Subjective Functional Difficulties and Subjective Cognitive Decline in Older-Age Adults: Moderation by Age Cohorts and Mediation by Mentally Unhealthy Days.
Subjective Functional Difficulties and Subjective Cognitive Decline in Older-Age Adults: Moderation by Age Cohorts and Mediation by Mentally Unhealthy Days.
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DOI：
10.3390/ijerph20021606
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发表时间：
2023-01-16
影响因子：
--
通讯作者：
Ingman, Stanley
中科院分区：
文献类型：
--
作者：
Komalasari, Renata;Mpofu, Elias;Prybutok, Gayle;Ingman, Stanley
关键词：
背景和目标：尽管主观功能障碍（SFD）和主观认知下降（SCD）之间存在预期的正相关，但对精神不健康日（MUD）的介导研究不足。此外，很少有SCD研究检查了情感反应的功能困难的年龄组。本研究通过老年人年龄组的适度性来检验MUD对SFD和SCD之间关联的中介作用。方法：采用横断面设计方法，我们使用2019年BRFSS数据集，研究对象为13，377名年龄在65岁至≥80岁之间的老年人（44%为男性，56%为女性）。结果如下：5000个样本的偏差校正百分位数自助法显示，MUD部分介导SFD和SCD之间的关系（14.12%的中介效应），控制抑郁症状，教育，收入水平和种族。年龄组调节SFD和SCD之间以及SFD和SCD之间的关系，但不调节MUDs和SCD之间的关系。从SFD到MUDs和从MUDs到SCD的路径的预测效果在中老年（65-69）中比中老年（70-79）和最老的老年人（≥80）年龄组更强。更糟糕的SCD与亚洲人、女性老年人以及教育和收入水平较低的人有关。结论：这些发现扩展了慢性压力理论的预测，即主观功能困难的情绪脆弱性可能会放大SCD，特别是在年龄较大的年龄组。这意味着，预防性SCD干预措施应寻求支持老年人的日常生活活动，成功老龄化过渡到老年人群。
Background and Objectives: Despite the expected positive association between subjective functional difficulties (SFD) and subjective cognitive decline (SCD), their mediation by mentally unhealthy days (MUDs) is under-studied. Moreover, few SCD studies have examined affective reactivity to functional difficulties by age cohort. This study examined the mediation effect of MUDs on the association between SFD and SCD by age cohorts’ moderation among older adults. Methods: Using a cross-sectional design approach, we used the 2019 BRFSS dataset on 13,377 older adults aged 65 to ≥80 (44% males and 56% females). Results: The bias-corrected percentile bootstrap with 5000 samplings revealed that MUDs partially mediate the relationship between SFD and SCD (14.12% mediation effect), controlling depressive symptoms, education, income levels, and race. Age cohorts moderated the relationship between SFD and SCD and between SFD and SCD but not between MUDs and SCD. The predictive effects of the path from SFD to MUDs and from MUDs to SCD were stronger in the younger-old (65–69) than the middle-old (70–79) and oldest-old (≥80) age cohorts. Worse SCD was associated with being Asian, in female older adults, and in those with lower education and income levels. Conclusions: These findings extend the chronic stress theory predictions that accentuated emotional vulnerability to subjective functional difficulties may magnify SCD, particularly in the younger-old age group. By implication, preventive SCD interventions should seek to support younger-old adults in their activities of daily life for successful aging transitioning into older-age cohorts.
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