社区老年人认知衰弱与自我感知老化的关系研究

目的 调查社区老年人认知衰弱的患病现状及其与自我感知老化的关系。方法 采用方便抽样法选取新乡市60岁及以上的社区老年人为研究对象,使用一般情况调查表、衰弱表型、简版自我感知老化量表、简易精神状态检查量表、患者健康问卷进行调查,采用χ2检验、Kruskal-Wallis H检验以及无序多分类logistic回归分析探究认知衰弱的影响因素。结果 共调查老年人643名,其中认知衰弱20名（3.1%）,可逆性认知衰弱96名（14.9%）,潜在可逆性认知衰弱99名（15.4%）;不同年龄、性别、婚姻状况、受教育程度、个人月收入、自我感知老化和抑郁得分的老年人,不同认知衰弱表型患病率差异有统计学意义（P＜0.01）。无序多分类logistic回归分析显示,低龄（OR=0.144）是老年人发生认知衰弱的保护因素,自我感知老化（OR=1.200）是其危险因素;抑郁（OR=1.149）和自我感知老化（OR=1.048）是老年人发生可逆性认知衰弱的危险因素;男性（OR=0.521）和低龄（OR=0.299）是老年人发生潜在可逆性认知衰弱的保护因素,受教育程度低（OR=2.405）、抑郁（OR=1.130）和自我感知老化（OR=1.060）是其危险因素。结论 自我感知老化是老年人认知衰弱的危险因素。自我感知老化有望成为减少或者避免认知衰弱发生发展的干预新靶点。     

石家庄某社区老年人衰弱现状及影响因素

目的了解河北省石家庄市某社区老年人衰弱现状,探讨影响石家庄某社区老年人衰弱的因素,为制定社区老年衰弱干预计划提供参考依据。方法于2015年7月—2016年7月应用老年衰弱综合评估工具(CFAI)对老年人采取面对面调查的方式,调查3 125名≥60岁常住社区老年居民衰弱水平。结果社区老年人衰弱评分为(41.01±10.64)分,年龄、婚姻状况、文化程度、收支情况、牙齿脱落、牙齿功能、刷牙习惯、睡眠质量、自理能力、健康促进方式、家庭关系、家中地位(beta值分别为0.074、0.138、0.153、0.108、–0.045、0.188、0.037、0.057、0.165、–0.182、0.129、0.096)是老年衰弱的重要影响因素。结论老年衰弱受多种因素影响,应采取有效干预措施,降低老年衰弱进程。     

Prevalence and risk factors of the co-occurrence of physical frailty and cognitive impairment in Chinese community-dwelling older adults

This cross-sectional study aimed to determine the prevalence of the co-occurrence of physical frailty and cognitive impairment and to identify its associated demographic, psychosocial and behavioural factors. Participants were recruited from 32 neighbourhoods using multistage sampling method in Xuhui District, Shanghai, China. A total of 1585 older adults were included who lived in community, were 75 years or older and without a clinical diagnosis of dementia. Based on the presences of frailty (using the modified frailty phenotype criteria) and/or cognitive impairment (using Chinese version Mini-Mental Status Examination stratified by educational level), the participants were classified into four groups: normal, cognitive impairment alone, frailty alone and co-occurrence. Multinomial logistic regression analyses were conducted to identify the demographic, psychosocial (depression, social participation and social support) and behavioural (sedentary lifestyle and sleep problems) characteristics associated with the co-occurrence of physical frailty and cognitive impairment. The prevalence of frailty alone, cognitive impairment alone and the co-occurrence of physical frailty and cognitive impairment in the study sample were 7%, 26.94% and 7.19% respectively. The results of multinomial logistic regression show the following characteristics significantly associated with the co-occurrence of physical frailty and cognitive impairment: advanced age (81–85 years old, Odds Ratio, OR = 1.99, 95% CI = 1.10–3.59; 86 years or older, OR = 6.43, 95% CI = 3.66–11.29), number of co-morbidities (OR = 1.34, 95% CI = 1.01–1.77), depression (OR = 3.88, 95% CI = 2.39–6.29), social participation (OR = 0.61, 95% CI = 0.39–0.96), sedentary lifestyle (OR = 2.69, 95% CI = 1.66–4.34) and sleep problems (insomnia occasionally, OR = 1.84, 95% CI = 1.07–3.17; insomnia every day, OR = 2.38, 95% CI = 1.33–4.26). The co-occurrence of physical frailty and cognitive impairment is a prevalent health issue in oldest old community-dwelling older adults. Advanced age, co-morbidity, depression, sedentary lifestyle and sleep problems are risk factors for cognitive frailty while good social participation may have a protective effect on it.     

