广州市番禺区≥65岁门诊老年患者认知障碍患病率及危险因素分析  

Analysis of the prevalence and risk factors of cognitive impairment in elderly outpatients aged≥65 years in Panyu District of Guangzhou City

作　　者：张垚 王小妹 戴锦媚 符镇发 陈汉威 何炳接 ZHANG Yao;WANG Xiaomei;DAI Jinmei;FU Zhenfa;CHEN Hanwei;HE Bingjie(Guangzhou Panyu District Health Management Center(Guangzhou Panyu District Rehabilitation Hospital),Guangzhou,Guangdong 511400,China;Law School,Guangdong University of Technology,Guangzhou,Guangdong 510520,China;Department of Neurology,Guangzhou Panyu District Maternal and Child Health Hospital(He Xian Memorial Hospital Affiliated to Southern Medical University),Guangzhou,Guangdong 511400,China;Department of Traditional Chinese Medicine,Guangzhou Panyu District Shilou Town Community Health Service Center,Guangzhou,Guangdong 511400,China)

机构地区：[1]广州市番禺区健康管理中心(广州市番禺区康复医院),广东广州511400 [2]广东工业大学法学院,广东广州510520 [3]广州市番禺区妇幼保健院(南方医科大学附属何贤纪念医院)神经内科,广东广州511400 [4]广州市番禺区石楼镇社区卫生服务中心中医科,广东广州511400

出　　处：《职业与健康》2025年第2期206-211,216,共7页Occupation and Health

基　　金：广州市卫生健康科技项目(20231A041009);广州市番禺区重点医疗项目(2022-Z04-106);广州市番禺区科技计划重大项目(2022-Z04-114);广州市卫生健康科技一般项目(20241A010110)。

摘　　要：目的了解广州市番禺区≥65岁门诊老年患者认知障碍患病率及其潜在危险因素,防止和推迟认知功能由轻度认知障碍阶段向痴呆阶段转化。方法收集2023年1—12月在广州市番禺区健康管理中心、石楼社区卫生服务中心、东环街道社区卫生服务中心、桥南街道社区卫生服务中心和沙头街社区卫生服务中心门诊就诊或健康检查的≥65岁患者的数据,采用简易精神状态检查量表(mini-mental state examination,MMSE)进行认知评估,统计认知障碍的患病率,并进行多因素logistic回归分析。结果10075名≥65岁老年参与者中,认知障碍患病为6065人,患病率为61.2%。多因素logistic分析确定了与认知障碍独立相关的5个可干预的危险因素,卒中(OR=1.363,95%CI:1.160~1.603)、高脂血症(OR=1.785,95%CI:1.681~1.905)、失眠(OR=2.387,95%CI:2.144~2.659)、精神疾病(OR=3.104,95%CI:1.721~5.598)和饮酒(OR=1.333,95%CI:1.074~1.654)。亚组分析显示,帕金森病是女性老年人认知障碍的另一个危险因素。结论广州市番禺区≥65岁门诊老年患者认知障碍患病率较高,实施有针对性的干预措施和综合管理策略,并降低5个可干预的危险因素对降低该人群认知障碍的发病率十分重要。Objective To investigate the prevalence rate and potential risk factors of cognitive impairment in elderly patients aged≥65 years in Panyu district of Guangzhou,and to prevent and delay the transformation of cognitive function from mild cognitive impairment to dementia.Methods The data of patients aged≥65 years who seek outpatient treatment or undergo health examination in Panyu District Health Management Center,Shilou Community Health Service Center,Donghuan Street Community Health Service Center,Qiaonan Street Community Health Service Center and Shatou Street Community Health Service Center in Guangzhou from January to December 2023 were collected.The mini-mental state examination(MMSE)was used for cognitive assessment,and the prevalence of cognitive impairment was statistically analyzed and multivariate logistic regression analysis was performed.Results Among 10075 elderly participants,the prevalence of cognitive impairment was 61.2%(6065 people).Multivariate logistic analysis identified five interventionable risk factors independently associated with cognitive impairment:stroke(OR=1.363,95%CI:1.160-1.603),hyperlipidemia(OR=1.785,95%CI:1.681-1.905),insomnia(OR=2.387,95%CI:2.144-2.659),mental illness(OR=3.104,95%CI:1.721-5.598)and alcohol consumption(OR=1.333,95%CI:1.074-1.654).Subgroup analysis revealed that Parkinson's disease was another risk factor for cognitive impairment in older women.Conclusion The prevalence rate of cognitive impairment was higher in elderly outpatients≥65 years old in Panyu District of Guangzhou.It is important to implement targeted interventions and integrated management strategies to reduce the impact of the five interventionable risk factors in this population.

关 键 词：门诊老年患者 认知障碍 患病率 危险因素 

分 类 号：R181.32[医药卫生—流行病学]