吸烟与老年人认知功能障碍的相关性

认知功能障碍的表现不仅包括记忆障碍、失语、失认、失用及视空间障碍等,还可伴随焦虑、抑郁、激越、冲动等情感行为障碍,这些情感和行为障碍同样也是患者致残的原因[1].早期干预可延缓认知功能衰退和行为问题的发展,使患者在更长时期内维持基本认知功能[2].如果在疾病后期干预,虽可能延缓认知能力衰退进程,但已发生不可逆的损害[3].认知功能障碍的发展是长期过程,对危险因素的监测干预具有重要意义[4].本文探讨吸烟对老年人认知功能障碍的影响.     

吸烟对老年人认知功能影响的研究——“北京市老龄化多维纵向研究”基线调查分析

目的　研究吸烟是否影响中国老年人认知功能。方法　 1 992年‘北京市老龄化多维纵向研究’基线调查采用随机、分层等原则抽取 55岁以上老年人 2 0 4 7例进行了入户调查和体格检查 ,其中包括吸烟史调查和认知功能检查 (MMSE)。结果　 31 .3%的男性和 76.3%的女性从不吸烟 ,45.3%的男性和 1 4 .1 %的女性目前吸烟 (调查时 )。研究发现吸烟对认知功能下降有保护作用 ,不吸烟者与吸烟者比较有 2倍的可能发生认知功能异常。保护作用依赖于吸烟时间的长短和量的多少。饮酒不干扰吸烟对认知功能紊乱的保护作用 ,同时吸烟又饮酒者对认知功能下降的保护作用是仅吸烟者的 2倍。吸烟对认知功能下降的保护作用不受年龄和居住地区的影响 ,但经性别和文化程度分层分析显示吸烟对老年女性和文盲老人的认知功能下降无保护作用。结论　吸烟对认知功能下降有适度的保护作用。但是 ,其他因素如性别和教育水平可能混淆吸烟对认知功能的影响     

老年人认知功能障碍及其影响因素

目的了解老年人认知功能障碍情况及其影响因素。方法随机抽取福建省749例年龄≥60岁的老年人通过长谷川简易智能测量表(HDS)、日常生活能力量表及自制的老年人生活方式调查量表进行评定。结果男女认知功能障碍发生差异无统计学意义(P>0.05);不同居住地、婚姻状况、学历、经济收入的老年人认知功能障碍发生差异显著(P<0.05);已婚、关注饮食、日常生活能力正常是老年人认知功能障碍的保护因素,而低经济收入、短睡眠时间则是危险因素。结论应采取多种干预和防控策略,延缓老年认知功能障碍的发生,通过引入老年社会工作专业手段,提高认知功能障碍者的生存质量和尊严。     

穴位按摩对轻度认知功能障碍老年人社会功能的影响

目的探讨和分析穴位按摩对轻度认知功能障碍(MCI)老年人社会功能影响。方法对按摩组50例MCI患者进行穴位按摩的指导和训练,对照组50例仅接受一般的健康教育;两组干预前后采用功能活动问卷(FAQ)进行社会功能活动评估。结果 MCI患者以票据支付、使用票据、记得约定、了解新事、独自外出等方面得分较高;对照组干预前后FAQ得分无统计学意义,按摩组干预前后FAQ得分差异显著(P0.05)。结论MCI患者的认知功能出现下降,导致其相应社会功能缺损明显,适当的干预能有有效改善社会功能。     

农村老年人认知功能障碍及其影响因素

目的：了解农村老年人的认知功能障碍现状及其影响因素。方法采用分层整群抽样的方法,对山东省郓城县年龄≥60岁的农村老年人488名进行面对面的问卷调查。结果郓城县农村老年人的简易精神状态量表（MMSE）得分为（21．02±6．48）;195名（40．0％）存在认知障碍;日常生活自理能力（ADL）得分与MMSE得分负相关（r＝－0．730,P＜0．05）;ADL得分与 MMSE 各因子得分的轮廓分析,三组间轮廓不平行（F＝30．780,P＜0．05）,正常组的轮廓得分高于下降组,高于明显障碍组。女性、体力劳动、离婚或丧偶、收入低、患有慢性病、ADL差是老年人认知障碍的危险因素,受教育水平高是保护因素。结论农村老年人的认知功能较低、影响因素较多,可从病有所医、老有所养、老有所学等方面进行早期干预。     

