健康生态学模型下社区轻度认知障碍老年人健康相关生命质量的影响因素  

Analysis of the influencing factors of health-related quality of life in community-dwelling elderly with mild cognitive impairment from the perspective of health ecology

作　　者：林嘉怡 朱燕波[1] 贾佳萌 罗宇豪 任家驹 丛建妮 娄悦恒 龙利群 曹锐 葛蒲 Lin Jiayi;Zhu Yanbo;Jia Jiameng;Luo Yuhao;Ren Jiaju;Cong Jianni;Lou Yueheng;Long Liqun;Cao Rui;Ge Pu(School of Management,Beijing University of Chinese Medicine,Beijing 102488,China;School of Chinese Medicine,Beijing University of Chinese Medicine,Beijing 102488,China;Dongsheng Community Health Service Center,Haidian District,Beijing 100083,China)

机构地区：[1]北京中医药大学管理学院,北京102488 [2]北京中医药大学中医学院,北京102488 [3]北京市海淀区东升镇社区卫生服务中心,北京100083

出　　处：《中华行为医学与脑科学杂志》2025年第3期245-251,共7页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：北京市自然科学基金(7222282);北京中医药大学基本科研业务费揭榜挂帅项目(2022-JYB-JBZR-036)。

摘　　要：目的基于健康生态学模型(HEM)分析社区轻度认知障碍(MCI)老年人的健康相关生命质量(HRQOL)现状及其影响因素。方法2023年12月至2024年9月,采用欧洲五维健康量表(EQ-5D-5L)、蒙特利尔认知评估量表(MoCA)、匹兹堡睡眠质量指数量表(PSQI)对北京、山东和重庆等地997名社区老年人进行横断面调查。采用Stata 18.0进行描述性分析、Mann-Whitney U检验、Kruskal-Wallis检验和Tobit回归分析。结果最终获得MCI有效样本324份,MCI老年人健康效用值为0.842(0.815,0.951),Tobit回归分析结果表明,个人特质层的≥80岁(β=-0.121,95%CI:-0.193~-0.050),行为特征层的不太运动(β=-0.196,95%CI:-0.255~-0.137)和睡眠质量较差(β=-0.064,95%CI:-0.116~-0.013),生活和工作条件层的主观经济状况差(β=-0.153,95%CI:-0.261~-0.045)是MCI老年人健康效用值的危险因素;行为特征层的饮酒(β=0.096,95%CI:0.022~0.171),人际网络层的参与社交活动(β=0.126,95%CI:0.062~0.190)是MCI老年人健康效用值的保护因素。结论社区MCI老年人HRQOL较低,其影响因素是多层次的,应结合HEM从个人特质到政策环境多维度加强对MCI老年人的干预和管理,提高其HRQOL。ObjectiveTo analyze the current situation of health-related quality of life(HRQOL)and its influencing factors among community-dwelling elderly with mild cognitive impairment(MCI)based on the health ecology model(HEM).MethodsFrom December 2023 to September 2024,a cross-sectional survey was conducted among 997 community-dwelling elderly in Beijing,Shandong,Chongqing and other regions.The EuroQol five-dimensional questionnaire 5 level(EQ-5D-5L),the Montreal cognitive assessment(MoCA),and the Pittsburgh sleep quality index(PSQI)were used to assess the subjects.Descriptive analysis,Mann-Whitney U test,Kruskal-Wallis test,and Tobit regression analysis were performed using Stata 18.0 software.ResultsA total of 324 valid samples were finally obtained,and the health utility value of MCI elderly was 0.842(0.815,0.951).Tobit regression analysis showed that≥80 years old(β=-0.121,95%CI=-0.193--0.050)in individual traits level,don't exercise(β=-0.196,95%CI=-0.255--0.137)and poor quality of sleep(β=-0.064,95%CI=-0.116--0.013)in behavior characteristics level,and poor subjective economic status(β=-0.153,95%CI=-0.261--0.045)in living and working conditions level were risk factors for the health utility value of the elderly with MCI.Drinking(β=0.096,95%CI=0.022-0.171)in behavior characteristics level and participating in social activities(β=0.126,95%CI=0.062-0.190)in interpersonal network level were protective factors for the health utility value of the elderly with MCI.ConclusionsThe HRQOL of the community-dwelling elderly with MCI in China is low,and its influencing factors are multi-level.HEM should be combined to strengthen the intervention and management of the elderly with MCI from personal constitution to policy environment to improve their HRQOL.

关 键 词：轻度认知障碍 健康生态学模型 健康相关生命质量 健康效用值 老年人 

分 类 号：R749.1[医药卫生—神经病学与精神病学]