基于老年综合评估建立老年人痴呆的简易筛查模型  

A simple screening model of dementia in the elderly based on comprehensive geriatric assessment

作　　者：刘雅玲 欧阳晓俊 史晓兰 潘晓东 LIU Yaling;OUYANG Xiaojun;SHI Xiaolan;PAN Xiaodong(Department of Geriatrics,Jiangsu Province Geriatric Hospital,Nanjing,Jiangsu 210024,China)

机构地区：[1]江苏省老年病医院老年医学科,南京210024

出　　处：《重庆医学》2023年第S02期51-54,共4页Chongqing medicine

基　　金：江苏省卫生健康委员会老年科研课题(LK2021011)。

摘　　要：目的基于老年综合评估结果,建立老年人痴呆的简易筛查模型。方法选取2016年1月至2019年12月该院老年医学科住院的200例患者为研究对象,分为认识功能正常组(NC组,63例)和痴呆组(DC组,137例)。采集人口学及一般临床资料,行老年综合评估,包括简易精神状态量表(MMSE)、4 m步速测定、5次椅子坐立试验、握力、日常生活能力评定,比较两组差异,逻辑回归筛选痴呆的影响因素,建立老年人痴呆的简易筛查模型,受试者工作特征(ROC)曲线分析该模型的校准度和区分度。结果通过纳入的变量分析,筛选出年龄、工具性日常生活能力、4 m步速3个独立因素(P<0.05),老年人痴呆发病的筛查模型为:Logit(P)=-0.902-0.396×IADL-2.483×步速+0.085×年龄。该模型AUC为0.891,Hosmer-Lemeshow检验P=0.404,灵敏度83.2%,特异度85.7%。结论本研究建立痴呆筛查模型可用于无法行神经心理量表的人。Objective Based on the results of senile comprehensive assessment,a simple screening model for senile dementia was established.Methods A total of 200 patients admitted to Department of Geriatrics in this hospital from January 2016 to December 2019 were selected as the study objects and divided into the normal cognitive function group(NC group,63 cases)and the dementia group(DC group,137 cases).Demographic and general clinical data were collected,and comprehensive assessment of the elderly was performed,including the simple mental State Scale(MMSE),the measurement of 4-meter walking speed,five chair sit-stand tests,grip strength,and assessment of daily living ability.The differences between the two groups were compared,and the influencing factors of dementia were screened by logistic regression to establish a simple screening model for dementia in the elderly.Receiver operating characteristic(ROC)curves were used to analyze the calibration and differentiation of the model.Results Three independent factors of age,instrumental activities of daily living(IADL)and 4-meter walking speed were screened out(P<0.05).The screening model of dementia in the elderly was Logit(P)=-0.902-0.396×IADL-2.483×Walking Speed+0.085×Age.AUC of the model was 0.891,Hosmer Lemeshow test P=0.404,sensitivity was 83.2%,specificity was 85.7%.Conclusion This study established a dementia screening model that can be used in people who cannot perform neuropsychological scales.

关 键 词：老年综合评估 日常生活能力 步速 痴呆 模型 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R195.4[医药卫生—临床医学]