社区老年人身体活动与罹患肌少症的关联

目的  探讨日常身体活动水平和体育锻炼习惯对社区老年人肌少症的影响。 方法  于2019年5月―8月招募≥65岁的老年人,通过亚洲肌少症诊断标准调查社区老年人肌少症患病率。采用自制问卷收集老年人一般人口学资料和生活习惯资料。采用国际体力活动量表（international physical activity questionnaire,IPAQ-s）对老年人日常身体活动量进行评估。使用Logistic回归分析模型分析肌少症与日常身体活动量、锻炼习惯之间的关系。 结果  社区老年人肌少症患病率为12.3%。在调整了人口学特征和生活习惯等混杂因素后,无锻炼习惯老年人肌少症患病率是有锻炼习惯者的2.759倍（OR=2.759,95% CI：1.213~5.919,P=0.017）。坚持锻炼年数每增加1年,老年人罹患肌少症的风险减少0.070（OR=0.930,95% CI：0.878~0.985,P=0.013）。每次锻炼时间增加1 h,老年人罹患肌少症的风险减少0.611（OR=0.389,95% CI：0.187~0.809,P=0.012）。 结论  我国≥65岁老年人肌少症患病率较高。尽早开始每周2 d以上、每次25 min以上的体育锻炼可降低老年人肌少症的患病风险。     

Nutrition, physical activity, and blood pressure in the elderly

Forty noninstitutionalized elderly subjects, ages 65-86 years, were recruited for a study to determine relationships between nutritional status, physical activity, and blood pressure. A 24-hour recall of dietary intake and activities, health history, skinfolds, circumferences, height, weight, and blood pressure were obtained. Obesity was associated with hypertension in this group of elderly subjects. Truncal skinfolds (abdomen and subscapula) were positively correlated (P less than .05) with systolic blood pressure while body mass index, dietary magnesium and dietary calcium to magnesium ratio were directly related (P less than .05) to diastolic blood pressure. Physical activity and energy expenditure were not correlated (P greater than .05) with blood pressure in this study; however, the level of activity did not include strenuous exercise.     

农村中老年高血压人群收缩压与舒张压的差异分析

目的 了解收缩压、舒张压在农村居民未控制高血压人群中的作用。方法 以整群抽样的方法对三峡坝区农村35a以上居民进行原发性高血压流行病学调查。结果 三峡坝区农村未控制高血压人群中，单纯收缩期高血压占37．9％，单纯舒张期高血压占15．8％，混合型高血压占46．3％。高年龄组的知晓率、治疗率要高于低年龄组。两年龄组人群中血压单独按收缩压进行分级，正确比例远高于单独按舒张压分级。达到控制目标收缩压所需降压值在单纯收缩期高血压和混合型高血压两亚型的高年龄组均要高于低年龄组。而单纯舒张期高血压的低年龄组所需降压值要高于高年龄组。结论在三峡坝区农村中老年人群中单纯收缩期高血压和混合型高血压是主要的血压亚型。收缩压的升高是当地未控制高血压的主要问题。     

群体“互联网+”健康管理对功能社区人群健康状况的影响

目的 评估“互联网+”为主导的健康管理模式对功能社区群体生活方式及健康指标的影响，为推动和发展健康管理新途径和新方法提供科学依据和经验参考。方法 对湖南省某功能社区内所有职工进行为期1年的健康管理，在健康管理开始前和管理结束后对研究对象进行体检和问卷调查，评估管理前后其生活方式和生理指标的变化情况。采用SAS 9.3软件进行统计分析，非正态分布的计量资料用中位数(四分位数间距)表示，采用秩和检验；计数资料用率或构成比表示，采用χ²检验，P<0.05为差异有统计学意义。结果 研究共纳入1 956人，其中男性1 445人(占73.88%)、女性511人(占26.12%)。健康管理前后，肉类摄入量达标率增加，由39.57%上升至44.48%,差异有统计学意义(χ²=9.669,P<0.05),吸烟、饮酒、蔬菜摄入量达标率、水果摄入量达标率等指标在健康管理前后差异无统计学意义(P>0.05);舒张压中位数由79 mmHg降低至78 mmHg、总胆固醇和低密度脂蛋白降低，而高密度脂蛋白、甘油三酯升高，差异有统计学意义(H=-44 51...     

