≥65岁居民老年痴呆流行病学特征及其与慢性病共病的相关性研究  

Epidemiological Characteristics of Dementia and Its Correlation with Multimorbidity among Residents Aged 65 and Above

作　　者：周思静 罗邦安[2] 曹慧 张熙[3] 王东欣 ZHOU Sijing;LUO Bangan;CAO Hui;ZHANG Xi;WANG Dongxin(College of Medicine,Hunan University of Traditional Chinese Medicine,Changsha 410208,China;Hunan Provincial Brain Hospital/The Second People's Hospital of Hunan Province,Changsha 410007,China;Hunan University of Traditional Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学医学院,湖南省长沙市410208 [2]湖南省脑科医院、湖南省第二人民医院,湖南省长沙市410007 [3]湖南中医药大学,湖南省长沙市410208

出　　处：《中国全科医学》2023年第29期3616-3621,共6页Chinese General Practice

基　　金：湖南省自然科学基金资助项目(2020JJ8009)。

摘　　要：背景老龄化社会背景下,老年痴呆患病数量逐年增加,且共病状态越发常见,但目前湖南省关于老年痴呆的广泛调查不足,疾病之间的共病关系尚不明确。目的全面了解湖南省≥65岁居民老年痴呆患病情况并分析其与常见11种慢性病的共病关系。方法于2021年4—5月,采用分层多阶段抽样方法,在湖南省30个区(县)、60个街道(乡镇)、180个居(村)委会随机调查≥65岁居民。以痴呆社区筛查量表(CSI-D)或8条目痴呆筛查问卷(AD8)为筛查工具,神经内科或精神科医生结合简易精神状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)诊断痴呆。同时调查居民高血压、脑血管病、缺血性心脏病、类风湿关节炎、椎间盘疾病、糖尿病、胃肠炎、慢性阻塞性肺疾病、胆结石胆囊炎、消化性溃疡、癌症的患病情况。结果本次共抽样5979人,共5616人完成调查,785例(13.98%)检出痴呆。不同地区、性别、年龄、吸烟史及有无慢性病者老年痴呆患病率比较,差异均有统计学意义(P<0.05)。共收集到5606份慢性病患病情况数据,排名前五位的疾病分别是高血压〔2205(39.33%)〕、椎间盘疾病〔553(9.86%)〕、糖尿病〔526(9.38%)〕、脑血管病〔492(8.78%)〕、缺血性心脏病〔467(8.33%)〕。老年痴呆群体中排名前五位的疾病分别是高血压〔325(41.40%)〕、脑血管病〔111(14.14%)〕、缺血性心脏病〔91(11.59%)〕、类风湿关节炎〔89(11.33%)〕、椎间盘疾病〔81(10.31%)〕。0、1、2、≥3种不同慢性病患病数量群体的老年痴呆患病率依次为11.46%(214/1867)、13.66%(309/2262)、17.50%(176/1006)、18.26%(86/471)。有无胃肠炎、类风湿关节炎、脑血管病、慢性阻塞性肺疾病、缺血性心脏病者老年痴呆患病率比较,差异均有统计学意义(P<0.05)。二元Logistic回归分析结果显示,居住在农村〔OR=2.048,95%CI(1.655,2.536)〕、女性〔OR=1.388,95%CI(1.163,1.655)〕、年龄增大〔OBackground In the context of aging society in China,the prevalence of Alzheimer's disease increases and multimorbidity becomes more common with years.However,the extensive investigations of Alzheimer's disease in Hunan province have not been reported adequately and the multimorbidity relationship between relevant diseases remains unclear.Objective To completely understand the prevalence of Alzheimer's disease in residents aged 65 or above in Hunan and analyze its multimorbidity relationships with 11 common chronic diseases.Methods The residents aged 65 years and above in 30 districts(counties),60 streets(townships),and 180 neighborhood(village)committees in Hunan Province were randomly selected between April and May 2021 by using stratified multistage sampling method.Alzheimer's disease was diagnosed by a neurologist or psychiatrist using the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA),after using the Community Screening Interview for Dementia(CSI-D)or the 8-item ascertain dementia(AD8)as the screening tools.In addition,all respondents were investigated for the prevalence of hypertension,cerebrovascular disease,ischemic heart disease,rheumatoid arthritis,intervertebral disc disease,diabetes,gastroenteritis,chronic obstructive pulmonary disease,calculous cholecystitis,peptic ulcer and cancer.Results A total of 5979 residents were sampled,5616 of them completed the examinations and 785(13.98%)were diagnosed with Alzheimer's disease.There were significant differences in the prevalence of Alzheimer's disease among respondents with different regions,gender,age,smoking history and presence of other chronic diseases(P<0.05).The total number of patients with other chronic diseases among all respondents was 5606,with the top five diseases of hypertension〔2205(39.33%)〕,intervertebral disc disease〔553(9.86%)〕,diabetes〔526(9.38%)〕,cerebrovascular disease〔492(8.78%)〕,and ischemic heart disease〔467(8.33%)〕.The top five diseases in the dementia patients were hypertension〔325(

关 键 词：痴呆 阿尔茨海默病 老年人 认知障碍 慢性病共病 影响因素分析 湖南 

分 类 号：R749[医药卫生—神经病学与精神病学]