步速联合生活空间移动性在老年2型糖尿病患者轻度认知障碍中的预测作用  

Prediction of mild cognitive impairment in elderly patients with type 2 diabetes mellitus by walking speed combined with life-space mobility

作　　者：张海燕 于卫华 张利 邓曼 张雨溪 杨侠 Zhang Haiyan;Yu Weihua;Zhang Li;Deng Man;Zhang Yuxi;Yang Xia(School of Nursing,Anhui Medical University,Hefei 230032,China;Department of Nursing,the Third Affiliated Hospital of Anhui Medical University,Hefei 230062,China)

机构地区：[1]安徽医科大学护理学院,合肥230032 [2]安徽医科大学第三附属医院护理部,合肥230062

出　　处：《中华现代护理杂志》2024年第12期1567-1574,共8页Chinese Journal of Modern Nursing

基　　金：国家重点研发计划(2020YFC2008802);安徽医科大学研究生科研与实践创新项目(YJS20230066);安徽医科大学护理学院研究生青苗培育项目(hlqm12023040)。

摘　　要：目的探究社区老年2型糖尿病患者步速、生活空间移动性(LSM)与认知功能及轻度认知障碍(MCI)之间的关系,比较步速、LSM单独和联合应用对于老年2型糖尿病患者MCI的预测价值。方法本研究为横断面研究。采用便利抽样法,选取2022年9月—2023年5月合肥市某3个社区的448例老年2型糖尿病患者为研究对象,使用4 m步速试验测量日常步速,使用中文版生活空间评估量表(LSA)评估LSM,使用中文版蒙特利尔认知评估量表(MoCA)评估认知功能并将其分为MCI组和非MCI组。采用Spearman相关分析研究步速、LSM与认知功能之间的关系;采用Logistic回归分析研究步速、LSM和MCI之间的关系;采用受试者工作特征曲线下面积(AUC)比较步速、中文版LSA评分单独及联合预测MCI的作用。结果步速、中文版LSA评分均与中文版MoCA评分呈正相关(r值分别为0.598、0.543,P<0.05)。中文版LSA评分(OR=0.942)、步速评分(OR=0.490)是老年2型糖尿病患者MCI的影响因素(P<0.05)。步速预测MCI的AUC为0.875、截断值为3分;中文版LSA评分预测MCI的AUC为0.887,截断值为59分;二者联合预测MCI的AUC为0.915,截断值为中文版LSA评分55分、步速评分为3分。结论步速、LSM联合应用较单独应用可以更准确地预测老年2型糖尿病患者MCI的发生,为改善老年2型糖尿病患者的认知功能提供了参考依据。Objective To investigate the relationship between walking speed,life-space mobility(LSM),cognitive function and mild cognitive impairment(MCI)in elderly patients with type 2 diabetes mellitus in community,and compare the predictive value of walking speed and LSM alone and combined in elderly patients with type 2 diabetes mellitus.Methods This was a cross-sectional study.Using the convenient sampling method,a total of 448 elderly patients with type 2 diabetes mellitus from three communities in Hefei City were selected as the research objects from September 2022 to May 2023.Daily walking speed was measured using the 4-Meter Walking Speed,LSM was assessed using the Chinese version of Life-Space Assessment(LSA),and cognitive function was evaluated using the Chinese version of Montreal Cognitive Assessment(MoCA).Participants were divided to the MCI group and non-MCI group.Spearman correlation analysis was used to explore the relationships between walking speed,LSM and cognitive function.Logistic regression analysis was used to analyze the relationship between walking speed,LSM and MCI.Area under the curve(AUC)of receiver operating characteristic(ROC)curve analysis was performed to compare the effects of walking speed and Chinese version LSA score on the prediction of MCI alone and in combination.Results The walking speed and the Chinese version LSA score were both positively correlated with the Chinese version MoCA score(r=0.598,0.543;P<0.05).Chinese version LSA score(OR=0.942)and walking speed score(OR=0.490)were influencing factors for MCI in elderly patients with type 2 diabetes mellitus(P<0.05).The AUC for walking speed in predicting MCI was 0.875,with a cutoff value of 3 points.Chinese version LSA score in predicting MCI had an AUC of 0.887 with a cutoff value of 59 points.When used in combination,they achieved an AUC of 0.915,with cutoff values of 55 points for Chinese version LSA scores and 3 points for walking speed scores.Conclusions The combination of walking speed and LSM can more accurately predict the occ

关 键 词：糖尿病 2型 认知功能 轻度认知障碍 社区老年人 步速 生活空间移动性 

分 类 号：R473.5[医药卫生—护理学]