PO.PS01.05 · 人群科学
有癌症史与无癌症史成年人的残障模式与主观认知下降
Disability patterns and subjective cognitive decline among adults with and without cancer history
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：主观认知下降（SCD）是一种自我报告的意识混乱或记忆丧失加重的体验，会增加痴呆风险，并可能受残障影响。本研究比较了有或无癌症史人群的残障类型、数量及SCD，并检验了残障数量与SCD之间的潜在关联。
方法：我们使用了2024年行为风险因素监测系统认知下降模块的横断面调查数据。样本包括≥45岁的成年人，有癌症史者（n=12,601）和无癌症史者（n=61,575）。结局指标为自我报告的过去12个月内SCD意识混乱或记忆丧失加重。残障类型包括听力、视力、行动、自我照护和独立生活方面的受限，并按数量分类为0、1、2、3-5项残障。我们进行了描述性统计和多变量logistic回归，纳入了癌症史与残障数量之间的交互项。
结果：约73.0%的参与者年龄≥75岁，53.2%为女性，66.1%自我认定为白人。总体而言，15.4%自我报告SCD，癌症幸存者的患病率高于无癌症史者（19.7%对比14.7%，p≤.001）。最常见的残障类型为行动受限，在有癌症史（31.0%）和无癌症史（20.4%）成年人中均如此。在癌症幸存者中，SCD患病率随残障数量增加而上升：无残障者为11.8%，1项为21.5%，2项为32.8%，3-5项为47.2%。在无癌症组中观察到类似模式：分别为8.9%、19.8%、30.2%和47.2%。在亚组回归模型中，有3-5项残障的癌症幸存者报告SCD的比值比较无残障者高341%（AOR=4.41，95% CI 3.07-6.33）。无癌症史且有3-5项残障者报告SCD的比值比较无残障者高403%（AOR=5.03，95% CI 4.05-6.25）。在完整模型中，残障数量和癌症状态均与SCD独立相关；然而，交互项无统计学显著性，提示癌症状态不影响残障数量与SCD之间的关系。
结论：我们估计SCD影响了众多≥45岁有癌症史（110万人）和无癌症史（480万人）的个体。对认知健康进行常规筛查，尤其是针对残障人士，对于早期识别、主动管理和量身定制地满足成年人群的健康需求至关重要，这有可能降低痴呆风险。构建个性化、基于需求的认知支持资源，如决策辅助工具、清单、数字化和手动提醒，将有助于促进对这一弱势群体的照护。
查看英文原文 English abstract
Background : Subjective cognitive decline (SCD) is a self-reported experience of worsening confusion or memory loss, which increases the risk of dementia and may be influenced by disabilities. This study compared disability types and counts and SCD of people with or without a cancer history and examined the potential association between disability counts and SCD.
Methods : We used cross-sectional survey data from the 2024 Behavioral Risk Factor Surveillance System Cognitive Decline module. The sample included adults aged ≥45 years, with (n=12,601) and without (n=61,575) cancer history. The outcome was self-reported SCD confusion or memory loss worsening in the past 12 months. Disability types included limitations in hearing, vision, mobility, self-care, and independent living, and were categorized by count as 0, 1, 2, 3-5 disabilities. We conducted descriptive statistics and multivariable logistic regression, incorporating an interaction term between cancer history and disability count.
Results : About 73.0% of participants were aged ≥75 years, 53.2% were female, and 66.1% self-identified as White. Overall, 15.4% self-reported SCD, with higher prevalence among cancer survivors than those without cancer history (19.7% vs. 14.7%, p≤.001). The most prevalent disability type was mobility among adults with (31.0%) and without (20.4%) a cancer history. Among cancer survivors, SCD prevalence increased with disability count: 11.8% with no disabilities, 21.5% with one, 32.8% with two, and 47.2% with 3-5 disabilities. Similar patterns were observed in the non-cancer group: 8.9%, 19.8%, 30.2%, and 47.2%, respectively. In subgroup regression models, cancer survivors with 3-5 disabilities have 341% increased odds of reporting SCD compared to those without disabilities (AOR=4.41, 95% CI 3.07-6.33). Individuals without a cancer history who have 3-5 disabilities have 403% higher odds of reporting SCD compared to their no-disability counterparts (AOR=5.03, 95% CI 4.05-6.25). In the full model, both disability count and cancer status were independently associated with SCD; however, the interaction term was not statistically significant, suggesting that cancer status does not influence the relationship between disability count and SCD.
Conclusions : We estimated that SCD affects many individuals with (1.1million) and without (4.8million) cancer history aged ≥45 years. Routine screening for cognitive health, particularly for individuals with disabilities, is crucial for the early identification, proactive management, and tailored care of health needs in the adult population that may potentially lower the risk for dementia. Building personalized and need-based cognitive support resources, such as decision aids, checklists, digital and manual reminders, will help to promote care to this vulnerable group.
利益披露 Disclosure
E. Samami, None..
S. Sarkar, None..
H. Poghosyan, None.