饮酒对老年人认知功能障碍的影响

对于认知功能障碍相关危险因素的研究 ,国内外学者作了大量努力 ,近年来饮酒对认知功能障碍的影响受到人们关注〔1〕。中国是饮酒的大国 ,但关于饮酒与认知功能障碍的关系国内尚未见报道。重庆市是我国人口最多的一个直辖市。我们对在重庆社区居住的老年人群进行抽样调查 ,采用 L ogistic回归方法进行分析 ,探讨老年人饮酒与认知功能障碍的关系。1　资料与方法1.1　 研究对象　本文采用随机整群抽样 ,以抽签的方法从重庆市高新区、渝北区、渝中区中分别抽取 2个居委会。调查对象为 6 0岁及以上人口 ,上述 6个居委会应查者 32 86人 ,共有 30…     

社区老年人日常生活功能异常对其认知功能的影响

目的探讨社区老年人日常生活功能(ADL)下降对其认知功能损害(MCI)的影响。方法采用巢式病例对照研究方法,病例为随访期间新发生的MCI患者105例,对照为随访队列中未发生MCI人群按年龄、性别、受教育程度进行1:4比例选择的420例对象。采用单因素和多因素分析方法,分析ADL,躯体生活自理能力(BADL)、工具性日常生活能力(IADL)受损对MCI发生的影响。结果 ADL和IADL受损者认知功能得分下降值均高于未受损老人(P<0.05),且发生MCI的危险性较高,其OR(95%CI)分别为2.75(1.208～6.236)和2.86(1.216～6.702),而BADL受损则未发现其影响。结论 ADL受损是MCI发生的重要高危因素,其中IADL受损可能是重要主因。     

认知功能对老年人生存质量的影响

<正>认知功能是衡量老年人生存质量(QOL)的一个重要指标。本研究分析认知功能与老年人QOL的相关性。1对象与方法1.1对象2011年12月至2012年4月多阶段分层随机整群抽唐山、张家口老年人(≥60岁)820人进行问卷调查,有效问卷797份(97.20%)。年龄60~101〔平均(70.00±7.38)〕岁,男397人,女400人;城市241人,农村556人;文盲234人,小     

甲状腺功能异常对老年人认知功能的影响

甲状腺功能异常在老年人中较常见,它不仅影响老年人的躯体功能,还可能引起注意力、记忆、情感等认知功能障碍.已有研究从动物实验、神经电生理、神经影像等角度对甲状腺功能与认知功能之间的关系展开探讨.此外,在临床工作中,甲状腺功能异常引起的严重认知功能损害易与老年性痴呆相混淆.因此,医务人员需重视,避免误诊.及时、合理地纠正老年人甲状腺功能异常,可能有利于认知能力的恢复.     

长期健身锻炼对老年人认知功能的影响

目的观察长期健身锻炼对老年人认知功能的影响。方法通过问卷调查法筛选960名老年人,其中包括无健身锻炼习惯425名,有长期健身锻炼习惯535名。运用精神状态检查量表(MMSE)进行认知功能状态评估。从425名无健身锻炼习惯的老年人中筛选有认知功能障碍者64例随机分成对照组和观察组,每组32例,对照组仍以常态进行日常生活,观察组以有氧运动方式进行健身干预,干预前及12 w后分别统计两组MMSE。结果与有长期健身锻炼习惯者比较,无健身锻炼习惯的老年人认知功能障碍发病率较高(P<0.05);观察组12 w健身锻炼干预后MMSE量表评分明显优于干预前及对照组(P<0.05)。结论长期健身锻炼可以预防老年认知功能障碍的发生,对于不经常参与健身锻炼的老年认知功能障碍患者,采用健身锻炼手段进行干预治疗,可以明显改善认知功能。     

性激素在老年人认知功能障碍中的作用

目的：探讨老年人性激素水平与认知功能障碍的关系。方法：用简易智能量表（MMSE）对216例60岁以上人选样本进行认知功能检查，并按MMSE得分，将样本分为认知功能正常组和认知功能障碍组，采用放射免疫学的方法，测定入选样本血清性激素（雌二醇，睾酮、泌乳素、孕酮、卵泡刺激素、黄体生成素）的水平，比较同性中认知功能正常组和认知功能障碍组性激素水平。结果：同性别中认知功能障碍组中的雌二醇、睾酮、泌乳素水平较认知功能正常组低（P＜0．05）。结论：老年认知功能障碍患者中存在性激素失衡，认知功能下降可能与雌二醇睾酮、泌乳素水平降低有关，适当调节性激素水平可能有助于对认知功能障碍的防治。     

