老年科住院患者认知功能减退相关因素分析  

Analysis of related factors of cognitive decline in inpatients in department of geriatrics

作　　者：张永怡[1] 张惠雯[1] 荣岚[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院老年科,上海200025

出　　处：《内科理论与实践》2017年第2期111-114,共4页Journal of Internal Medicine Concepts & Practice

摘　　要：目的:探讨老年患者认知功能减退的可能影响因素,以便通过对部分相关因素的早期干预,减少、延缓老年人认知功能的衰退。方法:使用蒙特利尔认知评估量表(Mo CA)对我院老年科202例患者进行认知功能评估,分为认知功能减退组与认知功能正常组。分析可能影响因素与认知功能的相关性。结果:202例患者中认知功能减退组142例(70.3%),认知功能正常组60例(29.7%)。年龄、文化程度、高血压、糖尿病、高脂血症、心房颤动(房颤)、颈动脉粥样硬化2组间差异有统计学意义(均P<0.05)。多因素Logistic回归分析提示,年龄[比值比(OR)=4.407,95%可信区间(CI):2.084~9.320]、高血压(OR=7.597,95%CI:2.478~23.297)、糖尿病(OR=2.975,95%CI:1.191~7.428)、高脂血症(OR=8.977,95%CI:2.913~27.659)、颈动脉粥样硬化(OR=4.400,95%CI:1.636~11.836)、房颤(OR=3.183,95%CI:1.059~9.566)是认知功能减退的危险因素,而文化程度(OR=0.305,95%CI:0.153~0.607)是认知功能的保护因素。结论:老年人群中认知功能减退发生率较高。年龄、高血压、糖尿病、高脂血症、颈动脉粥样硬化、房颤均是认知功能减退的危险因素,而文化程度是认知功能的保护因素。Objective To investigate the possible influencing factors for cognitive function impairment in the elderly, so that early intervention of relevant factors could be fulfilled to delay the cognitive function impairment. Methods The Montreal cognitive assessment scale （MoCA） was used to assess the cognitive function in 202 patients, and the patients were divided into cognitive function impaired group and cognitive function normal group. To analyze the association between the possible influencing factors and cognitive function. Results The study included 202 patients, consisted of cognitive func- tion impaired group 142 cases（70.3%） and cognitive function normal group 60 cases（29.7%）. Age, educational level, blood pressure, diabetes mellitus , hyperlipidemia , atrial fibrillation, carotid artery atherosclerosis were different significantly be- tween the two groups （all P〈0.05）. Multivariate Logistic regression analysis showed that among the above 7 factors, age [odds ratio （OR）=4.407, 95% confidence interval （CI）： 2.084-9.320], hypertension （OR=7.597, 95%Ch 2.478-23.297）, dia- betes （OR=2.975, 95%Ch 1.191-7.428）, hyperlipidemia （OR=8.977, 95%CI： 2.913-27.659）, carotid atherosclerosis （OR= 4.400, 95%CI： 1.636-11.836） and atrial fibrillation （OR=3.183, 95%Ch 1.059-9.566） were independent risk factors for cognitive function impairment, and culture level （OR=0.305, 95%CI： 0.153-0.607） was the protective factor for cognitive function. Conclusions The prevalence rate of cognitive function impairment in elderly is high. Age, hypertension, diabetes, hyperlipidemia, atherosclerosis, atrial fibrillation are risk factors of cognitive function impairment, and education is a pro- tective factor for cognitive function.

关 键 词：老年人 认知功能减退 危险因素 

分 类 号：R749.16[医药卫生—神经病学与精神病学]