我国老年人认知衰弱转移规律及其影响因素研究  

Transition rules of cognitive frailty and influencing factors in the elderly in China

作　　者：徐传海 袁满琼 方亚[1] Xu Chuanhai;Yuan Manqiong;Fang Ya(Key Laboratory of Health Technology Assessment of Fujian Province,School of Public Health,Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学公共卫生学院卫生技术评估福建省高校重点实验室,厦门361000

出　　处：《中华流行病学杂志》2022年第5期722-727,共6页Chinese Journal of Epidemiology

基　　金：国家自然科学基金(81973144,82073669)。

摘　　要：目的了解我国老年人认知衰弱转移规律及其影响因素,为制定认知衰弱早期干预措施提供科学依据。方法利用中国健康与养老追踪调查2011、2013和2015年3期数据,将个体健康状态划分为健壮-认知正常、认知障碍、躯体衰弱、认知衰弱4种,构建多状态Markov模型,探索认知衰弱转移规律及其影响因素。结果共纳入3470例老年人,基线为认知衰弱350例(10.09%);相较于躯体衰弱人群,认知障碍者两年后转移至认知衰弱的概率高(31.6%vs.7.6%);认知衰弱者两年后转移至躯体衰弱状态的概率高于转移至认知障碍的概率(29.7%vs.15.6%);女性(HR=1.599,95%CI:1.058~2.417)、共病(HR=3.035,95%CI:1.090~8.450)、抑郁(HR=1.678,95%CI:1.153~2.441)是我国老年人发生认知衰弱的危险因素,而接受过教育(HR=2.367,95%CI:1.567~3.575)是认知衰弱转移至躯体衰弱的保护因素。结论我国老年人认知衰弱的患病率较高,认知障碍人群发生认知衰弱的概率高,性别、接受过教育、共病以及抑郁是认知衰弱发生与转移的重要影响因素。Objective To understand the transition rules of cognitive frailty and its influencing factors in the elderly in China and provide evidence for the early intervention of cognitive frailty.Methods Data were retrospectively collected from China Health and Retirement Longitudinal Study with 3 round consecutive survey(2011,2013,2015)and the state of the subjects were classified into four categories:robust-normal cognitive,cognitive impairment,physical frailty,and cognitive frailty.A multi-state Markov model was established to explore the transition rules of cognitive frailty and its influencing factors.Results A total of 3470 older adults were included,and 350(10.09%)had cognitive frailty at baseline.After two years,the probability of cognitive frailty in the cognitive impairment population was higher than that in people with physical frailty(31.6%vs.7.6%).Persons with cognitive frailty were more likely to become physical frailty(29.7%vs.15.6%).Being women(HR=1.599,95%CI:1.058-2.417),comorbidity(HR=3.035,95%CI:1.090-8.450),and depression(HR=1.678,95%CI:1.153-2.441)were the risk factors associated with cognitive frailty in the elderly,while being educated(HR=2.367,95%CI:1.567-3.575)was a protective factor for the transition of cognitive frailty to physical frailty.Conclusions The prevalence of cognitive frailty is relatively high in the elderly in China.Those with cognitive impairment have a higher probability of cognitive frailty.Gender,education level,comorbidity,and depression are the main influencing factors for the occurrence and transition of cognitive frailty.

关 键 词：认知障碍 躯体衰弱 认知衰弱 多状态MARKOV模型 

分 类 号：R749.1[医药卫生—神经病学与精神病学]