社区居住的中国老年人的压力生活事件和晚年认知功能:来自大芝加哥地区基于人群的队列研究的发现

Gabriella C. Dong, Mengting Li
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引用次数: 2

摘要

大多数关于压力生活事件的研究集中在创伤后应激障碍和抑郁症上,而对于在生命过程中累积暴露于压力生活事件是否会损害认知功能的研究却很少。本研究旨在探讨移民人群一生压力生活事件与认知功能的关系。数据来自芝加哥华人老年人口研究(PINE)。2017-2019年,对3125名美国华裔老年人进行了面对面访谈。对12种生活压力事件进行了评估:身体攻击、住宅火灾、性侵犯、流产、堕胎、监禁、被诬告、离婚、亲人死亡、被抢劫、患癌症和无家可归。通过整体认知、情景记忆、工作记忆、处理速度和简易精神状态检查(MMSE)来测量认知功能。进行线性回归。老年人经历了更多的生活事件与全球相关认知(b = 0.11, = 0.01, p < 0.001),情景记忆(b = 0.14, = 0.02, p < 0.001),工作记忆(b = 0.17, = 0.03, p < 0.001),处理速度(b = 1.92, = 0.18, p < 0.001),和MMSE (b = 0.29, = 0.07, p < 0.001),而控制了年龄,性别,收入,教育,医学并存病、ADL,和抑郁症状。与早期的研究相反,我们确定了总体和个体生活事件与认知之间的正相关关系。先前有过压力生活事件经历的老年人可能比那些没有这种经历的人表现出优势。此外,在成年期和老年期经历过生活事件的老年人具有更高的认知功能。进一步的研究可以探讨个体如何应对压力生活事件,以及潜在的弹性机制如何促进认知功能。
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Stressful Life Events and Late-Life Cognitive Function in Community-Dwelling Chinese Older Adults: Findings from a Population-Based Cohort Study in the Greater Chicago Area
The majority of studies on stressful life events focus on posttraumatic stress disorder and depression, while less is known about whether the cumulative exposure to stressful life events over the life course will deteriorate cognitive function. This study aims to investigate the association between lifetime stressful life events and cognitive function in an immigrant population. The data were drawn from the Population Study of Chinese Elderly in Chicago (PINE). Face-to-face interviews were conducted with a sample of 3125 U.S. Chinese older adults in 2017–2019. Twelve types of stressful life events were assessed: physical assault, residential fires, sexual assault, miscarriage, abortion, imprisonment, being falsely accused, divorce, death of a loved one, being robbed, experiencing cancer, and being homeless. Cognitive function was measured through global cognition, episodic memory, working memory, processing speed, and Mini-Mental State Examination (MMSE). Linear regression was performed. Older adults who experienced a higher number of life events were associated with higher global cognition (b = 0.11, SE = 0.01, p < 0.001), episodic memory (b = 0.14, SE = 0.02, p < 0.001), working memory (b = 0.17, SE = 0.03, p < 0.001), processing speed (b = 1.92, SE = 0.18, p < 0.001), and MMSE (b = 0.29, SE = 0.07, p < 0.001), while controlling for age, gender, income, education, medical comorbidities, ADL, and depressive symptoms. In contrast with earlier studies, we identified the positive relationships between aggregate and individual life events and cognition. Older adults who had prior experience with stressful life events could demonstrate an advantage over those without such experiences. In addition, older adults who experienced life event(s) during adulthood and old age are associated with higher cognitive function. Further studies could investigate how individuals respond to stressful life events and how the underlying resilience mechanism would promote cognitive function.
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