中国老年期痴呆残疾的现况调查  

A cross-sectional study of disability rate of dementia and risk factors in Chinese old people

作　　者：吴闻雷 黄悦勤 刘肇瑞[2] 张婷婷[2] 马超[2] 徐一峰 李涛[4,15] 许秀峰[5] 于雅琴 闫永平[7] 王志忠[8,17] 徐向东 王丽敏[10] 李强 徐广明[12] 肖水源[13] 李凌江 WU Wenlei;HUANG Yueqin;LIU Zhaorui;ZHANG Tingting;MA Chao;XU Yifeng;LI Tao;XU Xiufeng;YU Yaqin;YAN Yongping;WANG Zhizhong;XU Xiangdong;WANG Limin;LI Qiang;XU Guangming;XIAO Shuiyuan;LI Lingjiang(Institute of Medical Technology,Peking University Health Science Center,Beijing 100191,China;Peking University Sixth Hospital,Peking University Institute of Mental Health,NHC Key Laboratory of Mental Health(Peking University),National Clinical Research Center for Mental Disorders(Peking University Sixth Hospital),Bejjing 100083,China;Shanghai Mental Health Center,School of Medicine,Shanghai Jiao Tong University,Shanghai 200030,China;Mental Health Centre of West China Hospital,Sichuan University,Chengdu 610041,China;Department of Psychiatry,The First Afiliated Hospital of Kunming Medical University,Kunming 650032,China;School of Public Health,Jilin University,Changchun 130021,China;Department of Epidemiology,School of Public Health,the Fouth Military Medical University,Xi'an 710032,China;Department of Epidemiology and Statistics,School of Public Health and Management,Ningxia Medical University,Yinchuan 750004,China;The Fourth People's Hospital in Urumqi,Urumqi 830002,China;National Center for Chronic and Nonommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Institute of Social Science Survey,Peking University,Bejing 100871,China;Tianjin Anding Hospital,Mental Health Center of Tianjin Medical University,Tianjin 300222,China;School of Public Health,Central South University,Changsha 410078,China;Mental Health Institute,the Second Xiangya Hospital,Central-south University,Changsha 410011,China)

机构地区：[1]北京大学医学部医学技术研究院,北京100191 [2]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083 [3]上海市精神卫生中心,上海交通大学医学院,上海200030 [4]四川大学华西医院心理卫生中心,成都610041 [5]昆明医科大学第一附属医院精神科,昆明650032 [6]吉林大学公共卫生学院,长春130021 [7]第四军医大学,预防医学系流行病学教研室,西安710032 [8]宁夏医科大学公共卫生与管理学院流行病与卫生统计学系,银川750004 [9]乌鲁木齐市第四人民医院,乌鲁木齐830002 [10]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050 [11]北京大学中国社会科学调查中心,北京100871 [12]天津市安定医院,天津医科大学精神卫生中心,天津300222 [13]中南大学公共卫生学院,长沙410078 [14]中南大学湘雅二医院精神卫生研究所,长沙410011 [15]浙江大学医学院附属精神卫生中心/杭州市第七人民医院 [16]珠海科技学院 [17]广东医科大学

出　　处：《中国心理卫生杂志》2024年第11期936-942,共7页Chinese Mental Health Journal

基　　金：国家重点研发计划(2017YFC0907800、2017YFC0907801);“十二五”国家科技支撑计划(2012BAI01B01);卫生部公益性行业科研专项(201202022)。

摘　　要：目的:描述中国社区65岁及以上老年期痴呆残疾现况,探讨残疾的危险因素。方法:对中国精神卫生调查数据进行深入分析,采用世界卫生组织残疾评定量表2.0(WHODAS 2.0)对老年期痴呆的残疾状况进行评定,采用社区痴呆筛查表(CSID)和老年精神状况检查(GMS)对老年期痴呆进行筛查和诊断。采用单因素分析方法描述老年期痴呆加权残疾率和致残率及其分布,采用多因素分析方法的多重线性回归和logistic回归分析老年期痴呆残疾及其严重程度的危险因素。结果:老年期痴呆加权残疾率为2.1%,加权致残率为38.6%,存在共病者残疾率和致残率均高于单一老年期痴呆。女性、高龄、低受教育程度、低收入水平、CSID-受访者问卷低分者残疾率高;女性、城市居民致残率较高。多重线性回归显示与WHODAS得分有统计学关联的因素为收入水平(β=0.11)、性别(β=0.11)、年龄(β=0.10)和12月治疗(β=-0.20);logistic回归显示与残疾发生有统计学关联的因素为女性(OR=2.81)和12月治疗(OR=2.38)。结论:低收入水平、女性和高龄者是老年期痴呆残疾的高危人群,应该高度重视老年期痴呆及其残疾的预防。Objective:To describe disability rates of dementia in community residents aged 65 years and over in China,and explore related risk factors of disability.Methods:This study conducted an in-depth data analysis of the China Mental Health Survey.World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)was used to assess dementia disability,Community Screening Interview for Dementia(CSID)and Geriatric Mental Status Examination(GMS)were used for dementia screening and diagnosing.Univariate analysis was used to calculate the weighted disability rates of dementia in population and in patients,and their population distribution.Multiple linear regression and logistic regression were used to analyze the risk factors of the occurrence of dementia disability and its severity.Results:The weighted disability rate of dementia was 2.1%in population,and 38.6%in patients.The disability rates of comorbid dementia in population and in patients were higher than those of patients with only dementia.Female,older age,lower education level,lower economic status,and lower cognitive test scores in CSID had higher disability rates of dementia in population.Female and urban resident had higher disability rates of dementia in patients.Multiple linear regression showed economic status(β=0.11),gender(β=0.11),age(β=0.10),and treatment in the last 12 months(β=-0.20)were statistically associated with WHODAS 2.0 scores.Multiple logistic regression showed female(OR=2.81)and treatment in the last 12 months(OR=2.38)were statistically associated with disability.Conclusions:Persons with low economic status,female and elderly people are the high-risk groups for dementia disability.It should be paid attention to prevent dementia and its consequential disabilities.

关 键 词：老年人 痴呆 精神残疾 残疾率 致残率 危险因素 

分 类 号：R749.16[医药卫生—神经病学与精神病学] R181.32[医药卫生—临床医学]