童年不良经历是否改变了灾难相关创伤与认知障碍之间的关联?
American journal of epidemiology
|July 13, 2023
概括
儿童不良经历 (ACE) 在老年人中显著增加了灾难创伤后认知障碍的风险,特别是家庭损失. 这凸显了灾难后需要有针对性的支持的脆弱人口.
科学领域:
- 老年学是指老年学的学科.
- 灾难精神病学 灾难精神病学
- 神经科学是一个神经科学.
背景情况:
- 识别受灾创伤对长期健康影响的脆弱人群至关重要.
- 童年不良经历 (ACE) 可能会加剧灾难创伤对健康结果的影响.
- 老年人是研究抗灾能力和长期健康后果的关键人口统计.
研究的目的:
- 调查ACE是否增强了老年成年幸存者的灾难相关创伤和随后的认知障碍之间的关联.
- 确定特定的与灾难有关的创伤,这些创伤在脆弱的老年人中具有较高的认知衰退风险.
- 量化ACEs对灾难创伤和认知障碍之间的关系的影响.
主要方法:
- 在2011年东日本大地震中幸存下来的老年人 (n=602) 的前性队列研究.
- 2013年对ACE和灾害相关创伤 (失去家园,失去朋友/物) 的回顾性评估.
- 2016年对认知障碍的客观评估,使用机器学习对灾难前的特征进行调整.
主要成果:
- 失去家园与增加的认知障碍 (0.19,95% CI:0.09,0.28) 有关.
- 这种关联在有ACE病史的人群中显著更强 (0.64,95% CI:0.24,1.03).
- 失去朋友或物与更高的认知障碍有关,仅在患有ACE的幸存者中.
结论:
- 具有ACE史的个人特别容易受到灾难创伤的长期认知健康后果的影响.
- 应急准备和心理健康干预措施应考虑老年人ACE史.
- 针对ACE幸存者的有针对性的支持对于减轻灾后不良健康结果至关重要.
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