≥60岁人群认知功能障碍发生现状及影响因素研究  

Occurrence Status and Influencing Factors of Cognitive Dysfunction in Population Aged 60 and Above

作　　者：禹延雪 白茹玉 于文龙 郭霞[1] 吴丽娥[1] YU Yanxue;BAI Ruyu;YU Wenlong;GUO Xia;WU Li'e(Department of Neurology,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science&Technology,Baotou 014010,China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院神经内科,内蒙古自治区包头市014010

出　　处：《中国全科医学》2023年第21期2581-2588,共8页Chinese General Practice

基　　金：内蒙古自治区自然科学基金资助项目(2018LH08072);包头医学院青年科技人才发展计划项目(BYJJ-QNGG 2022006)。

摘　　要：背景随着老龄化进程的加快,痴呆的发病率正逐年增高,但目前尚无有效治愈手段且预后差。主观认知下降(SCD)作为痴呆的临床前期阶段,认知功能仍有可塑性,探讨其患病率及影响因素对痴呆的防控管理具有重大意义。目的明确内蒙古包头地区60岁及以上人群SCD、轻度认知障碍(MCI)和痴呆的患病率及相关危险因素。方法于2021年6月—2022年9月,采用多阶段抽样、整群抽样、随机抽样相结合的方法,选择内蒙古自治区包头市的3个旗县区(昆都仑区、九原区、固阳县)随机抽取21个居委会、17个村委会的1120例研究对象开展横断面调查。采用问卷调查法收集研究对象的一般资料并进行认知功能评估。依据认知功能将研究对象划分为正常组(n=206)、SCD组(n=491)、MCI组(n=320)、痴呆组(n=103)。采用多因素Logistic回归分析探究研究对象认知功能状况的影响因素。结果研究对象中位年龄68.0(63.0,73.0)岁,中位受教育年限9.0(5.0,11.4)年。无配偶[OR=2.542,95%CI(1.139,5.674),P=0.023]、肥胖[OR=6.058,95%CI(2.281,16.093),P<0.001]、以素食为主[OR=3.037,95%CI(1.868,4.936),P<0.001]、每晚睡眠时长<6 h[OR=1.662,95%CI(1.099,2.516),P=0.016]、吸烟史[OR=1.971,95%CI(1.231,3.157),P=0.005]、糖尿病史[OR=1.975,95%CI(1.140,3.422),P=0.015]、冠心病史[OR=3.501,95%CI(1.016,12.062),P=0.047]及视力下降史[OR=2.454,95%CI(1.638,3.677),P<0.001]是≥60岁人群SCD患病的危险因素。居住农村[OR=2.636,95%CI(1.231,5.641),P=0.013]、无配偶[OR=2.843,95%CI(1.228,6.582),P=0.015]、肥胖[OR=5.626,95%CI(2.046,15.475),P=0.001]、以素食为主[OR=3.832,95%CI(2.212,6.640),P<0.001]、以肉食为主[OR=2.619,95%CI(1.536,4.465),P<0.001]、吸烟史[OR=1.912,95%CI(1.133,3.227),P=0.015]、糖尿病史[OR=2.544,95%CI(1.378,4.697),P=0.003]、冠心病史[OR=3.945,95%CI(1.110,14.016),P=0.034]及视力下降史[OR=2.846,95%CI(1.780,4.551),P<0.001]是≥60岁人群MCI患病的危险因素。受教育程�Background With the accelerated aging process,the incidence of dementia is increasing year by year,but there is no effective cure and the prognosis is poor.The cognitive function is still plastic during subjective cognitive decline(SCD),which as a preclinical stage of dementia,it is of great significance for the prevention and management of dementia to investigate the prevalence and influencing factors of SCD.Objective To investigate the prevalence and risk factors of SCD,MCI and dementia in population aged 60 and above in Baotou,Inner Mongolia.Methods From June 2021 to September 2022,a cross-sectional survey was conducted involving 1120 objects in 21 neighborhood councils and 17 village committees randomly selected from 3 banner counties(Hondlon District,Jiuyuan District and Guyang County)of Baotou City,Inner Mongolia Autonomous Region by using the combination of multistage sampling,cluster sampling and random sampling.General information of the study subjects were collected by questionnaire and their cognitive function was assessed.According to cognitive function,the study subjects were divided into the normal group(n=206),SCD group(n=491),MCI group(n=320)and dementia group(n=103).Multivariate Logistic regression was used to analyze the influencing factors of cognitive function.Results The median age of the study subjects was 68.0(63.0,73.0)years and the median number of years of education was 9.0(5.0,11.4)years.Absence of spouse〔OR=2.542,95%CI(1.139,5.674),P=0.023〕,obesity〔OR=6.058,95%CI(2.281,16.093),P<0.001〕,predominant vegetarian type of diet〔OR=3.037,95%CI(1.868,4.936),P<0.001〕,nightly sleep duration<6 hours〔OR=1.662,95%CI(1.099,2.516),P=0.016〕,smoking history〔OR=1.971,95%CI(1.231,3.157),P=0.005〕,diabetes history〔OR=1.975,95%CI(1.140,3.422),P=0.015〕,coronary heart disease history〔OR=3.501,95%CI(1.016,12.062),P=0.047〕,and vision loss history〔OR=2.454,95%CI(1.638,3.677),P<0.001〕were risk factor for the prevalence of SCD in population aged 60 and above.Rural residence〔OR=2.63

关 键 词：认知功能障碍 轻度认知障碍 痴呆 老年人 影响因素分析 内蒙古 LOGISTIC模型 

分 类 号：R741[医药卫生—神经病学与精神病学] R749.16[医药卫生—临床医学]