老年认知损害患者的老年综合征罹患情况  

The prevalenc of geriatric syndrome in elderly patients with cognitive impairment

作　　者：王秋梅 李娇娇 刘晓红 孙晓红 WANG Qiumei;LI Jiaojiao;LIU Xiaohong;SUN Xiaohong(Department of Geriatrics,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院老年医学科,北京100730

出　　处：《中国临床保健杂志》2025年第1期58-62,共5页Chinese Journal of Clinical Healthcare

基　　金：中央高水平医院临床科研专项(2022-PUMCH-B-132)。

摘　　要：目的探讨认知损害患者的老年综合征罹患情况,为临床干预提供依据。方法回顾性分析2016年9月至2019年6月在北京协和医院老年示范病房住院且有老年综合评估数据的497例老年患者临床资料,分析认知损害患者的老年综合征及躯体功能相关状况,用多因素logistic回归分析探讨认知损害与老年综合征的相关性。结果497例患者中,男性占47.1%,年龄75.0(69.0,81.0)岁;176例(35.4%)有认知损害,日常生活活动能力Barthel指数95.0(75.0,100.0)分;认知损害患者感官功能(视力、听力、嗅觉和味觉)明显下降的发生率均大于10%;营养不良(16.8%)和营养不良风险(34.1%)、尿失禁(34.1%)、便秘(34.7%)和大便失禁(9.1%)等发生率,均明显高于认知功能正常组(P<0.05)。认知损害老年人的握力、步速、5次起坐测试和简易体能状况量表评分均明显低于认知功能正常组(P<0.05)。多因素logistic回归分析提示听力下降(OR=2.38,95%CI:1.09~5.18,P=0.029)、尿失禁(OR=1.46,95%CI:1.09~1.95,P=0.012)和营养不良(OR=1.44,95%CI:1.03~2.02,P=0.032)与认知功能损害明显相关。结论认知损害患者的老年综合征罹患率很高,需要进行全面的老年综合评估,进行针对性个体化管理。Objective To explore the prevalence of geriatric syndrome in patients with cognitive impairment,providing the evidence for clinical intervention.Methods The clinical data of 497 elderly patients admitted to the geriatric demonstration ward of Peking Union Medical College Hospital from September 2016 to June 2019,with comprehensive geriatric assessment data for the elderly were analyzed retrospectively.The geriatric syndrome and physical function related status of patients with cognitive impairment were analyzed based on comprehensive evaluation data of elderly hospitalized patients.The correlation between cognitive impairment and geriatric syndrome was explored by using multiple logistic regression analysis.Results Among the 497 patients,males accounted for 47.1%,with an age of 75.0(69.0,81.0)years.Of these,176(35.4%)had cognitive impairment,and the Barthel Index for activities of daily living was 95.0(75.0,100.0)points.The incidences of significant decline in sensory functions(vision,hearing,smell,and taste)in patients with cognitive impairment were all more than 10%;other common geriatric syndromes,such as malnutrition(16.8%)and malnutrition risk(34.1%),urinary incontinence(34.1%),constipation(34.7%),and fecal incontinence(9.1%),were significantly higher than those with normal cognitive function(P<0.05).Elderly patients with cognitive impairment had decreased physical function,with grip strength,walking speed,5-time sit-to-stand test,and SPPB scores were significantly lower than those with normal cognitive function.Multivariate logistic analysis suggested that hearing loss(OR=2.38,95%CI:1.09-5.18,P=0.029),urinary incontinence(OR=1.46,95%CI:1.09-1.95,P=0.012),and malnutrition(OR=1.44,95%CI:1.03-2.02,P=0.032)were significantly associated with cognitive impairment.Conclusion The prevalence of geriatric syndrome in patients with cognitive impairment is high,which is need of a comprehensive geriatric assessment and individualized comprehensive management.

关 键 词：老年综合征 认知功能障碍 患病率 综合评估 老年人 

分 类 号：R47[医药卫生—护理学]