上海社区老年人轻度认知功能损害患病率调查及其影响因素分析  

Investigation of Prevalence and Factors Influencing Mild Cognitive Impairment in Elderly Community Residents in Shanghai

作　　者：张源[1] 汪志良[1] 许桦 王慧[1] 杨竹洁 彭磊[1] 宋园园[1] 徐光铮 王春燕[1] 张复亮 彭淑颖[1] 迟桂芬 陆爱萍 梅馨纯 申远[3] 李云霞[4] 李刚[5] 田亮 万鸣 甘荣兴 刘涵毅 高新义 李伟 史琰琛 江敏俊 洪波 岳玲[2] 严峰[2] 朱敏捷[2] 王静华[2] 孙琳[2] 王涛[2] 肖世富[2] 上海老年脑健康队列研究团队 ZHANG Yuan;WANG Zhi-liang;XU Hua;WANG Hui;YANG Zhu-jie;PENG Lei;SONG Yuan-yuan;XU Guang-zheng;WANG Chun-yan;ZHANG Fu-liang;PENG Shu-ying;CHI Gui-fen;LU Ai-ping;EI Xinchun;SHEN Yuan;LI Yun-xia;LI Gang;TIAN Liang;WAN Ming;GAN Rong-xing;LIU Han-yi;GAO Xin-yi;LI Wei;SHI Yan-chen;JIANG Min-jun;HONG Bo;YUE Ling;YAN Feng;ZHU Min-jie;WANG Jing-hua;SUN Lin;WANG Tao;XIAO Shi-fu;Shanghai Elderly Brain Health Cohort Study Team(Xujiahui Street Community Health Service Center,Xuhui District,Shanghai 200030,China;Shanghai Mental Health Center,Shanghai 200032,China;Tenth People's Hospital of Tongji University,Shanghai 200072,China;Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China;Eastern Hospital Affiliated to Tongji University,Shanghai 200120,China;Shanghai Clinical Research Center,Ltd,Shanghai 200032,China;Shanghai Brain Health Foudation,Shanghai 200032,China)

机构地区：[1]上海市徐汇区徐家汇街道社区卫生服务中心,200030 [2]上海市精神卫生中心,200032 [3]同济大学附属上海市第十人民医院,上海市200072 [4]同济大学附属同济医院,上海市200065 [5]同济大学附属东方医院,上海市200120 [6]上海医药临床研究中心有限公司,上海市200032 [7]上海东方脑医学基金会,上海市200032 [8]不详

出　　处：《中国全科医学》2018年第24期2909-2915,共7页Chinese General Practice

基　　金：上海东方脑医学基金会慈善公益项目(SHBHF2016001);上海市徐汇区卫生和计划生育委员会面上项目(SHXH201618);AD的早期识别、诊断与炎症发病机制研究(2015NKX003);阿尔茨海默病早期精准诊断标志物研究(15ZH4010);上海市市级医疗卫生优秀学科带头人培养计划资助项目(2017BR054).

摘　　要：目的调查上海社区常住老年人轻度认知功能损害(MCI)患病率,并分析其影响因素,为建立痴呆早期社区干预模式提供依据。方法本研究属于"上海老年脑健康队列研究"中的徐家汇街道老年人认知功能调查研究。2016年7月—2017年6月,选取徐家汇街道社区卫生服务中心管辖内的塘子泾社区、徐汇新村社区、泰东社区、零陵社区、南丹社区老年人1 033例为调查对象。采用统一编制的调查表进行问卷调查。调查问卷包括人口学资料(性别、年龄、居住状况、受教育时间、职业性质)、生活方式和习惯(吸烟史、饮酒史、饮茶史、运动情况、饮食习惯、业余爱好、右利手情况、睡眠异常情况、饮食异常情况)、BMI、主诉症状(主诉或知情人诉记忆下降、主诉情绪低落、主诉工作学习能力下降、主诉日常生活能力下降)及高血压、心脏病、糖尿病、高脂血症、脑创伤史。调查上海社区常住老年人MCI患病率,并分析其影响因素。结果共发放问卷1 033份,回收有效问卷1 033份,有效回收率100.00%。1 033例社区居民中MCI老年人430例,MCI患病率为41.63%。MCI老年人与正常老年人受教育时间、职业性质、饮茶史、运动情况、业余爱好情况、主诉或知情人诉记忆下降率、主诉工作学习能力下降率、高脂血症史比较,差异有统计学意义(P<0.05)。主诉或知情人诉记忆下降[OR=2.324,95%CI(1.538,3.511)]、主诉工作学习能力下降[OR=1.667,95%CI(1.258,2.209)]是社区老年人发生MCI的危险因素(P<0.05);受教育时间[OR=0.953,95%CI(0.913,0.996)]、职业性质[OR=0.695,95%CI(0.501,0.964)]、业余爱好[OR=0.723,95%CI(0.533,0.981)]、高脂血症史[OR=0.706,95%CI(0.536,0.929)]是社区老年人发生MCI的保护因素(P<0.05)。结论上海社区老年人MCI患病率较高,其发生的危险因素包括主诉或知情人诉记忆下降、主诉工作学习能力下降,保护因素包括受教育时间长、�Objective To investigate the prevalence of mild cognitive impairment(MCI)in elderly people living in Shanghai City and to analyze the influencing factors,in order to provide a scientific basis for establishing an early community intervention model for dementia.Methods This study was a survey investigating cognitive function in elderly people in the Xuejiahui district,as part of the"Shanghai Elderly Brain Health Cohort Study".Between July 2016 and June 2017,a total of 1 033 elderly people living in the Tangzijing,Xuhui New Village,Taidong,Lingling and Nandan communities in the Xujiahui district were selected to complete a survey questionnaire.The questionnaire included demographic information(sex,age,living status,education duration,and career features),lifestyle and habits(smoking history,drinking history,tea drinking history,exercise,dietary habits,hobbies,handedness,sleep abnormalities,diet abnormalities),BMI,health complaints(including complaints of memory decline,depressed mood,decreased work and study ability,and decreased daily life),history of hypertension,heart disease,diabetes,hyperlipidemia,and brain trauma.The prevalence of MCI among the elderly people was investigated,and associated influencing factors were analyzed.Results A total of 1 033 questionnaires were distributed,and 1 033 valid questionnaires were returned,with an effective recovery rate of 100.00%.There were 430 MCI cases among the 1 033 respondents.There were differences in the education duration,career features,tea drinking history,exercise,hobbies,rate of complaints of memory decline,rate of complaints of decreased work and study ability,and hyperlipidemia between the respondents with MCI and without MCI(P<0.05).The complaints of memory decline〔OR=2.324,95%CI(1.538,3.511)〕and decreased work and study ability〔OR=1.667,95%CI(1.258,2.209)〕were risk factors for MCI in the elderly people in the community(P<0.05).The education duration〔OR=0.953,95%CI(0.913,0.996)〕,career features〔OR=0.695,95%CI(0.501,0.964)〕,hobbies〔OR=0.723,

关 键 词：轻度认知障碍 患病率 影响因素分析 早期干预 

分 类 号：R741[医药卫生—神经病学与精神病学]