社区老老年人群痴呆患病率及其影响因素研究

目的调查北京市海淀区大有北里社区老老年人群的痴呆患病率及其危险因素,为防治老年痴呆提供依据。方法纳入大有北里社区129例年龄≥80岁的离退休人员,用简易智能状态量表(MMSE)、蒙特利尔认知量表(MoCA)进行认知功能障碍筛查。文盲MMSE评分≤17分,小学学历者MMSE评分≤20分,初中或以上学历者MMSE评分≤24分为痴呆;MoCA评分≤15分为痴呆。对MMSE评分≤24分或MoCA评分≤15分者,进一步行日常生活能力量表(ADL)调查,并按照美国精神障碍诊断统计手册第4版(DSM-Ⅳ)、NINDS-AIREN的血管性痴呆及帕金森病痴呆的诊断标准,结合临床做出痴呆的相应诊断。结果 129例老老年人MoCA评分均值为22.82分,MMSE评分均值为26.45分,新发痴呆患者12例,发病率为9.30%。既往已确诊痴呆患者12例,本社区141例老老年人中,共有痴呆患者24例,痴呆患病率为17.02%,其余82.98%为认知功能正常和轻度认知功能减退。年龄及饮酒是老老年人痴呆的危险因素。伴发心房纤颤、饮酒、帕金森病、吸烟、脑卒中、冠心病、糖尿病、高血压、血脂异常者痴呆患病率分别为36.84%(7/19)、30.77%(8/26)、28.57%(2/7)、22.22%(12/54)、20.00%(15/75)、19.57%(9/46)、16.22.00%(6/37)、15.09%(16/106)、14.04%(8/57)。结论北京大有北里社区老老年人认知功能相对良好。戒烟限酒,早期干预、积极治疗心脑血管疾病及帕金森病等疾病,对防治老年痴呆具有十分重要的现实意义。

Prevalence of Dementia among the Eldly and Its Influential Factors

Objective To investage the cognitive function of the eldly in an urban community in Beijing and explore its risk factors.Methods Totally 129 elderly individuals aged 80 years or above in Dayou Beili,an urban community in Beijing,were enrolled in this study.Initially,the subjects were evaluated by Mini Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA).Subjects with an MMSE score ≤24 or MoCA≤15 were further screened by Activity of Daily Living Scale(ADL) and diagnosed as vascular dementia or Parkinson disease with dementia according to DSM-Ⅳ and NINDS-AIREN.Results The average MoCA score of these 129 subjects was 22.82,and the average MMSE score was 26.45.Twelve subjects were newly diagnosed as dementia,with a morbidity of 9.3%.Another 12 subjects had a past history of dementia.Aging and drinking were the independent risk factors for senile dementia,while high educational degree was a protective factor.The morbidity of dementia in the patients suffered from atrial fibrillation,alcohol addiction,Parkinson′s disease,smoking,stroke,coronary heart disease,diabetes mellitus,hypertension,and dyslipidemia was 36.84%(7/19),30.77%(8/26),28.57%(2/7),22.22%(12/54),20.00%(15/75),19.57%(9/46),16.22.00%(6/37),15.09%(16/106),14.04%(8/57),respectively.Conclusion The cognitive function of the eldly in Dayou Beili community is in relatively good shape.Meanwhile,it is important to prevent senile dementia through smoking cessation,stopping harmful alcohol use and adopting early treatment for patients with cardiac cerebral vascular diseases and Parkinson′s disease.