Unmet needs for assistance related to subjective cognitive decline among community-dwelling middle-aged and older adults in the US: prevalence and impact on health-related quality of life.
Unmet needs for assistance related to subjective cognitive decline among community-dwelling middle-aged and older adults in the US: prevalence and impact on health-related quality of life.
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DOI：
10.1017/s1041610220001635
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发表时间：
2021-07
影响因子：
7
通讯作者：
McGuire LC
中科院分区：
文献类型：
--
作者：
Bouldin ED;Taylor CA;Knapp KA;Miyawaki CE;Mercado NR;Wooten KG;McGuire LC
评估美国主观认知功能减退(SCD)的中老年人中未满足的援助需求的普遍程度，并评估未满足的需求是否与健康相关的生活质量(HRQOL)有关。横断面研究美国-50个州、哥伦比亚特区和波多黎各社区居住的45岁及以上成年人，他们完成了2015-2018年行为风险因素监测系统上的认知下降模块，报告经历了SCD，并且总是、通常或有时因为SCD而在日常活动中需要帮助。我们将SCD定义为在过去12个月中发生更频繁或更严重的精神错乱或记忆丧失。患有SCD的受访者如果有时、很少或从未在日常活动中获得所需的帮助，则被认为有未得到满足的帮助需求。我们测量了≥生活质量的三个领域：(1)精神(频繁的精神困扰，≥在过去30天内有14天精神健康不良)，(2)身体(经常的身体困扰，在过去的30天内有14天身体健康不良)，(3)社交(精神疾病总是、通常或有时干扰工作、志愿者或从事户外社会活动的能力)。我们使用对数二项回归模型来估计患病率(PR)。所有的估计都经过了加权。在需要SCD相关帮助的人中，40.4%的人报告了未得到满足的需求。在无抑郁的受访者中，未满足的需求与更高的精神痛苦发生率相关(PR=1.6，95%CI：1.15-2.23，P=0.005)。在需求得到满足和未得到满足的人之间，频繁的身体痛苦和社会限制没有什么不同。有SCD相关援助需求的中老年人往往得不到这些需求的满足，这可能会对他们的心理健康产生负面影响。发现和满足SCD患者未得到满足的需求的干预措施可能会改善HRQOL。
To estimate the prevalence of unmet needs for assistance among middle-aged and older adults with subjective cognitive decline (SCD) in the US and to evaluate whether unmet needs were associated with health-related quality of life (HRQOL). Cross-sectional study United States – 50 states, District of Columbia, and Puerto Rico Community-dwelling adults aged 45 years and older who completed the Cognitive Decline module on the 2015–2018 Behavioral Risk Factor Surveillance System, reported experiencing SCD, and always, usually, or sometimes needed assistance with day-to-day activities because of SCD. We defined SCD as confusion or memory loss that was happening more often or getting worse over the past 12 months. Respondents with SCD were considered to have an unmet need for assistance if they sometimes, rarely, or never got the help they needed with day-to-day activities. We measured three domains of HRQOL: (1) mental (frequent mental distress, ≥14 days of poor mental health in the past 30 days), (2) physical (frequent physical distress, ≥14 days of poor physical health in the past 30 days), and (3) social (SCD always, usually, or sometimes interfered with the ability to work, volunteer, or engage in social activities outside the home). We used log-binomial regression models to estimate prevalence ratios (PR). All estimates were weighted. 40.4% of people who needed SCD-related assistance reported an unmet need. Among respondents without depression, an unmet need was associated with a higher prevalence of frequent mental distress (PR=1.60, 95%CI:1.15–2.23, p=0.005). Frequent physical distress and social limitations did not differ between people with met and unmet needs. Middle-aged and older adults with SCD-related needs for assistance frequently did not have those needs met, which could negatively impact their mental health. Interventions to identify and meet the unmet needs among people with SCD may improve HRQOL.