老年糖尿病患者的社区管理

目的:探讨某辖区老年糖尿病患者的社区管理。方法:对某辖区50位老年糖尿病人进行科学管理,定期体检,合理指导生活和用药。结果:观察和监督其生活和用药,体检指标,锻炼情况,有效控制血糖水平,减少并发症,改善生活质量。结论:通过科学合理指导用药,按时定量用餐,适度锻炼,提高其对疾病认识,坚持科学、系统治疗,提高生活质量,增强生活自信心。     

Depressive symptoms are associated with food insufficiency and nutritional deficiencies in poor community-dwelling elderly people

Abstract  

Depression is associated with nutritional deterioration in older persons and is highly prevalent among people of low socioeconomic status (LSES).     

社区老年人正常高值血压与高血压的区分因素

目的 分析社区老年人正常高值血压与高血压的区分因素及各因素间的相互作用。方法 抽取安徽省六安市城乡社区60岁及以上居民1 080人,将其中高血压和正常高值血压共967人纳入分析。采用logistic逐步回归筛选区分正常高值血压与高血压2组老年人的相关因素,并对筛选出的因素进行一阶交互作用分析。结果 相比正常高值血压,患高血压老年人下列因素分布比例更高:高年龄组（80～94岁组与 60～70岁组）、男性、有高血压家族史、慢性病共病数量（≥2组 与 0组）、肥胖、LDL - C高、TG高和尿蛋白异常。有统计学意义的交互作用项如下:性别（男/女）× 年龄（低、中、高）,性别（男/女）× 高血压家族史（有/无）和BMI（正常、超重、肥胖）× 高血压家族史（有/无）。结论 高龄、男性、高血压家族史、慢性病、肥胖及其相关因素与高血压存在关联。高龄只在男性中与高血压有关联;高血压家族史与高血压的关联强度在男性中高于女性;肥胖只在有高血压家族史老年人中与高血压有关联。     

Nutritional status and functional capacity of community-dwelling elderly in southern Laos

Objectives

The aim of this study was to assess the nutritional status and functional capacity of 144 community-dwelling elderly in three rural ethnic groups, namely, the Oy, the Brau and the Lao, of southern Laos.

Methods

The Mini nutritional assessment (MNA) questionnaire and Determine Your Nutritional Health checklist were used to assess nutritional status. The Barthel Activities of Daily Living questionnaire and Lawton and Brody’s Instrumental Activities of Daily Living questionnaire were used to assess the functional capacity of the respondents.

Results

The MNA score results indicated that 92.5 % of Oy respondents, 85.4 % of Brau respondents and 60 % of Lao respondents were malnourished. Analysis of variance tests showed that the MNA scores of the Oy and Lao ethnic groups and of the Brau and Lao ethnic groups were significantly different ( both p < 0.01), but that there was no significant difference between the MNA scores of the Oy and Brau ethnic groups (p > 0.05). In terms of functional capacity, 47.2 % of Oy respondents, 43.9 % of Brau respondents and 20 % of Lao respondents had limitations in their activities of daily living, whereas 98.1 % of Oy respondents, 97.6 % of Brau respondents and 86 % of Lao respondents had limitations in their instrumental activities of daily living. Body mass index, reduced appetite, number of meals consumed daily and presence of common diseases predicted nutritional status in all three ethnic groups; the remaining factors differed by ethnicity. This result implies that ethnic differences and other factors, such as location of the village, services, resources within the village and respondents’ lifestyles, can affect nutritional status.

Conclusions

Because predictors of nutritional status varied by ethnicity, there is a need for area-specific interventions aimed at improving the quality of life of the elderly in these areas.     

睡眠质量对社区老年人认知衰弱影响的归因分析

目的 探究睡眠质量和睡眠时长对社区老年人认知衰弱的作用大小。方法 采用现况调查方法,利用匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index, PSQI)评估老年人的睡眠质量,中文版AscertainDementia-8(AD-8)量表评估认知状态,Frail衰弱量表评估躯体衰弱。采用logistic回归分析和多因素调整的人群归因危险度分析睡眠对认知衰弱的作用大小。结果 本研究共调查955名社区老人受试者,男性425名(44.5%),女性530名(55.5%)。认知衰弱的检出率为8.7%,睡眠障碍的检出率为24.5%。在调整性别、年龄、BMI、婚姻、体育锻炼、午睡、慢性病、身体疼痛、抑郁、焦虑等混杂因素后,睡眠障碍(OR=1.891,95%CI:1.087～3.291)和睡眠时间<6 h(OR=1.859, 95%CI:1.044～3.312)的老年人更易发生认知衰弱,认知衰弱的发生风险随着PSQI得分增加而逐渐上升。睡眠质量和睡眠时长对于认知衰弱人群归因危险度分别为25.53%和23.95%。结论 社区老年人睡眠质量与认知衰弱程度相关,睡眠质量差...     

