社区中老年人降低痴呆风险的知信行类型及认知功能差异性研究  

Types of Knowledge,Beliefs,Behaviors of Reducing Dementia Risk in Middle-aged and Elderly Adults in Community and Difference Analysis of Cognitive Function

作　　者：彭滟 刘晓 张巾英 李洁 邓梦惠 李媛媛 杨燕妮[1] PENG Yan;LIU Xiao;ZHANG Jinying;LI Jie;DENG Menghui;LI Yuanyuan;YANG Yanni(Department of Fundamental Nursing,School of Nursing,Army Medical University/Third Military Medical University,Chongqing 400038,China;Tongjiaqiao Community Health Service Center,Shapingba District,Chongqing 400038,China)

机构地区：[1]陆军军医大学第三军医大学护理系基础护理学教研室,重庆市400038 [2]重庆市沙坪坝区童家桥社区卫生服务中心,400038

出　　处：《中国全科医学》2024年第5期521-526,546,共7页Chinese General Practice

基　　金：2020年度国家社会科学基金项目(20BRK039)。

摘　　要：背景生活行为方式是痴呆重要的可调控风险因素,知识和信念又是影响生活方式的重要原因。然而,目前尚缺乏针对降低痴呆风险的知识、信念、行为的类型研究,不同知信行类型居民的痴呆风险及认知功能是否有差异也未可知。目的了解社区中老年人群降低痴呆风险的知识、信念和行为现状,探索分析其知信行类型及认知功能差异,为社区制订有针对性的痴呆预防措施提供依据。方法2021年3月—2022年2月采用便利抽样法选取重庆市沙坪坝区5个社区中参加社区卫生服务中心免费体检并建立健康管理档案的中老年人为调查对象。采用一般资料问卷、痴呆预防相关知识量表(DKAS)、改变生活方式和健康行为以降低痴呆风险的动机量表(MCLHB-DRR)、降低痴呆风险的生活方式量表(DRRLS)、蒙特利尔认知评估量表(MoCA)北京版及心血管风险因素、衰老和痴呆风险(CAIDE)评分进行调查。采用K-means聚类分析,对居民降低痴呆风险的知识、信念和行为表现进行分类,比较分析不同类型间一般资料、认知功能及痴呆风险的差异。结果共发放调查问卷232份,回收有效问卷211份,有效回收率为90.9%。聚类分析结果显示,社区中老年人降低痴呆风险的知识、知信念和行为表现可分为3个类型:知信行优良型、低知识-行为不良型、低信念-行为不良型,分别占比为39.8%(84/211)、37.4%(79/211)、22.8%(48/211)。知信行优良型社区中老年人平均受教育年限高于低知识-行为不良型(t=2.703,P<0.001)、低信念-行为不良型(t=1.524,P=0.022)。低知识-行为不良型(t=1.431,P<0.001)、低信念-行为不良型(t=1.080,P=0.002)社区中老年人CAIDE得分高于知信行优良型。低知识-行为不良型社区中老年人MoCA得分低于知信行优良型(t=-2.529,P<0.001)、低信念-行为不良型(t=-1.869,P=0.018)。结论重庆市中老年人降低痴呆风险的知信行类型可分为知信Background Lifestyle is an important modifiable risk factor for dementia.Knowledge and beliefs are important factors affecting lifestyle.However,there is a lack of research on the types of knowledge,beliefs,behaviors of reducing dementia risk,and it remains unclear whether there are differences in dementia risk and cognitive function among residents with different types of knowledge,belief,and behavior.Objective To understand the current situation of knowledge,beliefs,behaviors of reducing dementia risk in the middle-aged and elderly adults in the community,explore and analyze the types of knowledge,beliefs and behaviors and the differences of cognitive function,and provide a basis for the development of targeted dementia prevention measures in the community.Methods From March 2021 to February 2022,middle-aged and elderly adults who participated in free health checkups at community health centers and established health management files in five communities in Shapingba District of Chongqing were selected as the survey objects by convenience sampling method.The general information questionnaire,Dementia Knowledge Assessment Scale(DKAS),Motivation to Change Lifestyle and Health Behaviors for Dementia Risk Reduction(MCLHB-DRR),Dementia Risk Reduction Lifestyle Scale(DRRLS),Beijing version of Montreal Cognitive Assessment(MoCA)and Cardiovascular Risk Factors,Aging and Dementia(CAIDE)scores were used for the investigation.K-means cluster analysis was used to classify the knowledge,beliefs,behaviors of reducing dementia risk of residents,and the differences in demographic characteristics,cognitive function and dementia risk among different types were compared and analyzed.Results A total of 232 questionnaires distributed and 211 valid questionnaires were recovered,with an effective recovery rate of 90.9%.The cluster analysis results showed that the knowledge,beliefs and behaviors of reducing dementia risk of the middle-aged and elderly adults in the community could be divided into three types of good knowledge,beliefs a

关 键 词：痴呆 认知 中年人 老年人 社区 生活方式 聚类分析 

分 类 号：R749.16[医药卫生—神经病学与精神病学]