Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons.
Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons.
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DOI：
10.1001/archgenpsychiatry.2009.208
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发表时间：
2010-03
影响因子：
--
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
--
作者：
Boyle, Patricia A.;Buchman, Aron S.;Barnes, Lisa L.;Bennett, David A.
新数据表明，心理和经历因素与阿尔茨海默病 (AD) 风险相关，但生活目标与 AD 发病之间的关系尚不清楚。检验更大的人生目标与降低 AD 风险相关的假设。老龄化的前瞻性、纵向流行病学研究。芝加哥大都市区的高级住房设施和住宅。 Rush Memory and Aging 项目使 900 多名社区居住的老年人没有患上痴呆症。参与者接受了生活目的基线评估和长达 7 年的详细年度随访临床评估，以记录 AD 事件。在随后的分析中，我们检查了生活目标与 AD 前兆、轻度认知障碍 (MCI) 以及认知功能变化率之间的关系。在长达 7 年的随访期间（平均 4.0 年），951 人中有 155 人（16.3%）患上了 AD。在根据年龄、性别和教育程度进行调整的比例风险模型中，更大的人生目标与 AD 风险的大幅降低相关（风险比，0.48；95% 置信区间，0.33-0.69；P< .001）。因此，在生活目的测量中得分高的人（得分 = 4.2，第 90 个百分位）与得分低的人（得分 = 3.0，第 10 个百分位）保持不患 AD 的可能性大约高 2.4 倍。这种关联并没有随着人口统计学的变化而变化，并且在添加抑郁症状、神经质、社交网络规模和慢性疾病数量等术语后仍然存在。在随后的模型中，生活目标还与 MCI 风险降低（风险比，0.71；95% 置信区间，0.53-0.95；P=0.02）和认知能力下降速度较慢（平均 [SE] 整体认知估计，0.03 [0.01]，P<0.01）相关。社区老年人的更大的生活目标与 AD 和 MCI 的风险降低相关。
Emerging data suggest that psychological and experiential factors are associated with risk of Alzheimer disease (AD), but the association of purpose in life with incident AD is unknown. To test the hypothesis that greater purpose in life is associated with a reduced risk of AD. Prospective, longitudinal epidemiologic study of aging. Senior housing facilities and residences across the greater Chicago metropolitan area. More than 900 community-dwelling older persons without dementia from the Rush Memory and Aging Project. Participants underwent baseline evaluations of purpose in life and up to 7 years of detailed annual follow-up clinical evaluations to document incident AD. In subsequent analyses, we examined the association of purpose in life with the precursor to AD, mild cognitive impairment (MCI), and the rate of change in cognitive function. During up to 7 years of follow-up (mean, 4.0 years), 155 of 951 persons (16.3%) developed AD. In a proportional hazards model adjusted for age, sex, and education, greater purpose in life was associated with a substantially reduced risk of AD (hazard ratio, 0.48; 95% confidence interval, 0.33-0.69; P< .001). Thus, a person with a high score on the purpose in life measure (score=4.2, 90th percentile) was approximately 2.4 times more likely to remain free of AD than was a person with a low score (score=3.0, 10th percentile). This association did not vary along demographic lines and persisted after the addition of terms for depressive symptoms, neuroticism, social network size, and number of chronic medical conditions. In subsequent models, purpose in life also was associated with a reduced risk of MCI (hazard ratio, 0.71; 95% confidence interval, 0.53-0.95; P=.02) and a slower rate of cognitive decline (mean [SE] global cognition estimate, 0.03 [0.01], P<.01). Greater purpose in life is associated with a reduced risk of AD and MCI in community-dwelling older persons.
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影响因子：
168.9
作者：
Fratiglioni, L;Wang, HX;Winblad, B
通讯作者：
Winblad, B
影响因子：
5
作者：
Stranges, Saverio;Dorn, Joan M.;Cappuccio, Francesco P.
通讯作者：
Cappuccio, Francesco P.
影响因子：
--
作者：
Wilson, Robert S.;Schneider, Julie A.;Bennett, David A.
通讯作者：
Bennett, David A.
影响因子：
1.8
作者：
Barnes, Lisa L.;Wilson, Robert S.;Bennett, David A.
通讯作者：
Bennett, David A.
影响因子：
7.2
作者：
Peters, Kevin R.;Rockwood, Kenneth;Feldman, Howard H.
通讯作者：
Feldman, Howard H.