贵州农村老年人认知功能与日常生活能力的纵向关联研究  

A longitudinal correlation study between cognitive function andactivities of daily living in rural elderly,Guizhou

作　　者：王静[1] 桂诗琦 李秋硕 杨星[1,2] 周全湘 杨敬源 WANG Jing;GUI Shi-qi;LI Qiu-shuo;YANG Xing;ZHOU Quan-xiang;YANG Jing-yuan(Key Laboratory of Environmental Pollution and Disease Control of Ministry of Education,School of Public Hygiene and Health,Guizhou Medical University,Guiyang,Guizhou 550025,China;不详)

机构地区：[1]贵州医科大学公共卫生与健康学院,环境污染与疾病监控教育部重点实验室,贵州贵阳550025 [2]贵州医科大学医药卫生管理学院 [3]黔南民族医学高等专科学校

出　　处：《现代预防医学》2024年第22期4033-4037,4050,共6页Modern Preventive Medicine

基　　金：国家自然科学基金资助项目(81860598)。

摘　　要：目的探讨贵州农村老年人认知功能(Cognitive Function,CF)与日常生活能力(Activities of Daily Living,ADL)是否存在纵向相互关联,为预防和控制农村老年人健康问题提供理论依据。方法采用多阶段整群抽样方法,选取贵州省2个县(区)内12个村60岁及以上老年人为研究对象,于2019年进行基线(T_(1))调查,2022年进行随访(T_(2)),将同时完成两次调查且变量值完整的792例老年人纳入本次分析;采用交叉滞后模型分析认知功能与日常生活能力之间的纵向关系。结果在校正相应协变量后的交叉滞后分析结果显示,控制T_(1)认知功能后,T_(1)日常生活能力可以预测T_(2)认知功能(β=-0.120,P<0.001);控制T_(1)日常生活能力后,T_(1)认知功能可以预测T_(2)日常生活能力(β=-0.099,P=0.005)。进一步将ADL分为基础性日常生活能力(Basic Activities of Daily Living,BADL)和工具性日常生活能力(Instrumental Activities of Daily Living,IADL)后进行分析,在控制T_(1)认知功能后,T_(1)IADL能够预测T_(2)认知功能(β=-0.138,P<0.001),同样,控制T_(1)IADL后,T_(1)认知功能可以预测T_(2)IADL(β=-0.124,P<0.001),BADL与认知功能之间没有预测作用。结论贵州农村老年人的认知功能与日常生活能力(仅IADL)之间存在纵向双向关联,提示了加强监测与干预老年人的认知功能有助于减少老年人的工具性日常生活能力下降风险,加强对工具性日常生活能力的训练对延缓认知下降也具有重要作用。Objective To explore the longitudinal correlation between cognitive function(CF)and activities of daily living(ADL)of the rural elderly in Guizhou province,and to provide theoretical basis for preventing and controlling health problems of the elderly.Methods The multi-stage cluster random sampling method was used to select the elderly aged 60 years and above from 12 villages in 2 counties(districts)of Guizhou Province as the research objects.In this study,792 elderly people who participated in two surveys in 2019(T_(1))and 2022(T_(2))and were≥60 years old at baseline with complete variable values were selected as survey subjects.The cross-lagged model was used to investigate the longitudinal relationship between cognitive function and ADL.Results The cross-lagged model showed that T_(1) ADL could predict T_(2) cognitive function after controlling T_(1) cognitive function(β=-0.120,P<0.001).After controlling for T_(1) ADL,T_(1) cognitive function predicted T_(2) ADL(β=-0.099,P=0.005).In the study of the association between two dimensions of ADL and cognitive function,it was found that T_(1) IADL could predict T_(2) cognitive function after controlling for T_(1) cognitive function(β=-0.138,P<0.001).Similarly,after controlling T_(1) IADL,T_(1) cognitive function could predict T_(2) IADL(β=-0.124,P<0.001).But there was no predictive effect between BADL and cognitive function.Conclusion There is a longitudinal bidirectional correlation between cognitive function and activities of daily living of the rural elderly in Guizhou,only between IADL and cognitive function,suggesting that strengthening the monitoring and intervention of cognitive function of the elderly can help reducing the risk of the decline of IADL in the elderly,and strengthening the training of IADL plays an important role in delaying cognitive decline.

关 键 词：认知功能 日常生活能力 交叉滞后模型 

分 类 号：R195.4[医药卫生—卫生统计学]