Loneliness in Older Black Adults with Human Immunodeficiency Virus Is Associated with Poorer Cognition.
Loneliness in Older Black Adults with Human Immunodeficiency Virus Is Associated with Poorer Cognition.
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作者：
Han SD;Adeyemi O;Wilson RS;Leurgans S;Jimenez A;Oullet L;Shah R;Landay A;Bennett DA;Barnes LL
人类免疫缺陷病毒（HIV）与认知障碍有关，孤独与老年认知能力下降有关。由于耻辱和缺乏社会资源，患有艾滋病毒的老年黑人成年人可能特别容易孤独。我们检验了以下假设：（1）老年黑人艾滋病毒感染者比老年白色艾滋病毒感染者表现出更大的孤独感，（2）老年黑人艾滋病毒感染者更大的孤独感与认知功能较差有关。370名参与者（177名HIV感染者，193名无HIV感染者，平均年龄=58.8岁，s.d.= 6.2;教育平均值=13.4，标准差= 2.9; 73.9%男性，68.9%黑人）在拉什艾滋病毒和老龄化差异卓越中心（CEDHA）的一项基于社区的横断面研究中完成了一项用于测量情感孤独和一系列认知测量的五项自我报告量表。与我们的预期相反，在控制年龄、教育、性别、全球认知和收入影响的模型中，老年黑人成年人的整体孤独感低于白色成年人（B=-0.3893; SE=0.1466，p=0.0087）。然而，在以认知功能为结果的模型中，观察到种族和孤独感之间的相互作用，表明孤独感更强的老年黑人成年人相对于白色成年人表现出更差的认知功能（B=-0.2736，SE=0.1138，p=0.0174）。老年黑人艾滋病毒感染者报告的孤独感比老年白色人少;然而，孤独感和认知功能之间的负相关性在黑人中比白色老年人更强。需要更多的工作来阐明这种相互作用的机制。
The human immunodeficiency virus (HIV) is associated with cognitive impairment, and loneliness is associated with cognitive decline in old age. Older Black adults with HIV may be at particular risk for loneliness due to stigma and lack of social resources. We tested the hypotheses that (1) older Black adults with HIV would show greater loneliness than older White adults with HIV, and (2) greater loneliness among older Black adults with HIV would be associated with poorer cognitive function. Three hundred and seventy participants (177 with HIV, 193 without HIV, age mean=58.8, s.d.=6.2; education mean=13.4, s.d.=2.9; 73.9% male, 68.9% Black) in a community-based cross-sectional study of the Rush Center of Excellence on Disparities in HIV and Aging (CEDHA) completed a five-item self-report scale used to measure emotional loneliness and a battery of cognitive measures. Contrary to our expectations, older Black adults indicated less overall loneliness than White adults (B=−0.3893; SE=0.1466, p=0.0087) in models controlling for the effects of age, education, sex, global cognition, and income. However, in models with cognitive function as the outcome, an interaction between race and loneliness was observed such that older Black adults who indicated greater loneliness showed poorer cognitive function relative to White adults (B=−0.2736, SE=0.1138, p=0.0174). Older Black adults with HIV reported less loneliness than older White adults; however, the inverse association between loneliness and cognitive function was stronger in Black than White older adults. Additional work is needed to elucidate the mechanisms underlying this interaction.