Spousal caregiving, widowhood, and cognition: A systematic review and a biopsychosocial framework for understanding the relationship between interpersonal losses and dementia risk in older adulthood.
Spousal caregiving, widowhood, and cognition: A systematic review and a biopsychosocial framework for understanding the relationship between interpersonal losses and dementia risk in older adulthood.
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DOI：
10.1016/j.neubiorev.2021.12.010
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发表时间：
2022-03
影响因子：
8.2
通讯作者：
Fagundes CP
中科院分区：
文献类型：
--
作者：
Wu-Chung EL;Leal SL;Denny BT;Cheng SL;Fagundes CP
越来越多的研究表明，生活压力事件，尤其是那些威胁亲密关系的事件，与痴呆症风险增加有关。失去配偶的悲伤，无论是在照顾方面还是在死亡之后，都是“生活中最重要的压力源”之一，会引起强烈的心理和生理痛苦。尽管许多研究报告称，与对照组相比，配偶照顾者和寡妇（鳏夫）的痴呆风险升高或认知能力较差，但没有任何评论总结了认知结果（即痴呆发生率、认知障碍率、认知表现）的研究结果，也没有提出一个理论模型来理解失去伴侣和异常认知衰退之间的联系。当前的系统综述总结了 64 项实证研究的结果。总体而言，横断面和纵向研究均显示伴侣丧失与认知结果之间存在不利关联。反过来，我们提出了认知衰退的生物心理社会模型，该模型解释了照顾和丧亲之痛如何可能导致某些人出现认知障碍或阿尔茨海默病和相关痴呆症。需要更多关注照顾者和寡妇的生物心理社会背景的纵向研究。
Accumulating research suggests that stressful life events, especially those that threaten close intimate bonds, are associated with an increased risk of dementia. Grieving the loss of a spouse, whether in the form of caregiving or after the death, ranks among ‘life’s most significant stressors’, evoking intense psychological and physiological distress. Despite numerous studies reporting elevated dementia risk or poorer cognition among spousal caregivers and widow(er)s compared to controls, no review has summarized findings across cognitive outcomes (i.e., dementia incidence, cognitive impairment rates, cognitive performance) or proposed a theoretical model for understanding the links between partner loss and abnormal cognitive decline. The current systematic review summarizes findings across 64 empirical studies. Overall, both cross-sectional and longitudinal studies revealed an adverse association between partner loss and cognitive outcomes. In turn, we propose a biopsychosocial model of cognitive decline that explains how caregiving and bereavement may position some to develop cognitive impairment or Alzheimer’s disease and related dementias. More longitudinal studies that focus on the biopsychosocial context of caregivers and widow(er)s are needed.
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