基于国际居民长期照护评估工具的养老机构老年人认知障碍现状及影响因素研究

背景　随着老龄化现象的加剧，老年人认知障碍的发生率逐步上升，通过研究相关影响因素对认知障碍进行早期筛查、诊断和干预，可以达到及时预防、延缓痴呆的效果。目的　调查养老机构老年人的认知障碍并探讨其影响因素。方法　于2018年4—6月采用方便抽样法，选取南京市江宁区某养老机构老年人（≥60岁，n=369）为调查对象。由经过专业培训获得资质的评估员依据国际居民长期照护评估工具（interRAI-LTCF）对老年人进行评估。根据其中的认知表现评分（CPS）判断老年人是否存在认知障碍，以老年人的基本情况及其他评估标尺得分为自变量，采用多因素Logistic逐步回归分析养老机构老年人发生认知障碍的影响因素。结果　共回收有效问卷338份，有效回收率为91.6%。138例老年人存在不同程度的认知障碍，认知障碍发生率为40.8%。多因素Logistic逐步回归分析结果显示，感觉受损情况、脑血管疾病患病情况、日常生活活动能力（ADL）评分、抑郁评分、疼痛评分、社会参与度评分是养老机构老年人是否发生认知障碍的影响因素（P<0.05）。结论　养老机构老年人的认知障碍发生率较高，感觉受损、患有脑血管疾病、ADL依赖、抑郁是其发生认知障碍的危险因素，社会参与度高是保护因素，应进行积极筛查并采取针对性的干预措施。

interRAI-LTCF-assessed Cognitive Impairment and Influencing Factors in Elderly People in Geriatric Nursing Facilities

Background　With the aggravation of aging，the incidence of cognitive impairment in the elderly is increasing.To prevent and delay dementia timely and effectively，early screening，diagnosis and intervention of cognitive impairment should be taken based on studying the factors associated with cognitive impairment.Objective　To investigate the status of cognitive impairment and its influencing factors in the elderly in geriatric nursing facilities.Methods　This survey was carried out from April to June 2018.Participants were 369 elderly people aged ≥60 years old who were selected from a geriatric nursing facility in Jiangning District of Nanjing，China，by use of convenience sampling.They received a face-to-face survey with the interRAI-LTCF by qualified and well-trained evaluators.Cognitive impairment was determined by the interRAI Cognitive Performance Score（CPS）．Demographic characteristics and other evaluation factors were taken as independent variables for establishing the Logistic model.Multivariate Logistic stepwise regression analysis was used to explore the influencing factors of cognitive impairment.Results　Totally 338 responsive questionnaires were collected，obtaining a response rate of 91.6%.138 respondnets were identified with different degrees of cognitive impairment，accounting for 40.8%（138/338）．Multivariate Logistic stepwise regression analysis showed that sensory impairment，cerebrovascular disease，ADL score，depression score，pain score and social participation score influenced cognitive impairment significantly（P<0.05）．Conclusion　The prevalence of cognitive impairment is high among the elderly in geriatric nursing facilities.Sensory impairment，cerebrovascular disease，ADL dependence and depression are risk factors while high social participation is a protective factor assocatied with cognitive impairment.In view of this，active screening of cognitive impairment and targeted interventions should be taken for this population.