。
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Perceived discrimination and incident dementia among older adults in the U.S.: The buffering role of social relationships
Objectives Recent studies have found that perceived discrimination as a chronic stressor predicts poorer cognitive health. However, little research has investigated how social relationships as potential intervening mechanisms may mitigate or exacerbate this association. Using a nationally representative sample of U.S. older adults, this study examined how the existence and quality of four types of relationships—with a partner, children, other family members, and friends—may modify the impact of perceived discrimination on incident dementia. Methods We analyzed data from the 2006–2016 Health and Retirement Study (N=12,236) using discrete-time event history models with competing risks. We used perceived discrimination, social relationships, and their interactions at the baseline to predict the risk of incident dementia in the follow-ups. Results Perceived discrimination predicted a higher risk of incident dementia in the follow-ups. Although having a partner or not did not modify this association, partnership support attenuated the negative effects of discrimination on incident dementia. Neither the existence nor quality of relationships with children, other family members, or friends modified the association. Discussion Our findings imply that intimate partnership plays a critical role in coping with discrimination and, consequently, influencing the cognitive health of older adults. While perceived discrimination is a significant risk factor for the incidence of dementia, better partnership quality may attenuate this association. Policies that eliminate discrimination and interventions that strengthen intimate partnership may facilitate better cognitive health in late life.
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