Social status, life changes, housing conditions, health, functional abilitiesand life-style as risk factors for recurrent falls among the home-dwelling elderly

Objective

To define the risk factors for recurrent falls in the home-dwelling elderly.

Design

A prospective population-based study covering two years.

Setting

Five rural municipalities around the city Oulu, northern Finland.

Participants

All home-dwelling elderly persons (N = 1,016) aged 70 years or older living in the municipalities.

Outcome measures

The risk factors of recurrent falling by variables related to social status, life changes,housing conditions, health, functional abilities and life style, using cross-tabulations and multivariate analyses.

Results

The recurrent fallers (at least two falls within 365 days after the examination day) consisted of 17 men (6% of the men) and 71 women (14%). Logistic regression analyses showed female sex, urinary urgency, frequent fear of falling, dizziness, a poor pulse rate rise 30 seconds after standing up and falling during the previous year to be risk factors for recurrent falls. After the variable representing previous falls had been removed from the analysis, urinary incontinence and a change in housing conditions during the past two years emerged and urinary urgency dropped out of the model.

Conclusions

Women particularly are a target group for the prevention of falls among the elderly. Urinary urgency and urinary incontinence, fear of falling, dizziness and changes in the housing conditions should be inquired about to identify the elderly at risk for falling and to take preventive interventions. In addition to testing blood pressure changes after standing up, the changes in pulse rate should be determined to identify and treat elderly people who have orthostatic conditions.     

Association of dietary variety with body composition and physical function in community-dwelling elderly Japanese

Objectives

To examine the associations of dietary variety with body composition and physical function in community-dwelling elderly Japanese

Design

Cross-sectional study.

Setting

Community-based.

Participants

A total of 1184 community-dwelling elderly adults aged 65 and over.

Measurements

Dietary variety was assessed with a food frequency questionnaire (maximum, 10 points) that encompassed the 10 main food components of Japanese meals (meat, fish/shellfish, eggs, milk, soybean products, green/yellow vegetables, potatoes, fruit, seaweed, and fats/oils). Body composition was determined by multifrequency bioelectrical impedance analysis. Physical function was assessed by measuring grip strength and usual walking speed. Multiple linear regression analysis was used to examine the associations of dietary variety with body composition and physical function.

Results

After adjusting for potential confounders, higher dietary variety scores were independently associated with higher lean mass (β (SE): 0.176 (0.049), p<0.001) and appendicular lean mass (β (SE): 0.114 (0.027), p<0.001) but not with body fat mass. Elders with a higher dietary variety score had greater grip strength and faster usual walking speed (β (SE): 0.204 (0.071), p=0.004, and β (SE): 0.008 (0.003), p=0.012, respectively).

Conclusion

Greater dietary variety was significantly associated with greater lean mass and better physical function in Japanese elders. The causal relationship warrants investigation in a prospective study.

     

Physical activity, physical fitness, blood pressure, and fibrinogen in the Northern Ireland health and activity survey.

STUDY OBJECTIVE: To investigate the relationship between physical activity, physical fitness, blood pressure, and fibrinogen. DESIGN: This was a cross sectional population study using a two stage probability sample. SETTING: Northern Ireland. PARTICIPANTS: A sample of 1600 subjects aged 16-74 years from the population of Northern Ireland. MAIN OUTCOME MEASURES: Physical activity profile from computer assisted interview using the Allied Dunbar national fitness survey scales. Physical fitness using estimation of VO2 max by extrapolation from submaximal oxygen uptake while walking on a motor driven treadmill. Systolic and diastolic blood pressure measured with a Hawksley random zero sphygmomanometer. Measurement of fibrinogen using the Clauss method. MAIN RESULTS: There were significant relationships between both current and past activity and blood pressure. These were of a magnitude that would have been clinically significant, but for the fact that, with the exception of the relationship between habitual activity and diastolic pressure (p = 0.03) and past activity and systolic pressure (p = 0.03) in men, they were not sustained after adjustment for the effect of age using analysis of variance. After adjustment for other potentially confounding factors using multiple regression, there was an inverse relationship between systolic blood pressure and past activity in men, so that those with a life-time of participation compared with a life-time of inactivity had a lower systolic blood pressure of 6 mmHg (p < 0.05). There was a highly significant (p < 0.001) inverse association between both systolic and diastolic blood pressure and physical fitness (VO2 max) which was not sustained after adjustment for possible confounding factors. There were relationships between fibrinogen and highest recorded activity (p < 0.001), habitual activity (p < 0.01), and past activity (p < 0.01) in men but no significant relationship in women. The relationship between fibrinogen and activity was no longer sustained after adjustment for possible confounding factors. There was a highly significant (p < 0.001) inverse relationship with physical fitness using VO2 max. This relationship was sustained after adjustment for possible confounding factors in both men (p < 0.05) and women (p < 0.001). CONCLUSIONS: There was a relationship between physical activity, physical fitness, and blood pressure but the relationship was greatly influenced by age. A reduction of 6 mmHg in systolic blood pressure associated with past activity is of clinical significance and supports the hypothesis that physical activity is of benefit in reducing cardiovascular risk. There was a lower level of fibrinogen in those who were most active but this relationship was not significant after adjustment for possible confounding factors. There was also a lower level of fibrinogen those who were most fit (VO2 max) and this relationship persisted even after adjustment for possible confounding factors.     