Study of the relationship between cigarette smoking,alcohol drinking and cognitive impairment among elderly people in China

OBJECTIVE: the incidence of cognitive impairment is increasing; however, little is known about the prevalence and risk factors for cognitive impairment of elderly people in China. This report focuses on investigating the relationship between cigarette smoking, alcohol drinking and cognitive impairment in elderly people. METHODS: 3012 participants aged 60 years old and over were enrolled from six communities of Chongqing. Cognitive function was measured by the Mini-Mental State Examination and Activities of Daily Living. The chi(2) test and logistic regression was used to find the relationship between cigarette smoking, alcohol drinking and cognitive impairment. RESULT: the rate of abnormal cognitive function in elderly people was 11.95%. Smoking was closely related to cognitive impairment (chi(2)=6.59, P=0.027). Alcohol drinking was also associated with cognitive impairment (chi(2)=6.31, P=0.025). In all smokers, current smoking was associated with a significantly increased risk of cognitive impairment (RR 2.33; 95% CI=1.37-5.82). In all people who drink every day, there was a significantly increased risk of cognitive impairment (RR 3.47; 95% CI=1.79-6.71). CONCLUSION: smoking and drinking are risk factors for cognitive impairment among elderly people. Cessation of smoking and reduction of drinking could be considered as part of a strategy to reduce the incidence of cognitive impairment.     

老年人轻度认知损害危险因素的调查分析

目的 调查北京老年人轻度认知损害(MCD)与年龄、性别、体质指数等的关系.方法 应用简易精神状态检查,对北京东直门社区招募的129例老年人进行认知功能评估.结果 检出记忆型轻度认知损害(aMCI)37例(28.7%),阿尔茨海默病(AD)36例(27.9%),认知正常者56例(43.4%).aMCI和AD患者年龄高于认知正常者,分别为(67.6±7.5)岁、(66.6±8.2)岁和(62.5±7.9)岁,两两比较差异均有统计学意义(t值分别为2.847、-1.747和-2.429,P>0.05、P<0.01和P<0.01);aMCI和AD患者受教育年限低(P<0.05);aMCI和AD患者的血压较认知正常者高(P<0.05);aMCI体质指数高于其他两组(P<0.05),不同性别老年人aMCI和AD患病率差异无统计学意义(P>0.05);不同月份出生aMCI和AD患病率差异无统计学意义(P>0.05).结论 aMCI患病率与年龄、教育程度、高血压和体质指数等因素有关,与性别、出生月份无关.     

Mortality and blood pressure in elderly people with and without cognitive impairment

BACKGROUND: Controversial data are available on the association between mortality, blood pressure and cognitive impairment in the elderly. Objective: To verify the role of blood pressure on mortality in an elderly population with and without cognitive impairment. METHODS: A cross-sectional survey with a 6-year mortality evaluation was conducted in a region of southern Italy in elderly subjects with and without cognitive impairment. Subjects were divided into 4 groups on the basis of systolic, diastolic, mean and pulse blood pressure values. RESULTS: Mortality shows a linear relationship with pulse blood pressure and a U-curve shape for diastolic blood pressure. This phenomenon was more evident in subjects with cognitive impairment showing the greatest risk of mortality at the lowest and highest levels of diastolic blood pressure. CONCLUSION: The study shows that mortality increases linearly with increasing blood pressure in the elderly. In contrast, mortality shows a U-shape curve for diastolic blood pressure; cognitively impaired patients with the lowest and highest diastolic blood pressures show the greatest relative risk of mortality.     

