嗅觉功能在轻度认知障碍老年人认知功能下降中的预测作用  

Predictive value of olfactory function for cognitive decline in older adults with mild cognitive impairment

作　　者：胡慧秀[1] 孙超[1] 赵雅洁 李美娟 邓颖[4] 张琳之 Hu Huixiu;Sun Chao;Zhao Yajie;Li Meijuan;Deng Ying;Zhang Linzhi(Nursing Department,Bejing Hospital&National Center of Gerontology&Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Bejing 100730,China;Department of Cardiology,Bejing Hospital&National Center of Gerontology&Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Otolaryngology,Bejing Hospital&National Center of Gerontology&Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Bejing 100730,China;Department of Neurosurgery,Bejing Hospital&National Center of Gerontology&Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Bejing 100730,China;School of Graduate,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]北京医院护理部、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [2]北京医院心内科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [3]北京医院耳鼻喉科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [4]北京医院神经外、科国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [5]中国医学科学院、北京协和医学院研究生院,北京100730

出　　处：《中华现代护理杂志》2024年第32期4359-4365,共7页Chinese Journal of Modern Nursing

基　　金：中央高校基本科研业务费专项资金资助(3332023093);国家自然科学基金(72304046);中央高水平医院临床科研业务费专项(BJ-2024-167);中华护理学会2022年度科研课题(ZHKYQ202216)。

摘　　要：目的分析嗅觉功能对于轻度认知障碍(MCI)老年人认知功能进一步下降的早期预测价值。方法采用便利抽样法,于2023年3月—2024年1月选取北京市东城区和丰台区两家社区卫生服务中心的385名MCI老年人为研究对象,对其进行6个月的追踪随访,进行一般资料、嗅觉功能检测、认知功能变化的数据收集,按照是否出现临床认知功能变化分为认知功能下降组和未下降组。采用二项Logistic回归分析探讨MCI老年人认知功能下降的独立影响因素,并采用受试者工作特征(ROC)曲线评价嗅觉功能对认知功能进一步下降的预测作用。结果385名MCI老年人中有113名(29.4%)出现认知功能下降。二项Logistic回归分析结果显示,受教育程度、被动认知活动、社交活动、嗅觉障碍是MCI老年人认知功能下降的独立影响因素(P<0.05)。ROC曲线下面积为0.819(95%CI:0.773~0.865,P<0.01),最佳临界值为9.5分,对应的灵敏度为81.3%,特异度为31.0%。结论嗅觉功能对于MCI老年人认知功能进一步下降具有良好预测价值,可用于早期筛查认知功能快速下降的MCI高危个体。Objective To analyze the early predictive value of olfactory function for cognitive decline in older adults with mild cognitive impairment(MCI).MethodsFrom March 2023 to January 2024,convenience sampling was used to select 385 older adults with MCI from two community health service centers in Dongcheng District and Fengtai District of Beijing as participants.Participants were followed up for six months to collect data on general information,olfactory function testing,and cognitive function.According to whether there were changes in clinical cognitive function,older adults were divided into a cognitive function decline group and a cognitive function non-decline group.Binary Logistic regression was used to analyze the independent influencing factors of cognitive decline in older adults with MCI,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive effect of olfactory function on cognitive decline.Results Among 385 older adults with MCI,113(29.4%)experienced cognitive decline.Binary Logistic regression analysis showed that education level,passive cognition activity,social activity,and olfactory dysfunction were independent influencing factors for cognitive decline in older adults with MCI(P<0.05).The area under the ROC curve was 0.819[95%CI(0.773,0.865),P<0.01],with an optimal cutoff value of 9.5 points,a sensitivity of 81.3%and specificity of 31.0%.Conclusions The olfactory function has good predictive value for cognitive decline in older adults with MCI,and can be used for early screening of MCI high-risk individuals with rapid cognitive decline.

关 键 词：老年人 轻度认知障碍 嗅觉 认知下降 预测 

分 类 号：R749.1[医药卫生—神经病学与精神病学]