Social disengagement and incident cognitive decline in community-dwelling elderly persons
Social disengagement and incident cognitive decline in community-dwelling elderly persons
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DOI：
10.7326/0003-4819-131-3-199908030-00002
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发表时间：
1999-08-03
影响因子：
39.2
通讯作者：
Berkman, LF
中科院分区：
文献类型：
--
作者：
Bassuk, SS;Glass, TA;Berkman, LF
背景：社会参与被定义为维持众多社会联系以及高度参与社会活动，一直被认为可预防老年人的认知能力下降。然而，对此关系的纵向研究却很少。
目的：确定社区居住老年人的社会脱离与偶发性认知能力下降之间的关系。
设计：队列研究。
地点：康涅狄格州纽黑文市。
参与者：2812名非机构养老的老年人（65岁及以上），他们于1982年、1985年、1988年和1994年在家中接受了访谈。
测量：从以下指标构建了一个总体社会脱离量表：是否有配偶、每月与三个或更多亲属或朋友的视觉接触、每年与十个或更多亲属或朋友的非视觉接触、参加宗教仪式、团体成员身份以及定期的社会活动。认知功能通过简易精神状态检查表进行评估。对问卷的回答分为高、中、低。认知能力下降被定义为向较低类别转变。
结果：与有五到六个社会关系的人相比，没有社会关系的人在对年龄、初始认知表现、性别、种族、教育程度、收入、住房类型、身体残疾、心血管状况、感觉障碍、抑郁症状、吸烟、饮酒以及身体活动水平进行调整后，发生认知能力下降的风险增加。3年的优势比为2.24（95%置信区间，1.40 - 3.58；P < 0.001），6年的优势比为1.91（置信区间，1.14 - 3.18；P = 0.01），12年的优势比为2.37（置信区间，1.07 - 4.88；P = 0.03）。
结论：社会脱离是老年人认知障碍的一个风险因素。
Background: Social engagement, which is defined as the maintenance of many social connections and a high level of participation in social activities, has been thought to prevent cognitive decline in elderly persons. However, few longitudinal studies of this relation have been done.Objective: To determine the relation between social disengagement and incident cognitive decline in community-dwelling elderly persons.Design: Cohort study.Setting: New Haven, Connecticut.Participants: 2812 noninstitutionalized elderly persons (65 years of age or older) who were interviewed in their homes in 1982, 1985, 1988, and 1994.Measurements: A global social disengagement scale was constructed from the following indicators: presence of a spouse, monthly visual contact with three or more relatives or friends, yearly nonvisual contact with 10 or more relatives or friends, attendance at religious services, group membership, and regular social activities. Cognitive function was assessed with the Short Portable Mental Status Questionnaire. Response to the questionnaire was scored as high, medium, or low. Cognitive decline was defined as a transition to a lower category.Results: Compared with persons who had five or six social ties, those who had no social ties were at increased risk for incident cognitive decline after adjustment for age, initial cognitive performance, sex, ethnicity, education, income, housing type, physical disability, cardiovascular profile, sensory impairment, symptoms of depression, smoking, alcohol use, and level of physical activity. The 3-year odds ratio was 2.24 (95% CI, 1.40 to 3.58; P < 0.001), the 6-year odds ratio was 1.91 (CI, 1.14 to 3.18; P = 0.01), and the 12-year odds ratio was 2.37 (CI, 1.07 to 4.88; P = 0.03).Conclusion: Social disengagement is a risk factor for cognitive impairment among elderly persons.