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| Title: | 初探臺灣主觀認知功能退化者之心理社會特性
Preliminary Study of the Psychosocial Characteristics among People with Subjective Cognitive Decline in Taiwan |
| Authors: | 黃榆淨
Huang, Yu Ching |
| Contributors: | 吳治勳
Wu, Chih-Hsun
黃榆淨
Huang, Yu Ching |
| Keywords: | 憂慮
焦慮
憂鬱
老化自我覺知
生活品質
Worry
Anxiety
Depression
Self-perception of aging
Quality of life |
| Date: | 2025 |
| Issue Date: | 2025-08-04 14:05:00 (UTC+8) |
| Abstract: | 研究目的：中老年人報告主觀認知功能退化（Subjective Cognitive Decline, SCD）是一常見又值得留意的現象。SCD被認為是阿茲海默型失智症的風險因子，個體表達認知功能表現不佳的主觀報告和經驗可能隱含覺察到本身認知功能些微退化，亦同時反映著與憂慮、焦慮、憂鬱、及老化態度的關聯性。此外，許多過去研究指出SCD具有高度異質性，但很少直接討論SCD可能的分類。本研究首先欲從各層面探討SCD的心理社會適應，評估可能預測個體報告SCD的因素，並以資料導向探索SCD在心理社會異質分群中可能的特徵表現，藉以瞭解主觀認知功能退化之於個體認知功能、情緒適應、生活品質的表現特性。
研究方法：本研究以臺灣社區中55歲以上認知功能表現正常之成年人為對象，使用神經心理功能測驗評估客觀認知功能表現，及單題「您是否覺得自己有記憶或認知上的困難」評估個體SCD報告，依此將研究參與者分為認知功能正常組（Normal Cognition, NC）135人、與主觀認知功能退化組（SCD）52人。採用臺灣版賓州憂慮量表、貝克焦慮量表、貝克憂鬱量表第二版、及臺灣老化態度量表作為心理社會之測量工具，以台灣簡明版世界衛生組織生活品質問卷評估個人整體健康適應狀態。以獨立樣本t檢定比較組間差異，邏輯斯迴歸分析探討可能報告SCD的預測性，並應用群集分析將SCD分群，比較不同SCD群集的異質樣態。
研究結果：SCD相較NC年齡較長、台灣版額葉評估量表表現較差，憂慮、憂鬱、負向老化自我覺知較高，生活品質各個範疇皆較低。邏輯斯迴歸分析結果發現，同時納入所有相關變項時，僅憂慮會顯著增加個體報告SCD的可能性（OR = 1.09, p = .001），排除共線性影響後，年齡亦具有顯著的預測性（OR = 1.11, p = 0.015）。參照心理社會特性可將SCD分為二個群集（組A、組B），組A相比組B之憂慮、憂鬱、焦慮、負向老化自我覺知均顯著較高，正向老化自我覺知顯著較低，且在彩色路徑描繪測驗第二部分所需時間較長，生活品質生理與心理範疇分數皆顯著較低。
討論與結論：面對老化，SCD或可視為瞭解中老年人如何評估自身改變與心理社會狀態的一種表現，越憂慮的老人傾向對本身認知功能有負面評價，且反映較高的負向情緒與較差的生活品質。在嘗試透過整合心理社會特性探索SCD的異質樣態中，亦發現心理社會變項可作為合適的分類參照，且可區辨部分與心理社會適應具較穩定影響關係的SCD群集，有機會作為初步預防與未來追蹤關聯影響的線索。整體而言，SCD不僅應視為認知退化或疾病的徵兆，亦是重要的心理社會適應議題。
Background: Subjective Cognitive Decline (SCD) is common and noteworthy among middle-aged and the elderly. It’s considered a risk factor of AD, which may not only imply a personal concern about subtle cognitive decline but also reflect their own psychosocial characteristics of worry, anxiety, depression, and self-perception of aging. The study aims to investigate the characteristics of SCD from multiple perspectives, identify which factors could predict SCD. Despite its significance of high heterogeneity, there are few researches focused on classifying SCD into various subgroups, which may appear to their cognitive performances or psychosocial adaptations while aging. Thereby, the study aims to explore the potential psychosocial characteristics within SCD, providing a preliminary understanding about those possibly subgroups with cognitive complaints.
Methods: This study recruited cognitively normal adults aged 55 and over from communities in Taiwan. We used a battery of neuropsychological tests and single-item question: "Do you have difficulties in memory or cognitive function?" to assess whether participants were SCD (n=52) or NC (Normal Cognition, n=135). Psychosocial characteristics were measured by using Taiwan Penn’s State Worry Questionnaire (T-PSWQ), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), and Taiwan Attitude toward Aging Questionnaire (TAAQ). World Health Organization Quality of Life brief form Taiwan Version (WHOQOL-BREF) questionnaire was used to evaluate overall perceptions of quality of life. Group comparisons were using independent t-test, logistic regression was employed to explore the predictors of SCD, and cluster analysis was applied to clarify subgroups within SCD.
Results: SCD were older, showed poorer performance on Taiwanese Frontal Assessment Battery (TFAB), and with higher levels of worry, depression, negative self-perceptions of aging, as well as lower quality of life in all domains compared to NC. When taking all variables into consideration, only “worry” significantly predicted SCD (OR = 1.09, p = .001). After excluding collinear effects, a person’s “age” also was the significant predictor of SCD (OR = 1.11, p = 0.015). Moreover, cluster analysis of SCD group based on psychosocial characteristics yielded to two subgroups (subgroup A, subgroup B). Subgroup A with poorer psychosocial characteristics (higher on worry, anxiety, depression, negative self-perception of aging and lower on positive self-perception of aging) took longer to complete Color Trials Test-2 (CTT-2), and had lower quality of life in physical and psychological domains compared to subgroup B.
Conclusions: SCD provides critical insight into how the elderly perceived their changes and overall psychosocial well-beings. The worrier the older adults, the higher probability they report SCD, which also corresponds to poorer psychosocial status and quality of life. By exploring the heterogeneous profiles of SCD, a person’s psychosocial characteristics could be the screening features when clarify psychosocial adaptation with pathologic cognitive degeneration. To elaborate, this preliminary study provides hints for prevention and for further longitudinal studies on its developmental impacts. It is imperative to view SCD not only as a risk factor of cognitive degeneration in pathology, but also a sign of psychosocial adaptation in aging. |
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| Description: | 碩士
國立政治大學
心理學系
110752007 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0110752007 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
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