基于社区老年人的轻度认知障碍与痴呆风险因素差异的横断面研究

Cross-sectional study on differences in risk factors for mild cognitive impairment and dementia among elderly people in the community

中文关键词: 轻度认知障碍    痴呆    老年人    多分类Logistic回归    危险因素    横断面研究

英文关键词: mild cognitive impairment  dementia  elderly  multinomial Logistic regression  risk factors  cross-sectional studies

中文摘要:

      目的 探讨老年人群中轻度认知障碍(MCI)与痴呆样症状的相关影响因素，识别不同认知阶段的危险与保护因素。方法 采用横断面研究设计，纳入2 007名60岁及以上社区老年人，通过问卷调查收集人口学特征、生活方式、心理状态及慢性病信息。采用多分类Logistic回归模型分析各因素对MCI组和疑似痴呆组的影响，以认知正常组为对照。结果 研究对象中认知正常组1 638例(81.61%), MCI组271例(13.50%),疑似痴呆组98例(4.89%)。多因素分析显示，女性(OR=1.672, 95%CI:1.168～2.393)是MCI的独立危险因素；睡眠质量差(OR=3.269)是危险因素，高水平体力活动(OR=0.279)是MCI保护因素。80岁及以上老年人患痴呆的风险是60～69岁人群的13.565倍(OR=13.565,95%CI:4.688～39.256),中重度抑郁(OR=8.330,95%CI:2.316～29.967)和慢性病史(OR=4.875,95%CI:1.737～13.679)是患痴呆的危险因素。结论 高龄、女性、抑郁、睡眠障碍、体力活动不足等因素与老年人认知功能下降密切相关，且在不同认知阶段作用模式存在差异。应针对不同阶段采取差异化干预策略，重点关注高龄、抑郁及生活方式因素，以延缓认知衰退进程。

英文摘要:

      Objective To explore the related influencing factors of mild cognitive impairment(MCI)and dementia-like symptoms among elderly people,and identify the risk and protective factors at different cognitive stages.Methods A cross-sectional study design was employed,enrolling 2 007 people aged 60 years and older in the community.Data on their demographic characteristics,lifestyle,psychological status,and chronic diseases were collected via questionnaire surveys.A multinomial Logistic regression model was used to analyze the effects of various factors on the MCI group and the suspected dementia group,with the cognitively normal group serving as the reference.Results Among the participants,1 638(81.61%)were in the cognitively normal group,271(13.50%)in the MCI group,and 98(4.89%)in the suspected dementia group.Multivariate analysis showed that female gender(OR=1.672,95%CI:1.168-2.393)was an independent risk factor for MCI;poor sleep quality(OR=3.269)was a risk factor for MCI,and high-level physical activity(OR=0.279)was a protective factor.Individuals aged 80 years and older had a 13.565-fold higher risk of dementia compared with those aged 60-69 years(OR=13.565,95%CI:4.688-39.256).Moderate to severe depression(OR=8.330,95%CI:2.316-29.967)and a history of chronic diseases(OR=4.875,95%CI:1.737-13.679)were identified as risk factors for dementia.Conclusion Factors such as advanced age,female gender,depression,sleep disturbances,and insufficient physical activity are closely associated with cognitive decline in the elderly,and there are differences in the patterns of action at different cognitive stages.Differentiated intervention strategies should be adopted for different stages,with a focus on advanced age,depression and lifestyle factors,in order to delay the progression of cognitive deterioration.