당뇨병 환자에서 지각된 건강상태가 주관적 인지 저하에 미치는 영향: 스트레스와 불안의 순차적 매개기전

초록

Subjective Cognitive Decline (SCD) is an early indicator of dementia risk. Understanding the psychosocial factors influencing SCD is crucial for preventative strategies. This study aimed to elucidate the serial dual mediation mechanism by which Perceived Health Status affects SCD through Stress and Anxiety sequentially. This cross-sectional study utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2021 (N=507). To account for the complex survey design, Complex Sample Regression Analysis was performed. The significance of the serial mediation effect was tested using the Sobel test, controlling for major covariates including age, sex, and HbA1c. The significance of the serial mediation effect was tested using the Sobel test. The analysis confirmed that all sequential pathways were statistically significant and positive. A worse Perceived Health Status significantly increased Stress, and Stress in turn significantly amplified Anxiety. Anxiety finally intensified SCD. The serial dual indirect effect of Perceived Health Status on SCD via Stress and Anxiety was highly significant. The findings confirm that the link between poor perceived health and increased SCD risk is significantly explained by a sequential psychological cascade where stress precedes and exacerbates anxiety. Interventions aimed at mitigating SCD risk should adopt a holistic and sequential psychological management strategy, focusing on interrupting the flow from stress to anxiety.

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