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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Chronic distress, age-related neuropathology, and late-life dementia.
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Chronic distress, age-related neuropathology, and late-life dementia.

机译：慢性窘迫，与年龄相关的神经病理学和晚期痴呆。

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OBJECTIVE: The objective of this study was to test whether common age-related neuropathology could account for the relation of chronic distress to dementia. METHODS: In a selected cohort of more than 1000 older Catholic clergy members undergoing annual clinical evaluations, 326 persons died, of whom 306 (94%) underwent brain autopsy, the results of which were available in 219 (mean age at death = 85.4, standard deviation [SD] = 6.6; mean postmortem interval = 7.6 hours, SD = 6.9). A composite measure of chronic distress was constructed from standard measures of two traits, neuroticism and anxiety proneness, completed at baseline, and of depressive symptoms, completed annually. Dementia was diagnosed according to standard criteria and cognition was assessed with previously established composite measures based on a uniform clinical evaluation that took place a mean of 9.1 months before death (SD = 9.5). On postmortem examination, levels of amyloid-beta and tau-positive neurofibrillary tangles and the presence of Lewy bodies were quantified in six brain regions, and the number and location of chronic cerebral infarctions were noted. RESULTS: In analyses that controlled for age, sex, education, amyloid, tangles, Lewy bodies, and cerebral infarction, higher level of chronic distress was associated with a higher likelihood of dementia and lower level of cognition proximate to death. Chronic distress was not correlated with any form of neuropathology, including limbic, neocortical, and global indices, and did not modify the association of pathology with cognition. CONCLUSIONS: Chronic psychological distress is associated with late-life dementia but not with its leading causes, suggesting that novel neurodeteriorative mechanisms may be involved.
机译：目的：本研究的目的是检验年龄相关的神经病理学是否可以解释慢性窘迫与痴呆的关系。方法：在一个选定的队列中，该队列中有1000多名接受年度临床评估的天主教神职人员，其中326人死亡，其中306名（94％）接受了脑部尸检，结果为219名（平均死亡年龄= 85.4，标准差[SD] = 6.6;平均验尸间隔= 7.6小时，SD = 6.9）。根据两个特征的标准量度，即在基线时完成的神经质和焦虑倾向的标准量度，以及每年完成的抑郁症状的标准量度，构建了慢性窘迫的综合量度。根据标准标准诊断出痴呆症，并根据之前在死亡前平均9.1个月进行的统一临床评估（SD = 9.5），通过先前建立的综合措施评估认知度。在死后检查中，量化了六个大脑区域中淀粉样蛋白β和tau阳性神经原纤维缠结的水平以及路易体的存在，并记录了慢性脑梗死的数量和位置。结果：在对年龄，性别，教育程度，淀粉样蛋白，缠结，路易体和脑梗塞进行控制的分析中，较高的慢性困扰与较高的痴呆可能性和较低的接近死亡的认知水平有关。慢性窘迫与任何形式的神经病理学均不相关，包括边缘，新皮层和整体指数，也没有改变病理学与认知的关联。结论：慢性心理困扰与晚期痴呆有关，但与其主要病因无关，这表明可能涉及新的神经退化机制。

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