2015年松滋市老年人早期认知功能障碍流行病学调查及影响因素分析

目的 调查松滋市老年人轻度认知功能障碍(MCI)的流行情况,探究老年MCI的危险因素,为有效预防老年MCI提供参考依据。 方法 本研究于2015年1月-2016年2月采用整群抽样的方式抽取松滋市1 248名60周岁以上的老年人进行一般健康情况问卷调查。采用MoCA量表、MMSE量表及ADL量表结合相关标准对所有受试者进行认知功能障碍筛查,并从一般资料、常见心脑血管疾病、生活方式三个方面分析归纳MCI患病的影响因素。 结果 共收回有效调查问卷1 248份,共筛查出MCI患者180例,MCI患病率为14.42%。不同年龄、居住区域(城区/乡镇)、文化程度、居住情况(独居/非独居)的老年人群MCI患病率差异有统计学意义(P<0.05)。年龄越高、文化程度越低,其MCI患病率越高,而乡镇老年人的MCI患病率明显高于城区,独居老人的MCI患病率明显高于非独居老人。单因素分析显示,高血压、心脏病、糖尿病、高血脂、抽烟对MCI患病并无影响(P>0.05),而脑卒中、饮酒、喝茶、运动对MCI患病有一定影响(P<0.05)。脑卒中、饮酒的MCI患病率(分别为19.46%、19.86%)高于非脑卒中、不饮酒者(13.55%、11.64%),经常喝茶和运动的老年人,其MCI患病率(分别为10.34%、8.67%)明显低于不经常喝茶和运动的老年人(分别为16.84%、19.55%),差异有统计学意义(P<0.05)。多因素非条件logistic回归分析发现,年龄、区域、文化程度、居住情况、脑卒中、经常饮酒、经常喝茶、经常运动是MCI的影响因素。 结论 对于年龄较大、文化程度较低、独居以及乡镇老人要尽早开展MCI的预防和干预工作,并侧重对脑卒中、经常饮酒的老人进行关注,以延缓和预防老年痴呆的发生。

Epidemiological survey and influencing factors of early cognitive impairment in the elderly in Songzi City, 2015

Objective To investigate the prevalence of mild cognitive impairment (MCI) in the elderly in Songzi City, to explore the risk factors of elderly MCI so as to provide evidence for effectively preventing elderly MCI. Methods A cluster sampling method was used to select 1,248 elderly persons aged 60 years and above in Songzi City from January 2015 to February 2016, and a questionnaire survey on general health condition was conducted. The Montreal Cognitive Assessment (MoCA) Scale, the Mini Mental State Examination (MMSE) Scale and Activity of Daily Living (ADL) Scale were used in combination with the relevant standards to screen MCI in all the subjects. And the factors influencing MCI incidence were analyzed and concluded from 3 aspects general information, common cardiovascular and cerebrovascular diseases and lifestyle. Results A total of 1,248 valid questionnaires were retrieved. 180 patients with MCI were screened out, and the incidence rate of MCI was 14.42%. The incidence rates of MCI of elderly groups with different ages, living areas (city/town), educational backgrounds and living conditions (solitary/non-solitary) showed statistically significant differences (P<0.05). The older the age and the lower the educational background, the higher the incidence rate of MCI. The incidence rate of MCI was significantly higher in the rural elderly than in the urban ones. The incidence rate of MCI of the elderly living alone was significantly higher than that of the elderly living with family members. Single factor analysis showed that hypertension, heart disease, diabetes, hyperlipidemia and smoking had no effect on the incidence of MCI (P>0.05), while stroke, alcohol drinking, tea drinking and exercise had a certain impact on the incidence of MCI (P<0.05). The incidence rates of MCI in the elderly with cerebral apoplexy (19.46%) and alcohol drinking (19.86%) were both higher than those of the elderly without cerebral apoplexy (13.55%) and alcohol drinking (11.64%). The incidence rates of MCI in the elderly with frequent tea drinking (10.34%) and exercise (8.67%) were significantly lower than those of the elderly\ with unfrequent tea drinking (16.84%) and exercise (19.55%), with statistically significant differences (P<0.05). Multifactor non-conditional logistic regression analysis showed that age, area, educational background, living condition, stroke, frequent alcohol drinking, regular tea drinking and regular exercise were the influencing factors of MCI. Conclusions It is necessary to conduct MCI prevention and interventions in the elderly with older age and lower educational level, living alone and living in villages as soon as possible. And more attention should be paid to the elderly with stroke and frequent alcohol drinking so as to delay and prevent the occurrence of senile dementia.