Mild cognitive impairment in older people

CONTEXT: As public awareness of Alzheimer's disease increases, more people are asking for help and advice about memory problems. Memory complaints may be secondary to psychiatric, psychological, and physical conditions and is an almost universal early symptom of dementia. The concept of amnestic mild cognitive impairment attempts to describe those people in whom memory loss is not of such severity to merit a diagnosis of dementia. The importance of this group of people is not just the need to develop interventions which ameliorate individual suffering but that they represent a population at high risk of developing dementia, especially Alzheimer's disease, and are an appropriate target for dementia prevention strategies. STARTING POINT: K Kantarci and colleagues (Dement Geriatr Cogn Disord 2002; 14: 198-207) looked at the diagnostic accuracy of magnetic-resonance hippocampal volumetry and spectroscopy in patients with mild cognitive impairment, in normal older people, and in patients with Alzheimer's disease. Hippocampal volumes and N-acetyl aspartate/creatine spectroscopy were the most sensitive assessments discriminating people with mild cognitive impairment from Alzheimer's disease. Combination assessments were better at discriminating these two groups from normal controls. The histological underpinning of cognitive symptoms in older people has been demonstrated by the Cognitive Function and Ageing study (Lancet 2001; 357: 169-75), which showed that a third of people with no clinical evidence of dementia had histopathological hallmarks of Alzheimer's disease. WHERE NEXT? 25 million people across the world have dementia. Mild cognitive impairment, if a validated concept, represents an opportunity for preventing dementia. As more information becomes available about the cause of Alzheimer's disease and prospects emerge for prevention, identification of predementia states offers considerable scope to reduce the individual and societal cost of the illness. Continued validation of the criteria for mild cognitive impairment and studies of intervention should be a priority. As more evidence becomes available highlighting the relatively arbitrary nature of dementia diagnosis (based largely on interference with activities) and interventions become available for the prevention of dementia, mild cognitive impairment and related conditions will become more important.     

Coexistence of lowered mood and cognitive impairment of elderly people in five birth cohorts.

The prevalences of lowered mood and cognitive impairment, and their combination were investigated in 1993 random subjects of five birth cohorts (at age of 65, 70, 75, 80 and 85 years). The frequency of a high Zung-score (> 45), indicating depressive symptoms, in the five age groups was 11%, 13%, 20%, 16%, and 36%, respectively. The corresponding figures for a low MMSE-score (Mini Mental State Examination < 24) were 11%, 9%, 25%, 46%, and 60%; the respective frequencies of subjects fulfilling both criteria simultaneously were 2%, 3%, 8%, 12% and 24%, respectively. Overall, about 30% of the subjects with a low MMSE-score had a high Zung-score. However, more than half of the old subjects (over 75 years) with a high Zung-score also had low MMSE-scores. The data indicate that the combination of impaired cognition and lowered mood doubles in frequency by five-year intervals after the age of 70 years in the general aged population, and that this condition is present in one of four subjects at the age of 85 years.     

Effects of hearing aids on cognitive functions and depressive signs in elderly people

With the physical, emotional and cognitive effects of senility, elderly people, especially those with impaired hearing, need rehabilitation for improving their life conditions. Hearing aids are frequently used to improve their daily life communications and activities. The aim of this study was to report the cognitive and psychological benefits of using hearing aids by the elderly people, over the age of 65. This was a prospective, single-arm interventional study in 34 elderly subjects with hearing impairment who answered the geriatric depression scale-short form (GDS) questionnaire and the mini mental state examination (MMSE) test, prior to, and 3 months following the use of hearing aid, after obtaining the patients’ consent to participate in study. Patients with evidence of focal neurological loss with clinical examination, a confusional state, sudden hear loss and severe tinnitus were not included in the study. Scores of the effects of hearing aids on mood and cognitive functions were compared for each subject, before and after, and between males and females. After 3 months of using a hearing aid, all patients showed a significant improvement of the psychosocial and cognitive conditions, and all of them showed betterment of their problems, i.e., the social communication and exchanging information. In conclusion, for the elderly people with the effects of hearing aids in presbycusis and due to the significant improvement in psychological state and mental functions, using and being adaptable to hearing aids is a good solution.     

Evaluation of cognitive impairment in the elderly

Received from the Department of Medicine, Division of General Internal Medicine/Geriatrics, University of California, San Diego, School of Medicine, La Jolla, California.     

智能运动毯对轻中度认知损害老年人认知及运动功能影响的研究

目的 探讨智能运动毯对轻中度认知损害老年人的认知功能及运动平衡功能的干预效果.方法 采用随机数字表法将入选对象随机分为干预组和对照组,干预组在日常照护的基础上进行12次智能运动毯训练,对照组仅接受日常照护.在基线、4周后进行MoCA、数字广度测验-顺背(DST-F)、数字广度测验-倒背(DST-B)、数字广度测验-顺背...