Subjective memory complaints, vascular risk factors and psychological distress in the middle-aged: a cross-sectional study.
Subjective memory complaints, vascular risk factors and psychological distress in the middle-aged: a cross-sectional study.
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DOI：
10.1186/1471-244x-11-108
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发表时间：
2011-07-01
期刊：
影响因子：
4.4
通讯作者：
Hickie IB
中科院分区：
文献类型：
--
作者：
Paradise MB;Glozier NS;Naismith SL;Davenport TA;Hickie IB
主观记忆抱怨（SMC）是常见的，但其意义尚不清楚。有人认为它们是轻度认知障碍（MCI）或痴呆的前兆，也是认知能力下降的早期指标。血管危险因素在痴呆和MCI的发展中起着重要作用。因此，我们的目的是在中年社区居民中检验血管危险因素与SMC相关的假设，独立于心理困扰。对45及以上研究的基线数据进行横断面分析。这是一项生活在新南威尔士州（澳大利亚）的人们的队列研究，我们探索了45,532名年龄在45到64岁之间的参与者的样本。在自我报告的李克特五分制记忆功能量表中，SMC被定义为“一般”或“较差”。血管危险因素包括肥胖、糖尿病、高血压、高胆固醇血症和吸烟。采用Kessler心理困扰量表测量心理困扰。我们用相同大小的验证样本对随机选择的探索性样本（n = 22,766）生成的模型进行了测试。5,479 / 45,532（12%）的受访者报告SMC。使用多变量logistic回归，只有两个血管危险因素：吸烟（OR 1.18; 95% CI = 1.03 - 1.35）和高胆固醇血症（OR 1.19; 95% CI = 1.04 - 1.36）与SMC有较小的独立关联。相反，心理困扰与SMC密切相关。那些心理困扰程度最高的人患SMC的可能性是无心理困扰者的7.00倍（95% CI = 5.41 - 9.07）。验证性样本也显示SMC与心理困扰而非血管危险因素有很强的关联。在没有任何重大情感性疾病或中风史的中年人的大样本中，心理困扰与SMC的相关性很强，而血管危险因素的相关性很弱，尽管我们不能否认心理困扰在血管危险因素和SMC之间的任何关联中的中介作用。鉴于此，临床医生在评估出现记忆问题的中年患者时应警惕情感性疾病的存在。
Subjective memory complaints (SMC) are common but their significance is still unclear. It has been suggested they are a precursor of mild cognitive impairment (MCI) or dementia and an early indicator of cognitive decline. Vascular risk factors have an important role in the development of dementia and possibly MCI. We therefore aimed to test the hypothesis that vascular risk factors were associated with SMC, independent of psychological distress, in a middle-aged community-dwelling population. A cross-sectional analysis of baseline data from the 45 and Up Study was performed. This is a cohort study of people living in New South Wales (Australia), and we explored the sample of 45, 532 participants aged between 45 and 64 years. SMC were defined as 'fair' or 'poor' on a self-reported five-point Likert scale of memory function. Vascular risk factors of obesity, diabetes, hypertension, hypercholesterolemia and smoking were identified by self-report. Psychological distress was measured by the Kessler Psychological Distress Scale. We tested the model generated from a randomly selected exploratory sample (n = 22, 766) with a confirmatory sample of equal size. 5, 479/45, 532 (12%) of respondents reported SMC. Using multivariate logistic regression, only two vascular risk factors: smoking (OR 1.18; 95% CI = 1.03 - 1.35) and hypercholesterolaemia (OR 1.19; 95% CI = 1.04 - 1.36) showed a small independent association with SMC. In contrast psychological distress was strongly associated with SMC. Those with the highest levels of psychological distress were 7.00 (95% CI = 5.41 - 9.07) times more likely to have SMC than the non-distressed. The confirmatory sample also demonstrated the strong association of SMC with psychological distress rather than vascular risk factors. In a large sample of middle-aged people without any history of major affective illness or stroke, psychological distress was strongly, and vascular risk factors only weakly, associated with SMC, although we cannot discount psychological distress acting as a mediator in any association between vascular risk factors and SMC. Given this, clinicians should be vigilant regarding the presence of an affective illness when assessing middle-aged patients presenting with memory problems.