老年患者认知功能减退相关因素病例对照研究  

A case-control study of cognitive impairment and related factors among elderly patients

作　　者：郭晓斌[1] 陶立元[2] 刘慧琳[1] 李学宇[1] 杨洋[1] 黄悦勤[3] 

机构地区：[1]北京大学第三医院老年内科,北京100191 [2]北京大学第三医院临床流行病学研究中心,北京100191 [3]北京大学第六医院,北京大学精神卫生研究所,卫生部精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100191

出　　处：《中国心理卫生杂志》2018年第3期252-258,共7页Chinese Mental Health Journal

基　　金：国家重点研发计划(2017YFC0907800);国家科技支撑计划项目(2012BAI01B01和2015BAI13B00)

摘　　要：目的:探讨老年患者认知功能减退的影响因素。方法:选取符合入选标准的门诊及住院老年慢性病患者257例,采集年龄、既往疾病史、吸烟史和运动史等一般资料,并进行简易智能精神状态检查量表(MMSE)、颈动脉彩色超声、血生化检测等检查。采用病例对照研究方法,以单因素和多因素logistic回归分析筛选影响认知功能减退和痴呆的危险因素。结果:颈动脉内膜中层厚度是老年认知功能障碍的可疑危险因素(P<0.001),且回归系数极大(15.105~22.065)。血清游离T3水平每升高1 pg/m L和体质量每增长1 kg,研究对象被判定为痴呆的风险平均降低71%~78%和4%,成为保护因素。结论:颈动脉内膜中层厚度的增加是认知功能减退的可疑危险因素;而血清游离T3水平和体质量下降是痴呆的危险因素。Objective： To explore risk factors for cognitive impairment among elderly patients. Methods： There were 257 qualified subjects recruited, a case-control study was performed by collecting data of Mini Mental State Examination, carotid artery color Doppler flow imaging, biochemical tests, personal information on ages, medi- cal histories, smoking as well as physical exercise among the recruited elderly in-patients/out-patients. A logistic re- gression was conducted to screen main effects of variables on occurrences of cognitive impairment. Results： Using logistic regression, the carotid intima-media thickness was found to be a significant risk factor （P 〈 0. 001 ） with lar- ger regression coefficients （15. 105 -22. 065） for the occurrence of cognitive impairment among elderly; about 71% -78% and 4% decrease in risks of dementia occurrence for every 1 pg/mL serum free triiodothyronine and 1 kg body weight increase. Condusion： The increase in carotid intima-media thickness is a significant risk factor for the occurrence of cognitive impairment among elderly patients. The decrease in serum free triiodothyronine and body weight are the related factors to increase risk for dementia.

关 键 词：认知功能障碍 痴呆 老年人 颈动脉内膜中层厚度 MMSE 病例对照研究 

分 类 号：R749.16[医药卫生—神经病学与精神病学]