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南昌市社区老年人轻度认知功能障碍向阿尔茨海默病转归研究
引用本文:蔡天盼, 陈铭, 龙静文, 邹婷婷, 刘斌, 吴磊. 南昌市社区老年人轻度认知功能障碍向阿尔茨海默病转归研究[J]. 中华疾病控制杂志, 2020, 24(1): 62-66. doi: 10.16462/j.cnki.zhjbkz.2020.01.013
作者姓名:蔡天盼  陈铭  龙静文  邹婷婷  刘斌  吴磊
作者单位:330006 南昌, 江西省预防医学重点实验室南昌大学公共卫生学院
基金项目:国家自然科学基金;国家级大学生创新创业训练计划项目;南昌大学研究生创新专项
摘    要:
目的  探讨南昌市社区老年人轻度认知功能障碍(mild cognitive impairment, MCI)向阿尔茨海默病(Alzheimer disease, AD)的转归率, 并分析其影响因素。 方法  采用分层整群抽样方法选取南昌市10个社区作为研究现场, 从抽取年龄≥60岁的1 942名老年人中筛查出361名MCI患者, 采用问卷调查和实验室检测收集研究对象一般人口学特征、生活习惯信息、疾病既往史、阿尔茨海默病相关神经丝蛋白(Alzheimer-associated neuronal thread protein, AD7c-NTP)、β淀粉样蛋白42(amyloidβ-protein 42, Aβ42)、β淀粉样蛋白40(amyloidβ-protein 40, Aβ40)等信息, 对MCI患者随访三年判断是否进展为AD。 结果  361例MCI患者共有121例转归为AD, 年均转归率为9.49%, Logistic回归分析模型分析结果显示, 高龄(80~98岁)(OR=3.651, 95%CI:1.295~10.297, P < 0.001)、女性(OR=2.603, 95%CI:1.136~5.966, P < 0.001)、大量饮酒(OR=1.479, 95%CI:1.343~1.627, P < 0.001)、ADL分值升高(OR=1.790, 95%CI:1.443~2.220, P=0.031)、吸烟(OR=1.157, 95%CI:1.091~1.224, P < 0.001)是危险因素, 而Moca分值升高(OR=0.766, 95%CI:0.681~0.861, P < 0.001)则是保护因素。 结论  加强对高龄女性的MCI患者监控, 并提倡老年人拥有健康生活方式, 积极参加体育锻炼、多读书和看报, 以延缓MCI患者向AD转归。

关 键 词:老年人   轻度认知功能障碍   阿尔茨海默病   影响因素
收稿时间:2019-07-04
修稿时间:2019-10-04

A study on the transfer of mild cognitive impairment to Alzheimer's disease among the elderly in Nanchang City
CAI Tian-pan, CHEN Ming, LONG Jing-wen, ZOU Ting-ting, LIU Bin, WU Lei. A study on the transfer of mild cognitive impairment to Alzheimer's disease among the elderly in Nanchang City[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2020, 24(1): 62-66. doi: 10.16462/j.cnki.zhjbkz.2020.01.013
Authors:CAI Tian-pan  CHEN Ming  LONG Jing-wen  ZOU Ting-ting  LIU Bin  WU Lei
Affiliation:Key Laboratory of Preventive Medicine of Jiangxi Province, School of Public Health, Nanchang University, Nanchang 330006, China
Abstract:
Objective To explore the incidence rate of mild cognitive impairment(MCI)among the elderly which transferred to Alzheimer disease(AD)and to analyze the related influencing factors.Methods 10 urban communities were selected through stratified cluster sampling as the research sites where 361 patients with MCI were screened from 1942 residents aged over 60 years old.Questionnaires and laboratory assays were used to collect data from subjects,including characteristics of demographic,life style,medical history,Alzheimer-associated neuronal thread protein,(AD7 C-(NTP)),amyloidβ-protein 42(Aβ42)and amyloidβ-protein 40(Aβ40),etc.Patients with MCI were followed up for three years to determine whether they progressed to AD.Results 121 of 361 patients of MCI converted to AD,and the incidence rate of MCI to AD was 9.49%person-years.According to the results of Logistic regression analysis model,elder(80-89 years)(OR=3.651,95%CI:1.295-10.297,P<0.001),female(OR=2.603,95%CI:1.136-5.966,P<0.001),heavy drinking(OR=1.479,95%CI:1.343-1.627,P<0.001),increased ADL score(OR=1.790,95%CI:1.443-2.220,P=0.031)and smoking(OR=1.157,95%CI:1.091-1.224,P<0.001)were the risky factors of the transition of MCI to AD.The increase of Moca score(OR=0.766,95%CI:0.681-0.861,P<0.001)was the protective factor of the transition.Conclusions We should strengthen our monitor on elder female MCI patients,and promote healthy lifestyles among the elders,encouraging them to actively participate in physical exercises and reading,in order to delay patients’transition of MCI to AD.
Keywords:Elderly  Mild cognitive impairment  Alzheimer’s disease  Influencing factor
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