Positive and Negative Experiences of Social Support and Risk of Dementia in Later Life: An Investigation Using the English Longitudinal Study of Ageing.
Positive and Negative Experiences of Social Support and Risk of Dementia in Later Life: An Investigation Using the English Longitudinal Study of Ageing.
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DOI：
10.3233/jad-161160
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Steptoe A
中科院分区：
文献类型：
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作者：
Khondoker M;Rafnsson SB;Morris S;Orrell M;Steptoe A
背景：拥有一个亲密的关系网络可以降低患痴呆症的风险。然而，社会交换理论表明，社会互动既需要回报，也需要成本。晚年密切社会关系的质量对患痴呆症风险的影响尚不清楚。目的：调查关键关系（配偶或伴侣，子女，其他直系亲属和朋友）中社会支持的积极和消极经验对晚年患痴呆症风险的影响。研究方法：我们分析了来自英国老龄化纵向研究（艾尔莎）的10,055名年龄在50岁及以上的无痴呆（基线）核心参与者的10年随访数据（2003/4至2012/13）。痴呆症的发病率是根据参与者或知情者报告的医生诊断的痴呆症或知情者填写的IQCODE问卷的总体评分确定的。采用比例风险回归法，以痴呆发生时间为截尾时间，研究了基线时社会支持的积极和消极经验对痴呆发生风险的影响。结果：随访期间发生痴呆340例（3.4%）。来自儿童的积极社会支持显著降低了痴呆症的风险（风险比，HR = 0.83，p = 0.042，95%CI：0.69至0.99）。 来自其他直系亲属的消极支持（HR = 1.26，p = 0.011，CI：1.05至1.50）;来自配偶和子女的综合消极评分（HR = 1.23，p = 0.046，CI：1.004至1.51）;配偶、子女和其他家庭（HR = 1.27，p = 0.021，CI = 1.04至1.56）;其他家人和朋友（HR = 1.25，p = 0.033，CI：1.02至1.55）;以及总体消极评分（HR = 1.31，p = 0.019，CI：1.05至1.64）均与痴呆风险增加显著相关。 结论：来自儿童的积极社会支持与降低患痴呆症的风险有关，而来自儿童和其他直系亲属的消极社会支持的经历会增加风险。需要进一步的研究来更好地理解驱动这些关联的因果机制。
Background: Having a network of close relationships may reduce the risk of developing dementia. However, social exchange theory suggests that social interaction entails both rewards and costs. The effects of quality of close social relationships in later life on the risk of developing dementia are not well understood. Objective: To investigate the effects of positive and negative experiences of social support within key relationships (spouse or partner, children, other immediate family, and friends) on the risk of developing dementia in later life. Methods: We analyzed 10-year follow up data (2003/4 to 2012/13) in a cohort of 10,055 dementia free (at baseline) core participants aged 50 years and over from the English Longitudinal Study of Ageing (ELSA). Incidence of dementia was identified from participant or informant reported physician diagnosed dementia or overall score of informant-completed IQCODE questionnaire. Effects of positive and negative experiences of social support measured at baseline on risk of developing dementia were investigated using proportional hazards regression accommodating interval censoring of time-to-dementia. Results: There were 340 (3.4%) incident dementia cases during the follow-up. Positive social support from children significantly reduced the risk of dementia (hazard ratio, HR = 0.83, p = 0.042, 95% CI: 0.69 to 0.99). Negative support from other immediate family (HR = 1.26, p = 0.011, CI: 1.05 to 1.50); combined negative scores from spouse and children (HR = 1.23, p = 0.046, CI: 1.004 to 1.51); spouse, children, and other family (HR = 1.27, p = 0.021, CI = 1.04 to 1.56); other family & friends (HR = 1.25, p = 0.033, CI: 1.02 to 1.55); and the overall negative scores (HR = 1.31, p = 0.019, CI: 1.05 to 1.64) all were significantly associated with increased risk of dementia. Conclusion: Positive social support from children is associated with reduced risk of developing dementia whereas experiences of negative social support from children and other immediate family increase the risk. Further research is needed to better understand the causal mechanisms that drive these associations.