The role of inflammation, chronic pain, and hypertension on cognitive functioning in an underserved, rural population: a Project FRONTIER study.

IF 1.8 4区 心理学 Q3 CLINICAL NEUROLOGY
Lauren Chrzanowski, Jonathan Singer, Peter Rerick, Lauren Elliott, Danielle E Levitt, Caroline Cummings, Boris Decourt, Veronica Molinar-Lopez, Volker Neugebauer
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引用次数: 0

Abstract

Background: Inflammation, chronic pain, and hypertension have been identified as risk factors for cognitive decline; few studies have examined the interplay between multiple risk factors and even fewer have considered these factors in underserved rural populations.

Objective: This study analyzed the relationships between inflammation, chronic pain, and hypertension with cognitive functioning in an underserved, primarily Hispanic, rural population from Project FRONTIER (Facing Rural Obstacles to Healthcare Now Through Intervention, Education, & Research).

Methods: This epidemiological study enrolled 1,864 participants (Mage = 59.68 years, SDage = 12.21) living in five rural counties in West Texas. Consented participants disclosed medical diagnoses (e.g. chronic pain), completed five cognitive evaluations (i.e. the Repeatable Battery for the Assessment of Neuropsychological Status, the Trails Making Test A and B, and Clock Drawing 1 and 2), and attended a medical examination during which a physician confirmed existing medical conditions (e.g. hypertension) and collected a blood sample for further analysis (e.g. inflammation markers).

Results: Analysis via MANOVA revealed a multivariate effect of inflammation (V = .02, F(4, 969) = 3.72, p = .006) and a multivariate effect of hypertension (V = .03, F(4, 969) = 6.69, p < .001). There was no multivariate effect for chronic pain (V = .01, F(4,969) = 2.18, p = .07) and no significant two way or three way interaction. Post-hoc ANOVAs further illustrated the relationships between specific cognitive functioning domains and inflammation or hypertension.

Conclusions: The current study findings suggest that underserved rural populations have unique epidemiological experiences that are distinct from prior findings in urban populations. Inflammation and hypertension are important clinical considerations as risk factors for cognitive decline. Future research should explore interventions that support rural-dwelling individuals impacted by provider shortages.

炎症、慢性疼痛和高血压在服务不足的农村人口认知功能中的作用:一项前沿项目研究。
背景:炎症、慢性疼痛和高血压已被确定为认知能力下降的危险因素;很少有研究检查了多种风险因素之间的相互作用,在服务不足的农村人口中考虑这些因素的研究就更少了。目的:本研究分析了来自Project FRONTIER(通过干预、教育和研究面对农村医疗障碍)的服务水平低下的农村人口中炎症、慢性疼痛和高血压与认知功能之间的关系。方法:本流行病学研究纳入了1,864名参与者(年龄59.68岁,年龄12.21岁),他们生活在德克萨斯州西部的五个农村县。同意的参与者披露了医疗诊断(例如慢性疼痛),完成了五项认知评估(即神经心理状态评估可重复测试,轨迹测试A和B,时钟绘制1和2),并参加了体检,期间医生确认了现有的医疗状况(例如高血压),并收集了血液样本进行进一步分析(例如炎症标志物)。结果:方差分析显示炎症的多因素影响(V =。02, F(4,969) = 3.72, p = .006)和高血压的多因素影响(V =。03, F(4,969) = 6.69, p p = .07),无显著的双向或三向交互作用。事后方差分析进一步说明了特定认知功能域与炎症或高血压之间的关系。结论:目前的研究结果表明,服务不足的农村人口具有独特的流行病学经验,与先前在城市人口中的发现不同。炎症和高血压是认知能力下降的重要临床危险因素。未来的研究应探索支持受提供者短缺影响的农村居民的干预措施。
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来源期刊
CiteScore
3.20
自引率
4.50%
发文量
52
审稿时长
6-12 weeks
期刊介绍: Journal of Clinical and Experimental Neuropsychology ( JCEN) publishes research on the neuropsychological consequences of brain disease, disorders, and dysfunction, and aims to promote the integration of theories, methods, and research findings in clinical and experimental neuropsychology. The primary emphasis of JCEN is to publish original empirical research pertaining to brain-behavior relationships and neuropsychological manifestations of brain disease. Theoretical and methodological papers, critical reviews of content areas, and theoretically-relevant case studies are also welcome.
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