社区轻度认知功能障碍老年人认知减退转归结果分析  

THE RESEARCH ON THE CONVERSION TO THE OUTCOME OF COGNITIVE DECLINE IN MCI SUBJECTS AMONG COMMUNITY-BASED ELDERLY POPULATION

作　　者：马菲[1] 王婷[2] 银炯[2] 苗汝娟[1] 张晓东[2] 孟珺[2] 张彩萍[2] 

机构地区：[1]天津医科大学流行病教研室,天津3000701 [2]山西医科大学流行病教研室

出　　处：《现代预防医学》2011年第19期3869-3871,共3页Modern Preventive Medicine

基　　金：国家自然科学基金资助项目(30571611)

摘　　要：[目的]了解轻度认知功能障碍(MCI)向认知减退转归结局及转化率,为预防痴呆发生提供可控制方案。[方法]采用整群随机抽样方法调查社区65岁以上老年人6192人,根据DSM-IV标准,在基底人群中筛选600MCI对象,年龄±2岁、性别相同、文化程度一致的原则选取正常对照组,与MCI组进行1︰1匹配,按半年1次随访计划,完成3次随访。按照人年法计算发病密度及比较转化为认知减退RR和95%CI,采用Log-rank检验对每一指标不同水平随访对象认知减退转归比较。[结果]565对研究对象纳入研究,认知减退组人年发病密度14.70%(14.52%,15.29%),正常对照组3.75%(3.56%,3.67%),两组随访对象转化为认知减退结局的生存曲线经Log-rank检验差异有统计学意义(χ2=11.643,P﹤0.01)。[结论]MCI转化为认知减退结局的危险性远远大于认知正常受试者。提示对社区MCI人群早期干预可能对认知减退甚至老年痴呆预防起到重要作用。[Objective]To understand the conversion to the outcome of cognitive decline in MCI and provide controllable scheme for the prevention of dementia.[Methods]By cluster random sampling,6 192 aged people over 65 were ultimately involved.According to DSM-IV,600 subjects with MCI were screened from the baseline population.Each case was matched with one control by age decade,education and gender.The follow-up interviews were performed twice a year,totally three times.According to the follow-up information,incidence density of cognitive decline in both MCI group and normal cognitive group were calculated by person-years approach.RR and 95%CI of the conversion to the outcome of cognitive decline in MCI group were compared with that in the normal cognitive group.Log-rank test was performed to make comparison with the different level in follow-up subjects＇ each index.[Results]According to changes and trends of cognitive function,565 pairs of cognitive decline subjects andnormal subjects were identified,both of which were matched on sex,age and educational level in a 1︰1 ratio.Incidence density of cognitive decline subjects was 14.70%（14.52%,15.29%）,while that of normal subjects was 3.75%（3.56%,3.67%）.By Log-rank test,there was a significant difference in survival curve on the outcome of cognitive decline between cognitive decline group and normal group（χ2 = 11.643,P﹤0.01）.[Conclusion]Risk of the conversion to cognitive decline for MCI is much higher than that for normal controls,which indicates that early intervention on the community-based elderly population with MCI may play an important role on cognitive decline even dementia.

关 键 词：轻度认知功能障碍 认知减退 老年人 队列研究 

分 类 号：R749.16[医药卫生—神经病学与精神病学]