基于老年健康综合评估探讨糖尿病与认知功能障碍的相关性研究

背景　目前糖尿病患者认知功能障碍被临床糖尿病治疗策略忽略,且尚未发现有效的治疗方法可以逆转痴呆的病程,因此,积极寻找痴呆的危险因素,从防治的角度预防痴呆的发生是改变目前在痴呆诊治中被动局面的一种有效方法。目的　探讨住院老年患者糖尿病与认知功能障碍的相关性。方法　选取2017年9月-2019年2月在成都市第一人民医院老年病科完成老年健康综合评估的住院老年患者为研究对象,采用简易精神状况量表（MMSE）、临床痴呆评定量表（CDR）、日常生活能力量表（ADL）进行评估。依据2型糖尿病诊断标准将患者分为正常组和糖尿病组。采用二分类Logistic回归分析探讨住院老年患者糖尿病与认知功能障碍的相关性。结果　共发放问卷610份,回收有效问卷606份,有效回收率99.3%。纳入研究的606例患者中,正常组428例,平均年龄（71.4±7.6）岁;男性180例（42.1%）,女性248例（57.9%）。糖尿病组178例,平均年龄（72.3±6.4）岁;男性82例（46.7%）,女性96例（53.9%）。两组患者MMSE、CDR、ADL评分及认知情况比较,差异有统计学意义（P<0.05）。二分类Logistic回归分析结果显示：糖尿病与住院老年患者认知功能障碍存在相关性（P<0.05）。结论　在住院老年患者中,糖尿病和认知功能障碍关系密切,临床上应关注两者共同的危险因素及影响因素,应注意筛查老年糖尿病患者的认知功能状况,及时发现认知功能障碍并进行有效的干预。

A Study on the Relationship between Diabetes Mellitus and Cognitive Impairment Based on Comprehensive Health Assessment of the Elderly

Background　There are no available treatments targeting cognitive dysfunction in elderly patients with diabetes.And no effective treatments have been found to reverse the development of dementia.Therefore,actively identifying risk factors for dementia,and preventing and control its development is an effective way to improve the passive diagnosis and treatment of dementia.Objective　To explore the correlation between diabetes and cognitive dysfunction in elderly inpatients.Methods　Elderly inpatients with an experience of completing comprehensive health assessment from Department of Geriatrics,Chengdu First People's Hospital were enrolled during September 2017 to February 2019.A survey using Mini-Mental State Examination（MMSE）,Clinical Dementia Rating （ CDR ） Scale,and Activities of Daily Living Scale （ADL） was conducted to collect prevalence of cognitive impairment and dementia,and level of independent living skills,respectively.According to the diagnostic criteria of type 2 diabetes,the patients were divided into normal group and diabetic group.Binary Logistic regression analysis was used to explore the correlation of diabetes and cognitive impairment in elderly inpatients.Results　A total of 610 questionnaires were distributed and 606 valid questionnaires were recovered, with an effective recovery rate of 99.3%.Of the 606 cases enrolled,428 were found without diabetes,including 180 men（42.1%）,and 248 women（57.9%）,with an average age of （71.4±7.6） years,other 178 with diabetes,including 82 men（46.1%）,and 96 women（53.9%）,with an average age of （72.3±6.4） years.There were significant differences in mean scores of MMSE,CDR,ADL,as well as cognition between the two groups （P<0.05）.The results of binary Logistic regression analysis showed that there was a correlation between diabetes and cognitive dysfunction（P<0.05）．Conclusion　There is a close relationship between diabetes mellitus and cognitive dysfunction.We should pay close attention to the common risk and influencing factors of the two in clinical practice,and also to the screening of cognitive function in elderly diabetic patients to find out cognitive dysfunction in time and deliver effective intervention.