广州城区60岁及以上不同年龄段认知功能正常的老年人不同认知维度变化的随访研究  

A follow-up study on the changes of different cognitive dimensions in the elderly aged 60 years and above with normal cognitive function of different age groups in urban areas of Guangzhou

作　　者：董洁 苏婵 张若曦 唐牟尼[4] Dong Jie;Su Chan;Zhang Ruoxi;Tang Muni(Department of Psychiatry,Hainan General Hospital,Haikou 570100,China;Department of Adult Psychiatry,Brain Hospital Affiliated to Guangzhou Medical University,Guangzhou 510145,China;Department of Affective Disorders,Brain Hospital Affiliated to Guangzhou Medical University,Guangzhou 510145,China;Department of Geriatric Psychiatry,Brain Hospital Affiliated to Guangzhou Medical University,Guangzhou 510145,China)

机构地区：[1]海南省人民医院精神心理科,海口570100 [2]广州医科大学附属脑科医院成人精神科,广州510145 [3]广州医科大学附属脑科医院情感障碍科,广州510145 [4]广州医科大学附属脑科医院老年精神科,广州510145

出　　处：《中华精神科杂志》2024年第6期360-366,共7页Chinese Journal of Psychiatry

基　　金：国家科技支撑计划项目(2009BAI77B03)。

摘　　要：目的:探讨不同年龄段认知功能正常的老年人随时间进展各认知维度变化的特点。方法:以广州某城区60岁及以上人群为研究对象,以简明精神状态检查(Mini-mental State Examination,MMSE)、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)、世界卫生组织成套神经心理测验(World Health Organization-Battery of Cognitive Assessment Instrument for Elderly,WHO-BCAI)等为调查工具,筛选出认知功能正常的被试者共281名,分为高龄组(≥80岁)、中龄组(70~79岁)和低龄组(60~69岁),分别于1年和5年后对被试者进行随访研究,应用混合线性模型分析比较随时间变化不同年龄组不同认知维度(包括数字广度、听觉词语、联想学习、视觉辨认、语言流畅性、延迟回忆、韦氏填图、韦氏木块图)的变化差异和特点,组间两两比较采用Bonferroni法进行对比校正。结果:(1)在不同调查时间3个年龄组间MMSE(F=32.22)、MoCA(F=42.98)、数字广度(F=3.62)、听觉词语(F=30.21)、联想学习(F=17.97)、视觉辨认(F=18.62)、语言流畅性(F=15.17)、延迟回忆(F=33.43)、韦氏填图(F=19.92)、韦氏木块图(F=18.51)评分差异均有统计学意义(P<0.01或P<0.05)。(2)Bonferroni多重均数比较校正结果显示,与基线时相比,第1次随访时低龄组、中龄组听觉词语得分显著上升(t=3.73、3.98,均P<0.05);与基线时相比,第2次随访时3个年龄组MMSE(t=-4.64、-4.48、-4.28)和MoCA(t=-6.22、-5.11、-4.38)得分均有显著下降(均P<0.01),低龄组数字广度、韦氏木块图得分显著下降(t=-2.75、-2.54,均P<0.05),听觉词语得分显著上升(t=3.01,P<0.05)。第2次随访时与第1次随访时相比,3个年龄组MMSE(t=-4.85、-2.70、-2.61)和MoCA(t=-6.52、-5.67、-3.89)得分均有显著下降(均P<0.05),低龄组和中龄组韦氏填图得分显著下降(t=-3.57、-2.61,P<0.05),低龄组韦氏木块图得分显著下降(t=-2.79,P<0.05)。结论:随着时间推移低龄组老年人的持续注意、短时�Objective To explore the characteristics of the changes in each cognitive dimension of the elderly with normal cognitive function in different age groups over time.Methods Individuals aged 60 and above in an urban area of Guangzhou were invited to participate in the study.Mini-mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),and the World Health Organization Complete Set of Neuropsychological Tests(WHO-BCAI)were used,a total of 281 subjects with normal cognitive function were enrolled and allocated into the senior age group(≥80 years old),the middle age group(70-79 years old)and the younger age group(60-69 years old).All of the subjects were followed up after 1 year and 5 years.Mixed linear model was used to analyze the differences and characteristics of different cognitive dimensions(including numerical breadth,auditory words,associative learning,visual recognition,language fluency,delayed recall,Wechsler mapping,and Wechsler block diagrams)in different age groups over time.Results The differences of all cognitive assessment items between the three age groups at different survey times were statistically significant,including MMSE(F=32.22,P<0.01),MoCA(F=42.98,P<0.01),Digital Breadth(F=3.62,P<0.05),Auditory Words(F=30.21,P<0.01),Associative Learning(F=17.97,P<0.01),Visual Recognition(F=18.62,P<0.01),Language Fluency(F=15.17,P<0.01),Delayed Recall(F=33.43,P<0.01),Wechsler Mapping(F=19.92,P<0.01),and Wechsler Block Diagram(F=18.51,P<0.01).The results of Bonferroni multiple means comparison showed that when comparing to the baseline and the one-year follow-up timepoint,the auditory word scores of the elderly in the younger and middle-age groups were significantly increased(t=3.73,P<0.05;t=3.98,P<0.05).When comparing to the 5-year follow-up and the baseline,the MMSE scores of the elderly in the three age groups(t=-4.64,P<0.05;t=-4.48,P<0.05;t=-4.28,P<0.05)were significantly decreased,the numerical breadth and Wechsler block diagram scores of the elderly in the younger age group were significantly d

关 键 词：认知 老年人 随访研究 

分 类 号：R749[医药卫生—神经病学与精神病学]