Health-related Quality of Life, Cognitive Performance, and Incident Dementia in a Community-based Elderly Cohort
Health-related Quality of Life, Cognitive Performance, and Incident Dementia in a Community-based Elderly Cohort
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DOI：
10.1097/wad.0000000000000324
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发表时间：
2019-07-01
影响因子：
2.1
通讯作者：
Lipton, Richard B.
中科院分区：
文献类型：
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作者：
Ezzati, Ali;Zammit, Andrea R.;Lipton, Richard B.
背景：我们假设更高的生活质量将与更好的认知功能和更低的事件风险相关，所有这些都会导致老年人的痴呆症和阿尔茨海默病(AD)。材料和方法：研究对象为爱因斯坦老龄化研究中的1183名老年人，平均年龄78.2岁(SD=5.3)。采用36项简式健康调查问卷测量健康相关生活质量(HRQOL)。我们使用36项简式健康调查的8个子量表(身体功能、身体问题造成的角色限制、身体疼痛、一般健康认知、社会功能、情感问题造成的角色限制、活力和一般心理健康)和身体成分概述(PCS)和心理成分概述(MCS)两个组成部分的总分，调查了记忆、执行功能和一般流体能力的认知领域之间的基线关系。接下来，我们使用COX比例风险模型来评估HRQOL子量表对偶发痴呆和偶发AD的预测有效性。结果：基线时，在MCS及其4个子量表(社会功能、因情绪问题造成的角色限制、活力和一般心理健康)上得分较高(较好的HRQOL)与记忆和执行功能领域的较高表现相关。身体问题导致的角色限制、情绪问题导致的角色限制以及一般心理健康分量表得分越高，痴呆的风险就越低。较高的MCS，但不是PCS，预示着全因痴呆症和AD的发生率减少。结论：这些发现表明，HRQOL的降低在可诊断痴呆发病之前，可能有助于痴呆发病的预测。
Background: We hypothesized that higher quality of life would be associated with better cognitive function and a reduced risk of incident all cause dementia and Alzheimer disease (AD) in older adults. Materials and Methods: Participants included 1183 older adults with an average age of 78.2 (SD=5.3) from Einstein Aging Study. The 36-Item Short-Form Health Survey was used to measure health-related quality of life (HRQoL). We investigated baseline associations between the cognitive domains of memory, executive function, and general fluid ability with 8 subscales of the 36-Item Short-Form Health Survey (physical functioning, role limitations due to physical problems, bodily pain, general health perceptions, social functioning, role limitations due to emotional problems, vitality, and general mental health) and the 2 component summary scores of physical component summary (PCS) and mental component summary (MCS). Next, we used Cox proportional hazard models to assess the predictive validity of HRQoL subscales for the onset of incident dementia and incident AD. Results: At baseline, higher scores (better HRQoL) on MCS and its 4 subscales (social functioning, role limitations due to emotional problems, vitality, and general mental health) were associated with higher performance on both memory and executive function domains. Higher scores in role limitation due to physical problems, role limitation due to emotional problems, and general mental health subscales were associated with reduced risk of incident dementia. Higher MCS, but not PCS, predicted a reduced incident of all-cause dementia and AD. Conclusions: These findings suggest that diminution of HRQoL precedes the onset of diagnosable dementia and may be useful in the prediction of dementia onset.