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首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >Brain Structural Markers and Caregiving Characteristics as Interacting Correlates of Caregiving Strain
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Brain Structural Markers and Caregiving Characteristics as Interacting Correlates of Caregiving Strain

机译：脑结构标志物和护理特征作为识别护理菌株的关联

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Objective: To evaluate the association between brain structural markers and caregiving strain among older informal caregivers. Design: A secondary data analysis combining data from the Caregiver Health Effects Study (1993-1994) and the Cardiovascular Health Study MRI examination (1992-1994). Setting: Four United States communities. Participants: Co-residing spousal caregivers (N = 237; mean age: 76.2 years, SD: 2.2 years). Measurements: Visually rated ventricular and white matter (WM) grades from magnetic resonance imaging, caregiving strain defined as "emotional or physical strain associated with providing care" for any of 12 activities of daily living (ADLs) and instrumental activities of daily living (IADLs), plus measures of caregiving characteristics and caregiver's health. Results: Overall, 56% of caregivers reported strain. We detected an interaction where strain was very common (>82%) among caregivers who helped with four or more IADLs, regardless of WM grades, and among caregivers with the worst WM grades (WM grades >= 4), regardless of the number of IADLs they helped with. Among caregivers helping with fewer than four IADLs, having WM grade 4 or greater was associated with a 55% higher prevalence ratio for reporting strain. This association remained statistically significant but was most markedly attenuated by adjustments for: care recipient's memory and behavioral problems, caregiver's depression symptoms, and caregiver's ADL impairment. Conclusions: Caregiving strain is very common among older informal caregivers who provide help with many IADLs, and among caregivers who help with fewer IADLs, but have manifest signs of white matter pathology. Modern quantitative-neuroimaging studies are needed to evaluate whether more subtle variability in brain structure confers caregiving strain and the related health consequences.
机译：目的：评价较旧的非正式护理人员脑结构标志物与护理应变的关联。设计：辅助数据分析与护理人员健康效应研究（1993-1994）和心血管健康研究MRI考试（1992-1994）组合的二级数据分析。环境：四个美国社区。参与者：共同居住的配偶护理人员（n = 237;卑鄙年龄：76.2岁，SD：2.2岁）。测量：视觉额定心室和白质（WM）从磁共振成像，护理菌株定义为12个日常生活（ADL）和日常生活活动（IADLS的工具活动中的任何一个），加上护理特色和照顾者的健康的措施。结果：总体而言，56％的护理人员报告了应变。我们检测到一种互动，其中菌株在可见的护理人员中非常普遍（> 82％），这些护理人员在帮助四个或更多的IADLS，无论WM等级，以及最糟糕的WM成绩（WM成绩> = 4），无论数量如何他们帮助了。在少于四个IADL的护理人员中，具有WM级或更大的IADL，与报告菌株的患病率较高的55％较高的55％相关。这种关联仍然存在统计学意义，但最明显衰减，通过调整：护理获得者的记忆和行为问题，照顾者的抑郁症状和照顾者的ADL损伤。结论：在较旧的非正式护理人员之间提供众多IADLS的较旧的非正式护理人员，以及在帮助更少的IADLS的护理人员中，但是白质病理学的表现迹象。需要现代定量 - 神经影像学研究来评估脑结构中更细微的变异性是否赋予护理菌株和相关的健康后果。

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