贵州农村老年人可逆认知衰弱与日常生活功能受损、住院、跌倒的关联研究  

A study on the relationship between reversible cognitive decline and impairment of daily life function, hospitalization, and fall among the elderly in rural areas of Guizhou Province

作　　者：黄慧[1] 杨敬源[1] 杨星[1,2] 周全湘 高岚 蒋芸[1] 赵奕 朱宇杰 HUANG Hui;YANG Jing-yuan;YANG Xing;ZHOU Quan-xiang;GAO Lan;JIANG Yun;ZHAO Yi;ZHU Yu-jie(School of Public Health,Guizhou Medical University,Guiyang,Guizhou 550025,China;不详)

机构地区：[1]贵州医科大学公共卫生与健康学院、环境污染与疾病监控教育部重点实验室、贵州省卫生发展研究院,贵州贵阳550025 [2]贵州医科大学医药卫生管理学院 [3]贵州黔南民族医药高等专科学校 [4]贵阳市疾病预防控制中心

出　　处：《现代预防医学》2023年第21期3924-3929,共6页Modern Preventive Medicine

基　　金：国家自然科学基金资助项目(81860598)。

摘　　要：目的 了解农村老年人可逆认知衰弱与日常生活功能受损、住院、跌倒的关联,为预防老年人发生功能残疾、住院等不良结局及促进健康老龄化提供参考。方法 采用现况调查设计,多阶段整群抽样方法,选取贵州省2个县(区)内12个村60岁及以上老年人为研究对象,进行问卷调查及体格检查。通过多因素logistic回归模型分析并计算比值比(OR)和95%置信区间(CI)分析可逆认知衰弱与ADL受损、住院、跌倒之间关联。结果 此次纳入老年人1 279人,可逆认知衰弱的检出率为37.8%,ADL受损率为4.3%,住院率为19.0%,半年内跌倒率为10.7%。多因素二分类logistic回归调整混杂因素后结果显示,与无可逆认知衰弱的老年人相比,有可逆认知衰弱的老年人ADL受损风险较高(OR=4.492,95%CI:2.405~8.389),与住院风险存在关联(OR=1.371,95%CI:1.020~1.841),但与跌倒风险没有关联(OR=0.897,95%CI:0.612~1.313)。进一步对慢性病分层分析发现,可逆认知衰弱与ADL受损的关联依然存在(P<0.05),可逆认知衰弱与住院风险的关联仅存在于慢性病患者中(OR=1.466,95%CI:1.044~2.059)。结论 老年人可逆认知衰弱与ADL受损、住院之间存在关联,尽早识别可逆认知衰弱的高危人群并及时干预可能是改善老年人生活质量、减轻医疗负担的有效措施。Objective To investigate the relationship between reversible cognitive decline and impairment of daily life function,hospitalization and fall among the elderly in rural areas,so as to provide reference for preventing adverse outcomes such as functional disability and hospitalization and promoting healthy aging.Methods By using the method of cross-sectional survey and multi-stage cluster sampling,the elderly aged 60 and above in 12 villages in 2 counties(districts)of Guizhou Province were selected for questionnaire survey and physical examination.Multivariate logistic regression model was used to analyze and calculate the odds ratio(OR)and 95%confidence interval(CI)to analyze the correlation between reversible cognitive impairment and ADL impairment,hospitalization,and fall.Results In total 1279 elderly people were included,and the detection rate of reversible cognitive impairment was 37.8%.The damage rate was 4.3%,the hospitalization rate was 19.0%,and the fall rate within half a year was 10.7%.After adjusting the confounding factors by multivariate binomial logistic regression,the results showed that compared with the elderly with irreversible cognitive impairment,the elderly with reversible cognitive impairment had a higher risk of ADL impairment(OR=4.492,95%CI:2.405-8.389),which was associated with hospitalization risk(OR=1.371,95%CI:1.020-1.841),but not with fall risk(OR=0.897,95%CI:0.612-1.313).Further stratified analysis of chronic diseases showed that there was still a correlation between reversible cognitive impairment and ADL impairment,and the correlation between reversible cognitive impairment and hospitalization risk was found only in patients with chronic diseases(OR=1.466,95%CI:1.044-2.059).Conclusion There is a correlation between reversible cognitive impairment and ADL impairment and hospitalization in the elderly.Early identification of high-risk groups of reversible cognitive impairment and timely intervention may be effective measures to improve the quality of life and reduce the medical burden

关 键 词：可逆认知衰弱 日常生活功能受损 住院 跌倒 农村老年人 

分 类 号：TS976.34[轻工技术与工程]