浙江丽水健康体检老年人群静脉血细胞参数参考范围调查

目的:建立丽水地区老年人静脉血细胞分析参数的参考范围。方法:随机抽取丽水地区18岁以上健康体检人数13734例,检测该人群血细胞参数,并分析其结果。结果:男性(>65岁)WBC、RBC和Hb浓度均低于男性(18岁～65岁);女性(>65岁)与女性(18岁～65岁)之间RBC、Hb差别有统计学意义;未分年龄组结果与操作规程相比较女性白细胞血小板稍低;与其它地域比较血小板测定差异明显。结论:丽水地区静脉血血细胞大部分参数存在性别与年龄的差别,并与不同地域静脉血细胞参数存在差别,应根据不同年龄组建立本地区的静脉血血细胞参考范围。     

Cognitive impairment and nocturnal blood pressure fall in treated elderly hypertensives

Objectives We investigated the association between the fall of nocturnal blood pressure (BP) and cognitive impairment in elderly subjects. Methods The study was a cross-sectional survey of 204 elderly subjects who had no cerebrovasucular episodes. Ambulatory BP monitoring and assessments of cognitive functions using the Mini-Mental State Examination (MMSE) were performed at the subjects’ homes. We classified, the subjects treated with antihypertensive drugs into three groups: non-dippers (nocturnal fall<10% of the mean day diastolic BP; n=51), normal dippers (10% to less than 20%; n=58), and extreme dippers (20% or more; n=17). The subjects not treated with antihypertensive drugs were also classified as non-dippers (n=40), normal dippers (n=24), and extreme dippers (n=14). Results The mean age of participants was 75.2±7.2 years, and 126 (61.7%) were being treated with antihypertensive drugs. In the group of antihypertensive drug users, the number with MMSE≤23 was 30 and the adjusted odds ratio for cognitive impairment in those with an extreme dip in diastolic BP (DBP) was 4.18 (95% CI, 1.07–16.40) in reference to the normal dippers. In contrast, no association was observed between cognitive function and nocturnal BP fall in the group no using antihypertensive drugs. Conclusions Cognitive impairment was associated with an extreme dip in DBP in the antihypertensive drug users only. It remains to be seen whether careful monitoring of nighttime BP as well as daytime BP may reduce the risk of cognitive impairment in antihypertensive drug users.     

Factors associated with functional decline and improvement in a very elderly community-dwelling population.

The objective of this study was to analyze the factors associated with functional decline and improvement in a community-dwelling population of people aged 75 years and older. A representative sample of elderly people living at home in the city of Sherbrooke (Quebec, Canada) was assessed yearly on three occasions (1991-1993) by a nurse. A health questionnaire, together with standardized instruments measuring disabilities, cognitive status, and depressive mood, was administered on the three assessments. From the 655 subjects who agreed to participate, a total of 504 subjects completed the study. The most important factors associated with functional decline were the number of days off regular activities (odds ratio (OR) = 1.31), the number of hot meals per day (OR = 1.59), and cognitive status (OR = 0.96), whereas weight loss (OR = 0.37) and living alone (OR = 0.54) were significant protective factors. Previous declines in functional autonomy, cognitive state, or mood were not independent risk factors. The most important factors associated with functional improvement were the disability score (OR = 1.08), previous functional decline (OR = 6.06), and decline in the disability score (OR = 1.09). Perceiving health to be worse than it was the previous year was a significant factor against improvement (OR = 0.24). This study identifies risk factors that can be helpful for targeting high-risk subgroups within the very elderly population who may benefit from a preventive program.