Cognitive health among older adults in the United States and in England.
Cognitive health among older adults in the United States and in England.
复制标题
DOI：
10.1186/1471-2318-9-23
复制
发表时间：
2009-06-25
期刊：
影响因子：
4.1
通讯作者：
Huppert FA
中科院分区：
文献类型：
--
作者：
Langa KM;Llewellyn DJ;Lang IA;Weir DR;Wallace RB;Kabeto MU;Huppert FA
认知功能是老年人独立性和生活质量的关键决定因素。与英国成年人相比，美国成年人的心血管危险因素和疾病的患病率更高，可能导致认知功能较差。我们比较了美国和英国老年人的认知表现，并试图确定与两国认知功能差异相关的社会人口统计学和医学因素。数据来自2002年的美国健康与退休研究（HRS）（n = 8，299）和英国老龄化纵向研究（艾尔莎）（n = 5，276），这些研究具有全国代表性，以人群为基础，旨在促进健康、财富和幸福感的直接比较。HRS和艾尔莎调查的管理存在差异，包括与仅亲自进行艾尔莎相比，同时使用电话和亲自进行HRS，HRS的应答率显著更高（HRS为87%，艾尔莎为67%）。在每个国家，我们使用相同的记忆和定向测试（0到24分量表）评估了65岁及以上非西班牙裔白人的认知表现。美国成年人在24点认知量表上的得分明显高于英国成年人（未校正平均值：12.8 vs. 11.4，P <0.001;年龄和性别校正后：13.2 vs. 11.7，P <0.001）。尽管美国成年人的心血管危险因素和疾病的患病率明显较高，但美国的认知优势是明显的。在一系列控制了一系列社会人口和医疗因素的OLS回归分析中，较高的教育和财富水平以及较低的抑郁症状水平解释了美国的一些认知优势。美国成年人也更有可能服用高血压药物，在美国，高血压治疗与认知功能显著改善相关，但在英国则不然（治疗×国家相互作用P = 0.014）。尽管两国在调查管理方面存在方法学差异，但年龄≥ 65岁的美国成年人在认知方面似乎比英国成年人更健康，尽管他们的心血管风险因素和疾病负担更高。鉴于全世界老年人的数量不断增加，未来旨在确定可能预防或延缓老年人认知能力下降的医疗和社会因素的跨国研究将对公共卫生做出重要和宝贵的贡献。
Cognitive function is a key determinant of independence and quality of life among older adults. Compared to adults in England, US adults have a greater prevalence of cardiovascular risk factors and disease that may lead to poorer cognitive function. We compared cognitive performance of older adults in the US and England, and sought to identify sociodemographic and medical factors associated with differences in cognitive function between the two countries. Data were from the 2002 waves of the US Health and Retirement Study (HRS) (n = 8,299) and the English Longitudinal Study of Ageing (ELSA) (n = 5,276), nationally representative population-based studies designed to facilitate direct comparisons of health, wealth, and well-being. There were differences in the administration of the HRS and ELSA surveys, including use of both telephone and in-person administration of the HRS compared to only in-person administration of the ELSA, and a significantly higher response rate for the HRS (87% for the HRS vs. 67% for the ELSA). In each country, we assessed cognitive performance in non-hispanic whites aged 65 and over using the same tests of memory and orientation (0 to 24 point scale). US adults scored significantly better than English adults on the 24-point cognitive scale (unadjusted mean: 12.8 vs. 11.4, P < .001; age- and sex-adjusted: 13.2 vs. 11.7, P < .001). The US cognitive advantage was apparent even though US adults had a significantly higher prevalence of cardiovascular risk factors and disease. In a series of OLS regression analyses that controlled for a range of sociodemographic and medical factors, higher levels of education and wealth, and lower levels of depressive symptoms, accounted for some of the US cognitive advantage. US adults were also more likely to be taking medications for hypertension, and hypertension treatment was associated with significantly better cognitive function in the US, but not in England (P = .014 for treatment × country interaction). Despite methodological differences in the administration of the surveys in the two countries, US adults aged ≥ 65 appeared to be cognitively healthier than English adults, even though they had a higher burden of cardiovascular risk factors and disease. Given the growing number of older adults worldwide, future cross-national studies aimed at identifying the medical and social factors that might prevent or delay cognitive decline in older adults would make important and valuable contributions to public health.