无锡市社区老年人群主观认知下降患者门诊就诊率调查及其影响因素分析

目的 了解无锡市社区老年人群主观认知下降（SCD）患者的门诊就诊率及其影响因素，为阿尔茨海默病（AD）超早期精准干预提供参考依据。方法 2021年2—8月，以居民健康档案为线索，采用分层整群随机抽样方法，在无锡市社区招募60岁及以上老年人1 500名，采用一般情况调查表、简易老年人认知筛查问卷（BECSI）、老年快速认知筛查量表（QCSS-E）、成套核心神经心理测验(CNT)及相关实验室检查进行SCD筛查和临床诊断，分析SCD患者的门诊就诊率及影响因素。结果 共获得有效样本1 314名，检出SCD患者379例，占比28.84%，其中因主观认知下降在门诊就诊的仅91例，门诊就诊率为24.01%。多因素logistic回归分析结果显示，经常参加社区老年健康讲座（OR=8.323,95%CI:2.955～23.442）、对痴呆早期预防持积极态度（OR=3.852,95%CI:1.152～12.883）、了解SCD相关知识（OR=2.762,95%CI:1.258～6.061）、病程3年（OR=4.072,95%CI:1.282～12.935）是影响SCD患者就诊的积极因素；而受教育程度为小学...

Survey on outpatient visit rate of patients with subjective cognitive decline and its influencing factors among community elderly in Wuxi

Objective To investigate the outpatient visit rate of patients with subjective cognitive decline (SCD) and its influencing factors among the community elderly in Wuxi, so as to provide reference for promoting the ultra-early and precise intervention of Alzheimer’s disease (AD). Methods From February to August of 2021, 1 500 elderly aged 60 and over were recruited from Wuxi community using stratified cluster random sampling method based on resident health records. The general information questionnaire, Brief Elderly Cognitive Screening Inventory (BECSI), Quick Cognitive Screening Scale for Elderly (QCSS-E), Core Neuropsychological Test (CNT), and related laboratory examination were completed to conduct SCD screening and clinical diagnosis, and the outpatient visit rate and influencing factors of SCD patients were analyzed. Results A total of 1 314 valid samples were obtained, and 379 SCD patients were detected, accounting for 28.84%. Among them, only 91 patients visited the outpatient department due to SCD, and the outpatient visit rate was 24.01%. Multivariate logistic regression analysis showed that frequent participation in community health lectures for the elderly (OR=8.323, 95%CI: 2.955-23.442), positive attitude towards early prevention of dementia (OR=3.852, 95%CI: 1.152-12.883), understanding of SCD related knowledge (OR=2.762, 95%CI: 1.258-6.061), and course of disease less than 3 years (OR=4.072, 95%CI: 1.282-12.935) were the positive factors that affected the visit of patients with SCD, while education level of primary school or junior high school (OR=0.113, 95%CI: 0.029-0.446; OR=0.150, 95%CI: 0.062-0.363), per capita monthly income of family less than 3 000 yuan (OR=0.212, 95%CI: 0.098-0.461), prejudice against dementia (OR=0.203, 95%CI: 0.094-0.435), BECSI score of 5 to 9 points (OR=0.215, 95%CI: 0.092-0.502), and HAMD score less than or equal to 2 points (OR=0.200, 95%CI: 0.042-0.946) were the negative factors that affected the visit of SCD patients. Conclusion The SCD outpatient visit level among the elderly in Wuxi is relatively low. Promoting the appropriate technology for early AD screening, strengthening the popularization of SCD related knowledge, and enhancing the public awareness of the prevention of AD risk are the key measures to improve the outpatient visit rate of SCD.