年龄和受教育年限与简易精神状态量表评分的非线性相关关系:一项以西安市鄠邑区40岁及以上农村人群为基础的横断面调查  

The non-linear correlation of age and years of schooling withthe Mini-mental State Examination scores in the aged 40 years or above:A cross-sectional study in a rural area of Xi'an, China

作　　者：商苏杭 王敬谊 张彬艳 王瑾[1] 费裕朗 江毓 陈晨[1] 马楼艳 霍康[1] 曹红梅[1] 党亮君 屈秋民[1] SHANG Suhang;WANG Jingyi;ZHANG Binyan;WANG Jin;FEI Yulang;JIANG Yu;CHEN Chen;MA Louyan;HUO Kang;CAO Hongmei;DANG Liangjun;QU Qiumin(Department of Neurology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Department of Encephalopathy,the Traditional Chinese Medicine Hospital of Huyi District,Xi'an 710300;Department of Epidemiology and Biostatistics,School of Public Health of Xi'an Jiaotong University Health Science Center,Xi'an 710061;Department of Neurology,Shaanxi Provincial People s Hospital,Xi'an 710068;Department of Neurology,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004;Department of Geriatrics,the Ninth Hospital of Xi'an,Xi'an 710054,China)

机构地区：[1]西安交通大学第一附属医院神经内科,陕西西安710061 [2]陕西省西安市鄠邑区中医医院脑病科,陕西西安710300 [3]西安交通大学医学部公共卫生学院流行病与卫生统计系,陕西西安710061 [4]陕西省人民医院神经内科,陕西西安710068 [5]西安交通大学第二附属医院神经内科,陕西西安710004 [6]西安市第九医院老年病科,陕西西安710054

出　　处：《西安交通大学学报（医学版）》2020年第5期788-794,806,共8页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家卫健委社区脑卒中高危人群筛查项目;西安交通大学第一附属医院临床研究项目(No.XJTU1AF-CRF-2019-018)。

摘　　要：目的研究40岁及以上农村人群年龄、受教育年限与简易精神状态量表(Mini-Mental State Examination,MMSE)评分的关系。方法于2014年10月-2015年3月,选取西安市鄠邑区某村40岁及以上人群作为研究对象,采用MMSE评估总体认知功能。同时收集一般人口学信息、生活习惯、既往病史、家族史、体格检查、生化检查。通过单因素、多因素中位数回归分析、分层分析等方法研究年龄、受教育年限与MMSE评分的相关性。结果共纳入研究对象1799人,其中男性726人,占40.35%;40~69岁者1613人,占89.66%,≥70岁者186人,占10.34%,平均年龄(55.52±9.93)岁;文盲222人,占12.34%,受教育年限1~6年者568人,占31.57%,≥7年者1009人,占56.09%。MMSE评分中位数(25%分位数,75%分位数)为27(24,29)。多因素中位数回归分析MMSE评分与年龄的关系,结果显示,在40~69岁人群中,年龄每增加1岁,MMSE评分中位数下降0.06分(β=-0.06,P<0.001),而在≥70岁人群中下降0.34分(β=-0.34,P=0.001);即随着年龄增长,≥70岁人群的MMSE评分下降速度高于40~69岁人群;在男性、女性、文盲、受教育年限1~6年等亚组人群中重复上述分析,均存在与总人群类似的非线性相关关系;由于受教育年限≥7年亚组人群中年龄≥70岁者仅有30例,因此,在该亚组中是否存在类似的非线性关系需进一步明确。关于MMSE评分与受教育年限的关系,多因素中位数回归分析结果显示,在受教育年限0~6年的人群中,受教育年限每增加1年,MMSE评分中位数增长0.86分(β=0.86,P<0.001),在受教育年限≥7年的人群中增长0.16分(β=0.16,P<0.001);即随着受教育年限增长,受教育年限0~6年的人群的MMSE评分增长速度高于≥7年人群;在男性、女性、40~69岁亚组人群中分析上述关系仍然成立;由于年龄≥70岁亚组人群中受教育年限≥7年者样本量低,是否存在类似关系需进一步明确。根据年龄、受教育年限分为4个亚组,分别在4个Objective To investigate the relationship of age and years of schooling with the Mini-mental State Examination(MMSE)scores among the aged 40 years or above in rural areas of Xi'an,China.Methods From October 2014 to March 2015,subjects who lived in a village in the suburbs of Xi'an,China,were selected as the research samples.MMSE was performed to assess their global cognitive function.At the same time,we collected the data about demographic information,living habits,medical history,family history,physical examination,and biochemical examination.The relationship of age and years of schooling with MMSE scores was analyzed by simple median regression analysis,multivariate median regression analysis,and stratified analysis.Results We enrolled for the study a total of 1799 subjects,including 726(40.35%)males,1613(89.66%)subjects aged 40-69 years,and 186(10.34%)subjects aged≥70 years.The average age was 55.52±9.93 years.Of them,222(12.34%)subjects were illiterate,568(31.57%)subjects received 1-6 years of schooling,and 1009(56.09%)subjects received≥7 years of schooling.The median MMSE score(25%quantile,75%quantile)was 27(24,29).Regarding the relationship between MMSE score and age,multivariate median regression analysis was performed to correct the confounding factors,which showed that in the subjects aged 40-69 years old,the median MMSE score decreased by 0.06 points(β=-0.06,P<0.001)for every 1 year of age increase,while that was 0.34 points decrease(β=-0.34,P=0.001)in the subjects aged≥70 years old.That is,with the increase of age,the decline rate of MMSE score was higher in people aged≥70 years old than that in the subjects aged 40-69 years old.The similar non-linear correlation was found in subgroups such as male,female,illiterate,1-6 years of schooling;while in the subjects with≥7 years of schooling,such relationship was not certain,due to the small sample size of 30 subjects in the group with both aged≥70 years and≥7 years of schooling.As for the relationship between MMSE score and years of schooli

关 键 词：简易精神状态量表 年龄 受教育年限 

分 类 号：R74[医药卫生—神经病学与精神病学]