老年人认知异常现状及影响因素分析

目的了解四川省绵阳市60岁及以上老年人认知异常的流行现况及其分布特征,并探讨其影响因素。方法采用多阶段整群随机抽样方法,选取具有绵阳市户籍并居住一年以上的60岁及以上老年人作为研究对象,2015-07/2016-08对其开展问卷调查、体格检查和实验室检测,采用AD8量表结合MMSE量表对老年人认知功能进行评定。采用多因素非条件Logistic回归分析绵阳市老年人认知异常的影响因素。结果 3 996名研究对象平均年龄为(69.66±6.51)岁,其中男性1 824名(45.65%),女性2 172名(54.35%)。绵阳市60岁及以上老年人总体认知异常检出率为11.74%。与认知异常正相关的因素有:女性(OR=1.48)、年龄较大(70~74岁:OR=1.72;75~79岁:OR=2.39;≥80岁:OR=2.03)、农村(OR=2.66)、睡眠问题(OR=1.82)、嗅觉变化(OR=1.59)、患有糖尿病(OR=1.44)、哮喘(OR=2.28)、听力下降(失聪)(OR=1.70)。与认知异常负相关的因素有:小学文化程度(OR=0.61)、社会活动(每年几次:OR=0.67;每周几次:OR=0.40)、打牌或玩麻将(偶尔:OR=0.42;经常:OR=0.50)、经常使用电脑(OR=0.39)、读书看报(偶尔:OR=0.55;经常:OR=0.43)。以上P均<0.05。结论绵阳市老年人认知异常检出率处于中等水平,但应重点关注女性、70岁及以上人群、农村老年人、存在睡眠问题、嗅觉变化者、有糖尿病、哮喘、听力下降(失聪)人群。

Prevalence and Influential Factors of Cognitive Impairment Among the Elderly

Objective To understand the prevalence and influential factors of cognitive impairment among the elderly aged 60 years old and above in Mianyang City of Sichuan Province.Methods A multi-stage cluster random sampling method was employed to select a total of 3996 residents aged 60 years old and above in Mianyang to conduct the questionnaire survey,physical examination and laboratory detection from July 2015 to August 2016.The Chinese version of 8-item Ascertain Dementia(AD8)combined with the Mini-Mental State Examination(MMSE)was used to screen the cognitive impairment of the elderly.Results Among the 3996 subjects,1824 were males(45.65%),2172 were females(54.35%),and the average age was(69.66±6.51)years old.The overall detection rate of cognitive impairment among the elderly aged 60 years old and above was 11.74%in Mianyang.Factors positively associated with cognitive impairment were female(OR=1.48),aged 70~74 years old(OR=1.72),aged 75~79 years old(OR=2.39),aged≥80 years old(OR=2.03),rural(OR=2.66),sleep problems(OR=1.82),and olfactory changes(OR=1.59).Factors negatively associated with cognitive impairment were primary school education(OR=0.61),participating in social activities yearly(OR=0.67)and weekly(OR=0.40),playing cards or mahjong occasionally(OR=0.42)and frequently(OR=0.39),and reading books and newspapers occasionally(OR=0.55)and frequently(OR=0.43).All the P values above were less than 0.05.Conclusion The overall detection rate of cognitive impairment among the elderly was at the medium level in Mianyang.However,more attention should be paid to females,the elderly aged 70 years old and above,rural elderly people,the elderly with sleep problems and olfactory changes.