Psychological well-being in individuals with mild cognitive impairment
Psychological well-being in individuals with mild cognitive impairment
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DOI：
10.2147/cia.s58866
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发表时间：
2014-01-01
影响因子：
3.6
通讯作者：
Singh, Maria A. Fiatarone
中科院分区：
文献类型：
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作者：
Gates, Nicola;Valenzuela, Michael;Singh, Maria A. Fiatarone
目的：与衰老和痴呆相关的认知障碍是造成负担、生活质量恶化和心理幸福感降低的主要原因。为了减少疾病的发病率和改善患者的PWB，预防措施越来越多地针对早期疾病阶段有轻度认知障碍(MCI)的个体。然而，关于早期认知改变和记忆关注之间的关系，以及成年MCI患者的生活质量和PWB之间的关系的信息非常有限；此外，PWB的结果在干预试验中往往被忽视。因此，本研究的目的是在MCI中对PWB理论模型进行实证检验，以便为临床干预提供依据。方法：收集参加心理活动和常规训练(SMART)试验的100名社区MCI患者的基线数据。结果：主观记忆关注、认知功能、生活质量评价和负性情感是预测认知缺陷的显著因素，最终模型可以解释认知缺陷的61%的变异量。讨论：我们的经验研究结果支持微认知缺陷的理论分层模型，有助于理解早期细微认知缺陷对认知缺陷的影响。确定了临床干预的多个目标和切入点。这些措施包括改善与MCI相关的认知困难。此外，这些研究强调了减少记忆担忧、解决情绪低落的重要性，并表明改善一个人的生活质量可能会减轻抑郁和焦虑对这一队列中的PWB的负面影响。
Objectives: Cognitive impairments associated with aging and dementia are major sources of burden, deterioration in life quality, and reduced psychological well-being (PWB). Preventative measures to both reduce incident disease and improve PWB in those afflicted are increasingly targeting individuals with mild cognitive impairment (MCI) at early disease stage. However, there is very limited information regarding the relationships between early cognitive changes and memory concern, and life quality and PWB in adults with MCI; furthermore, PWB outcomes are too commonly overlooked in intervention trials. The purpose of this study was therefore to empirically test a theoretical model of PWB in MCI in order to inform clinical intervention.Methods: Baseline data from a convenience sample of 100 community-dwelling adults diagnosed with MCI enrolled in the Study of Mental Activity and Regular Training (SMART) trial were collected. A series of regression analyses were performed to develop a reduced model, then hierarchical regression with the Baron Kenny test of mediation derived the final three-tiered model of PWB.Results: Significant predictors of PWB were subjective memory concern, cognitive function, evaluations of quality of life, and negative affect, with a final model explaining 61% of the variance of PWB in MCI.Discussion: Our empirical findings support a theoretical tiered model of PWB in MCI and contribute to an understanding of the way in which early subtle cognitive deficits impact upon PWB. Multiple targets and entry points for clinical intervention were identified. These include improving the cognitive difficulties associated with MCI. Additionally, these highlight the importance of reducing memory concern, addressing low mood, and suggest that improving a person's quality of life may attenuate the negative effects of depression and anxiety on PWB in this cohort.