自我感知老化在社区老年人衰弱和认知功能间的中介作用  

Mediating effects of self-perceptions of aging between frailty and cognitive function in community-dwelling older adults

作　　者：王飞飞 姚桂英[1] 侯秀珍[2] 孙俊俊 张会敏[1] 王华 吴慧敏 李佳波 周宁 罗艳艳[1] Wang Feifei;Yao Guiying;Hou Xiuzhen;Sun Junjun;Zhang Huimin;Wang Hua;Wu Huimin;Li Jiabo;Zhou Ning;Luo Yanyan(Nursing College of Xinxiang Medical University,Xinxiang 453003,China;Department of Nursing,Xinxiang Central Hospital,Xinxiang 453000,China;Community Health Service Center,Xinxiang Municipal Hospital,Xinxiang 453000,China)

机构地区：[1]新乡医学院护理学院,新乡453003 [2]新乡市中心医院护理部,新乡453000 [3]新乡市直机关医院社区卫生服务中心,新乡453000

出　　处：《中华行为医学与脑科学杂志》2023年第3期250-256,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：河南省高等学校重点科研项目资助计划项目(21A310013);新乡医学院2021年研究生科研创新支持计划(YJSCX202165Y);新乡市软科学研究计划项目(RKX2021008)。

摘　　要：目的:探讨自我感知老化在社区老年人衰弱和认知功能间的中介作用。方法:2021年2—7月采用衰弱量表、简版自我感知老化量表和简易智能精神状态量表对新乡市528名社区老年人进行调查。根据简易智能精神状态量表总分和文化程度将被试分为认知障碍组(文盲≤17分,小学≤20分,初中及以上≤24分,n=74)和认知正常组(n=454)。采用SPSS 25.0进行共同方法偏差检验、描述性统计和相关分析,应用AMOS 24.0构建结构方程模型并采用Bootstrap法进行中介效应检验。结果:(1)社区老年人认知障碍的发生率为14.1%;认知正常组和认知障碍组在年龄、文化程度、患慢性病数目、抑郁方面均差异有统计学意义(χ^(2)=59.21,6.53,9.84,25.47;均P<0.05);在衰弱(χ^(2)=75.65,P<0.001)和自我感知老化(t=77.67,P<0.001)方面均差异有统计学意义。(2)认知障碍组自我感知老化得分[(47.39±8.66)分]高于认知正常组[(38.22±8.24)分](t=77.67,P<0.001);认知障碍组衰弱得分[2.00(1.00,3.00)分]高于认知正常组[0.00(0.00,1.00)分](Z=-8.63,P<0.001)。(3)衰弱与认知功能呈负相关(r=-0.492,P<0.01),与自我感知老化呈正相关(r=0.540,P<0.01),自我感知老化与认知功能呈负相关(r=-0.541,P<0.01);控制年龄、文化程度、患慢性病数目、抑郁等因素后,相关性依然显著(均P<0.01)。(4)自我感知老化在衰弱和认知功能间起部分中介作用,且中介效应占总效应的58.5%。结论:衰弱和自我感知老化对社区老年人认知功能有显著影响,且自我感知老化在社区老年人衰弱和认知功能间起部分中介作用。Objective To explore the mediating role of self-perceptions of aging between frailty and cognitive function in community-dwelling older adults.Methods From February to July 2021,a total of 528 elderly people in Xinxiang community were investigated with the frailty phenotype,the brief self-perceptions ageing questionnaire and the Mini-mental state examination(MMSE)scale.According to the MMSE total score and education level,the subjects were divided into cognitive impairment group(illiteracy≤17,primary school≤20,junior high school and above≤24,n=74)and cognitive normal group(n=454).SPSS 25.0 software was used for common method deviation test,descriptive statistics and correlation analysis,while AMOS 24.0 software was used to build structural equation model and Bootstrap method was used for intermediary effect test.Results(1)The prevalence of cognitive impairment among the elderly in the community was 14.1%.The differences between the cognitively normal group and cognitively impaired group were statistically significant in terms of age,education,number of chronic diseases suffered and depression(χ^(2)=59.21,6.53,9.84,25.47,all P<0.05).The differences were statistically significant in terms of frailty(χ^(2)=75.65,P<0.001)and self-perceptions of aging(t=77.67,P<0.001).(2)Self-perceptions of aging in the cognitively impaired group(47.39±8.66)was higher than that in the cognitively normal group(38.22±8.24)(t=77.67,P<0.001).Frailty score in cognitively impaired group(2.00(1.00,3.00))was higher than that in the cognitively normal group(0.00(0.00,1.00))(Z=-8.63,P<0.001).(3)Frailty was negatively correlated with cognitive function(r=-0.492,P<0.01),and positively correlated with self-perceptions of aging(r=0.540,P<0.01).Self-perceptions of aging was negatively correlated with cognitive function(r=-0.541,P<0.01).After controlling the influencing factors such as age,education level,chronic diseases and depression,the correlation was still significant(all P<0.01).(4)Self-perceptions of aging played a partially mediati

关 键 词：社区老年人 衰弱 自我感知老化 认知功能 中介作用 

分 类 号：R749.1[医药卫生—神经病学与精神病学]