上海市虹口区社区老年人轻度认知功能障碍的危险因素调查研究

目的 调查上海市虹口区社区居家模式老年人群轻度认知功能障碍（MCI）患者的危险因素。方法分为两步，第一步采用整群分层抽样的方法随机选取上海市虹口区4个街道社区，采用AD8简体中文版对社区卫生服务中心年度体检的≥65岁健康体检老年人进行评测，AD8≥2分为有认知功能障碍；第二步为完成第一步的认知功能障碍受试者，完成一般资料调查表、MMSE、MoCA等量表评测，进行临床诊断，以临床诊断的MCI患者作为研究对象，共163例，并随机选取健康照料者及体检健康人群127例作为健康对照组；采用Logistic回归分析筛查MCI患者的危险因素；组间比较采用秩和检验或t检验，计数资料采用卡方检验。结果第一步共8549名社区老年人完成评估；第二步有163例诊断为MCI，单因素logistic回归分析可见性别、年龄、教育年限、年收入、社会活动、锻炼、睡眠障碍与MCI的发生有关(P<0.05)；多因素logistic回归分析表明女性、高龄、教育程度低、低年收入、缺少社会活动、缺少锻炼、睡眠障碍为虹口区社区居家模式MCI患者的高危因素。结论上海市虹口区社区老年人认知功能障碍的发病率较高，女性、高龄、教育程度低、低年收入、缺少社会活动、缺少锻炼、睡眠障碍是轻度认知功能障碍的主要危险因素。

The research on cognitive impairment of community elders in Hongkou district of Shanghai

Objective To investigate the risk factors of mild cognitive impairment (MCI) among elderly people living in community mode in Hongkou District of Shanghai. Methods First,four neighborhood communities in Hongkou District of Shanghai were randomly selected by cluster stratified sampling. The elderly people aged ≥65 were assessed by AD8 in the annual physical examination of community health service centers. The elderly people with AD8 ≥2 were served as cognitive impairment. Secondly, general information, MMSE, MoCA and other scales were used to make the clinical diagnosis of MCI. 163 MCI patients were selected as research subjects. 127 health caregivers and health check-up population were randomly selected as healthy control group. Logistic regression analysis was used to screen the risk factors of MCI patients. Rank sum test or t test were used for comparison between groups, and chi-square test was used for counting data. Results In the first step, 8549 community elderly people completed the evaluation. In the second step, 163 people were diagnosed as MCI. Univariate logistic regression analysis showed that gender, age, education years, annual income, social activities, exercise, sleep disorders were correlated with MCI (P< 0.05). Multivariate logistic regression analysis showed that women, older age, low education level, low income, lack of social activities, lack of exercise, sleep disorders were high risk factors for MCI patients. Conclusion The prevalence of cognitive impairment among the elderly in Hongkou District of Shanghai was higher. The main risk factors of mild cognitive impairment were women, old age, low education level, low income, lack of social activities, lack of exercise and sleep disorder.