METHODS: A population sample of 777 women (aged 38, 46, 50 and 54 years) without dementia at baseline was followed over 50 years, from 1968 to 2019. Stress-related exhaustion was based on information from the psychiatric examination in 1968/69. Information on dementia incidence between 1968 and 2019 was obtained from neuropsychiatric examinations, key-informant interviews, and hospital registry. Dementia was diagnosed according to the DSM-III-R criteria. A subgroup of non-demented women (n = 284) was examined for cognitive functions by the Gottfries-Bråne-Steen scale 24 years after baseline.
RESULTS: Stress-related exhaustion in midlife was associated with higher risk for development of dementia before age 75 (Hazard ratio and 95% confidence interval: 2.95 and 1.35-6.44). The association remained after adjustment for age, major depression, and anxiety disorder. Mean age of dementia onset was younger for women with stress-related exhaustion than women without stress (mean ± SD, 76 ± 9 vs. 82 ± 8 . p = 0.009). Women with stress-related exhaustion in midlife still showed more cognitive impairments 24 years later compared with women without stress (Odds ratio and 95% confidence interval: 2.64 and 1.15-6.06).
CONCLUSIONS: We found that women with stress-related exhaustion in midlife were at a higher risk to develop dementia at relatively younger age. These women showed persistently lower cognitive functions over years even without dementia. Present study results need to be interpreted with caution due to small sample size and should be confirmed in future studies with larger sample size. Our study findings may imply the importance of long-term follow-up regarding cognitive function among individuals with stress-related exhaustion.
方法:对基线无痴呆的777名女性(年龄38、46、50和54岁)进行了50年以上的随访。从1968年到2019年。与压力相关的疲惫是基于1968/69年精神病检查的信息。1968年至2019年痴呆症发病率的信息来自神经精神检查,关键线人采访,和医院登记处。根据DSM-III-R标准诊断痴呆。基线后24年,通过Gottfries-Bräne-Steen量表检查了一组非痴呆妇女(n=284)的认知功能。
结果:中年时期与压力相关的疲惫与75岁之前发生痴呆的风险更高(危害比和95%置信区间:2.95和1.35-6.44)。在调整了年龄后,协会仍然存在,严重的抑郁症,和焦虑症。与压力相关的疲惫女性的痴呆发病平均年龄比没有压力的女性年轻(平均值±SD,76±9vs.82±8。p=0.009)。与没有压力的女性相比,中年与压力相关的疲惫的女性在24年后仍表现出更多的认知障碍(赔率和95%置信区间:2.64和1.15-6.06)。
结论:我们发现,中年时期有压力相关疲惫的女性在相对较年轻的年龄患痴呆的风险较高。即使没有痴呆症,这些女性多年来仍表现出持续较低的认知功能。由于样本量小,目前的研究结果需要谨慎解释,并应在未来样本量较大的研究中得到证实。我们的研究结果可能暗示了长期随访对与压力相关的疲惫个体的认知功能的重要性。