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Psychosocial Stressors, Prescription Drug Use/Misuse, and Risk of Cognitive Impairment Among Middle-aged and Older Adults
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| 자료유형 | 학위논문 |
|---|---|
| 서명/저자사항 | Psychosocial Stressors, Prescription Drug Use/Misuse, and Risk of Cognitive Impairment Among Middle-aged and Older Adults. |
| 개인저자 | Hu, Yi-Han. |
| 단체저자명 | Indiana University. School of Public Health. |
| 발행사항 | [S.l.]: Indiana University., 2019. |
| 발행사항 | Ann Arbor: ProQuest Dissertations & Theses, 2019. |
| 형태사항 | 136 p. |
| 기본자료 저록 | Dissertations Abstracts International 81-04A. Dissertation Abstract International |
| ISBN | 9781085654821 |
| 학위논문주기 | Thesis (Ph.D.)--Indiana University, 2019. |
| 일반주기 |
Source: Dissertations Abstracts International, Volume: 81-04, Section: A.
Advisor: Lin, Hsien-Chang. |
| 이용제한사항 | This item must not be sold to any third party vendors. |
| 요약 | As the prevalence of dementia increases in the past decades, identifying and reducing risk factors for dementia has grown in importance. Chronic non-cancer pain (CNCP) has been linked to cognitive dysfunction, but the relationships between CNCP and mild cognitive impairment (MCI) and Alzheimer's disease and related diseases (ADRDs) have not been comprehensively studied. In addition, given the accompanying detrimental effects of prescription drug misuse (PDM) on older adults' cognitive function, more information on the determinants of PDM is needed to inform evidence-based interventions. This dissertation consists of three related studies: Study 1 and Study 2 examined the impact of CNCP and pharmacological pain treatments on the risk of developing MCI/ADRD among middle-aged or older adults using an 11-year administrative claims data. Study 3 used a 20-year longitudinal cohort to examine the association of adverse childhood experiences (ACEs) with PDM in middle-aged or older adults, and investigate the mediation effect of adulthood psychosocial stressors.Study 1 revealed that CNCP patients had higher risks for MCI and ADRDs relative to non-CNCP patients. Study 2 found out that opioid use was associated with lower risks of incident MCI/ADRDs. However, a dose-response relationship between cumulative amount of opioid use and risk of ADRDs was found. Study 3 discovered the long-term impact of ACEs on PDM and revealed that the relationship between ACEs and PDM was significant mediated by adulthood psychosocial stressors.Our findings suggest that chronic pain should be carefully and effectively managed by patients and health care providers to reduce MCI and ADRDs risks. Opioid analgesics may alleviate the negative effect of CNCP on cognitive impairment but high dose of opioid should be administrated with cautions when treating CNCP. For individuals with a history of ACEs, early intervention that helps them manage stressful life circumstances in adulthood is needed to prevent PDM in their later life. |
| 일반주제명 | Public health. Gerontology. Physiology. Aging. Clinical psychology. Neurosciences. Health sciences. Social psychology. Cognitive psychology. |
| 언어 | 영어 |
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: 이 자료의 원문은 한국교육학술정보원에서 제공합니다. |
