基于影响因素的老年阿尔茨海默病认知功能障碍预测模型构建及电子化认知康复训练的应用价值  

Construction of predictive model for cognitive impairment in elderly patients with Alzheimer's disease based on influencing factors and application value of electronic cognitive rehabilitation training

作　　者：郭翃江[1] 符雪彩[1] 朱妍妍 严之红[1] 王丽娜[1] 纪红[1] Guo Hongjiang;Fu Xuecai;Zhu Yanyan;Yan Zhihong;Wang Lina;Ji Hong(Second Department of Geriatrics,Aerospace Center Hospital,Beijing 100040,China)

机构地区：[1]航天中心医院老年医学二科,北京100040

出　　处：《中华脑科疾病与康复杂志（电子版）》2023年第3期156-161,共6页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：中国航天科工集团有限公司医疗卫生科研项目(2019-LCYL-012)。

摘　　要：目的探讨基于影响因素的老年阿尔茨海默病(AD)认知功能障碍预测模型的构建及电子化认知康复训练的应用价值。方法选择航天中心医院老年医学二科自2019年1月至2020年1月收治的102例老年AD认知功能障碍患者作为观察组,根据治疗方式的不同分为2个亚组,常规认知干预组(51例)和电子化认知康复训练组(51例)。选择同期50例诊断正常的老年人作为对照组。采用单因素和Logistic回归分析构建基于影响因素的老年AD认知功能障碍的预测模型。采用蒙特利尔认知评估量表(MoCA)、日常生活活动能力量表(ADL)评估所有患者的认知功能和日常生活能力。结果观察组和对照组在年龄、职业状况、高脂血症占比、服用阿司匹林占比方面比较,差异具有统计学意义(P<0.05);Logistic回归分析结果显示,脑力劳动是老年AD认知功能障碍的危险因素(OR=0.348,P<0.05);采用ROC曲线评价老年AD认知功能障碍预测模型,灵敏度为95.06%,特异度为92.01%,曲线下面积为0.908(95%CI:0.879~1.000)。2组患者干预后MoCA评分均高于干预前,且电子化认知康复训练组高于常规认知干预组,差异具有统计学意义(P<0.05)。2组患者干预后ADL评分均低于干预前,且电子化认知康复训练组低于常规认知干预组,差异具有统计学意义(P<0.05)。结论预测模型显示,职业状况是老年AD认知功能障碍的影响因素,其中脑力劳动是老年AD认知功能障碍的一个危险因素,电子化认知康复训练可改善老年AD认知功能障碍患者的认知功能及提高其日常活动能力。Objective To explore the construction of a predictive model for cognitive impairment in elderly patients with Alzheimer's disease(AD)based on influencing factors and the application value of electronic cognitive rehabilitation training.Methods A total of 102 elderly patients with AD cognitive dysfunction admitted to the Second Department of Geriatrics of Aerospace Center Hospital from January 2019 to January 2020 were selected as the observation group,which were divided into two subgroups according to different treatment methods,including conventional cognitive intervention group(51 cases)and electronic cognitive rehabilitation training group(51 cases).The 50 elderly patients with normal diagnosis in the same period were selected as the control group.Univariate Logistic regression analysis was used to construct a predictive model of cognitive dysfunction in aged AD based on protective factors.Cognitive function and daily living performance were assessed using the Montreal cognitive assessment scale(MoCA)and the activities of daily living(ADL)scale.Results The differences between observation and control groups were statistically significant in age,occupational status,proportion of hyperlipidemia and proportion of aspirin(P<0.05);Logistic regression analysis showed that mental work was a risk factor for cognitive dysfunction in aged AD(OR=0.348,P<0.05);The ROC curve was used to evaluate the predictive model of cognitive dysfunction in elderly AD,with a sensitivity of 95.06%,a specificity of 92.01%,and a area under the curve of 0.908(95%CI:0.879-1.000).The MoCA scores of both groups of patients after intervention were higher than before intervention,and that of the electronic cognitive rehabilitation training group was higher than that of the conventional cognitive intervention group,with a statistically significant difference(P<0.05).The ADL scores of the patients in the 2 groups were lower than those before the intervention,and the electronic cognitive rehabilitation training group was lower than the conventional

关 键 词：阿尔茨海默病 认知功能障碍 老年 预测模型 电子化认知康复训练 

分 类 号：R749.16[医药卫生—神经病学与精神病学]