Association of Stress With Cognitive Function Among Older Black and White US Adults.
Association of Stress With Cognitive Function Among Older Black and White US Adults.
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较老的黑人和白人成年人的压力与认知功能的关联。
DOI：
10.1001/jamanetworkopen.2023.1860
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发表时间：
2023-03-01
影响因子：
13.8
通讯作者：
Judd, Suzanne
中科院分区：
文献类型：
--
作者：
Kulshreshtha, Ambar;Alonso, Alvaro;McClure, Leslie A.;Hajjar, Ihab;Manly, Jennifer J.;Judd, Suzanne
知觉压力与认知表现之间是否存在关联？这项对24448名45岁或45岁以上的黑人和白色参与者的队列研究发现，感知压力与普遍和偶发认知障碍之间存在独立关联。这项研究表明，可能有必要筛查高风险老年人的压力，当他们在初级保健。感知到的压力会产生长期的生理和心理后果，并已被证明是阿尔茨海默病和相关痴呆症的一个可改变的风险因素。在45岁或以上的黑人和白色参与者的大型队列研究中调查感知压力和认知障碍之间的关联。卒中地理和种族差异的原因（REGARDS）研究是一项基于全国人群的队列研究，包括30239名45岁或以上的黑人和白色受试者，从美国人群中抽样。参与者于2003年至2007年招募，并持续进行年度随访。数据收集电话，自填问卷，并在家里检查。于二零二一年五月至二零二二年三月进行统计分析。感知压力使用科恩感知压力量表的4项版本进行测量。在基线访视和1次随访访视期间进行评估。使用六项筛选器（SIS）评估认知功能;评分低于5的参与者被认为有认知障碍。偶发性认知损害定义为从首次评估时的完整认知（SIS评分>4）转变为最近一次评估时的认知受损（SIS评分≤4）。最终分析样本包括24448名参与者（14646名女性[59.9%];中位年龄64岁[范围45-98岁]; 10177名黑人参与者[41.6%]和14271名白色参与者[58.4%]）。共有5589名参与者（22.9%）报告压力水平升高。在调整社会人口学变量、心血管危险因素和抑郁后，感知压力水平升高（分为低压力与高压力）与认知能力差的几率高出1.37倍相关（调整后的比值比[AOR]，1.37; 95%CI，1.22-1.53）。在未校正模型中（OR，1.62; 95%CI，1.46-1.80）和校正社会人口学变量、心血管危险因素和抑郁后（AOR，1.39; 95%CI，1.22-1.58），感知压力量表评分变化与事件性认知障碍的相关性均显著。与年龄、种族和性别没有相互作用。这项研究表明，有一个独立的协会之间的感知压力和普遍的和事件的认知障碍。研究结果表明，需要定期筛查和针对老年人的压力进行有针对性的干预。这项队列研究调查了45岁或以上的黑人和白色参与者的大队列中感知压力和认知障碍之间的关联。
Is there an association between perceived stress and cognitive performance? This cohort study of 24 448 Black and White participants aged 45 years or older found an independent association between perceived stress and both prevalent and incident cognitive impairment. This study suggests that there may be a need for screening for stress among high-risk older adults when they present in primary care. Perceived stress can have long-term physiological and psychological consequences and has shown to be a modifiable risk factor for Alzheimer disease and related dementias. To investigate the association between perceived stress and cognitive impairment in a large cohort study of Black and White participants aged 45 years or older. The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study is a national population-based cohort of 30 239 Black and White participants aged 45 years or older, sampled from the US population. Participants were recruited from 2003 to 2007, with ongoing annual follow-up. Data were collected by telephone, self-administered questionnaires, and an in-home examination. Statistical analysis was performed from May 2021 to March 2022. Perceived stress was measured using the 4-item version of the Cohen Perceived Stress Scale. It was assessed at the baseline visit and during 1 follow-up visit. Cognitive function was assessed with the Six-Item Screener (SIS); participants with a score below 5 were considered to have cognitive impairment. Incident cognitive impairment was defined as a shift from intact cognition (SIS score >4) at the first assessment to impaired cognition (SIS score ≤4) at the latest available assessment. The final analytical sample included 24 448 participants (14 646 women [59.9%]; median age, 64 years [range, 45-98 years]; 10 177 Black participants [41.6%] and 14 271 White participants [58.4%]). A total of 5589 participants (22.9%) reported elevated levels of stress. Elevated levels of perceived stress (dichotomized as low stress vs elevated stress) were associated with 1.37 times higher odds of poor cognition after adjustment for sociodemographic variables, cardiovascular risk factors, and depression (adjusted odds ratio [AOR], 1.37; 95% CI, 1.22-1.53). The association of the change in the Perceived Stress Scale score with incident cognitive impairment was significant in both the unadjusted model (OR, 1.62; 95% CI, 1.46-1.80) and after adjustment for sociodemographic variables, cardiovascular risk factors, and depression (AOR, 1.39; 95% CI, 1.22-1.58). There was no interaction with age, race, and sex. This study suggests that there is an independent association between perceived stress and both prevalent and incident cognitive impairment. The findings suggest the need for regular screening and targeted interventions for stress among older adults. This cohort study investigates the association between perceived stress and cognitive impairment in a large cohort of Black and White participants aged 45 years or older.
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DOI：
10.1007/s12160-015-9715-2
发表时间：
2015-12
期刊：
Annals of behavioral medicine : a publication of the Society of Behavioral Medicine
影响因子：
--
作者：
O'Neal WT;Qureshi W;Judd SE;Glasser SP;Ghazi L;Pulley L;Howard VJ;Howard G;Soliman EZ
通讯作者：
Soliman EZ
影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
--
作者：
Irwin, M;Artin, KHH;Oxman, MN
通讯作者：
Oxman, MN
影响因子：
2.1
作者：
Katz MJ;Derby CA;Wang C;Sliwinski MJ;Ezzati A;Zimmerman ME;Zwerling JL;Lipton RB
通讯作者：
Lipton RB
影响因子：
48
作者：
Barnes, Deborah E.;Yaffe, Kristine
通讯作者：
Yaffe, Kristine