少儿期缺乏关爱与中老年人认知障碍的相关性研究

Association between lack of care in childhood and cognitive impairment in middle-aged and elderly population

目的 探讨少儿期缺乏关爱与中老年人认知障碍的相关性。方法 基于2007年1月至2008年1月开展的＂广州生物库队列研究＂（GBCS）第三期基线调查资料，选取其中完成简易精神状态检查量表（MMSE）的9 223名≥ 50岁广州市中老年人，回顾性调查其少儿期是否觉得有亲密亲属关心支持、是否与母亲连续分开≥ 1年、是否父母双亡3个反映少儿期关爱情况的变量，分别采用线性回归模型、非条件logistic回归和多项式logistic回归模型分析少儿期关爱与中老年MMSE得分和认知障碍的相关性。结果 经调整年龄、性别、文化程度、居住地、婚姻状况、体力活动、吸烟、饮酒、职业、个人年收入、少儿期家庭经济环境和抑郁症状后，少儿期觉得缺乏亲密亲属的关心支持、与母亲连续分开≥ 1年、父母双亡与中老年MMSE得分负相关，偏回归系数β值（95%CI）分别为-0.44（-0.65^-0.23）、-0.26（-0.38^-0.14）和-0.61（-0.96^-0.27）。少儿期觉得缺乏亲密亲属的关心支持、与母亲连续分开≥ 1年、父母双亡均与认知障碍风险增加有关，OR值（95%CI）分别为1.43（1.15~1.78）、1.26（1.08~1.47）和1.64（1.16~2.31），其中，小学及以下文化者分别为1.27（1.01~1.62）、1.29（1.09~1.55）和1.75（1.19~2.55）；初中及以上文化者，仅亲密亲属与中老年认知障碍风险增加相关，OR=2.26（95%CI：1.41~3.50）。结论 少儿期缺乏关爱与中老年认知障碍有关，重点表现在文化程度较低者。 英文摘要：

Objective To investigate the association between people who were under lack of care in childhood and the development of cognitive impairment in their middle-aged and elderly life spans. Methods Based on the baseline survey data of the third phase of ＂Guangzhou Biobank Cohort study＂ conducted from January 2007 to January 2008, 9 223 residents aged ≥ 50 years with records on Mini Mental State Examination （MMSE） were included in a retrospective survey on received childhood care of their early lives. Questions would include：feelings of care and support from their close relatives during childhood, the status of separation from their mothers for ≥ 1 year, and the current status of their parents. Linear regression, unconditional and multinomial logistic regression models were used to analyze the associations between the received childhood care and cognitive function （i.e., MMSE scores and cognitive impairment） in middle and old age, of this population under study. Results After adjusting for age, gender, education, place of residence, marital status, physical activity, smoking, drinking, occupation, personal income, childhood socioeconomic position and depressive symptoms etc., factors as feeling lack of concern and support from close relatives （LC）, status of separation from the mother for ≥ 1 year （SM）, and the current status of their parents etc., were all negatively associated with the MMSE score when in middle and old age, with partial regression coefficient β （95%CI） as -0.44 （-0.65--0.23）, -0.26 （-0.38--0.14） and -0.61 （-0.96--0.27）, respectively. The presence of LC, SM or PD were associated with the increased risks of cognitive impairment, and the adjusted odds ratio OR （95%CI） appeared as 1.43 （1.15-1.78）, 1.26 （1.08-1.47） and 1.64 （1.16-2.31） respectively in all the participants, but 1.27 （1.01-1.62）, 1.29 （1.09-1.55） and 1.75 （1.19-2.55） respectively, in those with education level of primary school or below. In those with secondary school education or above, only the presence of item A was associated with an increased risk of cognitive impairment （OR=2.26, 95%CI：1.41-3.50）. Conclusion We noticed that ‘lack of care’ in childhood was associated with cognitive impairment during middle and old age, mainly in those population with lower education.