上海市社区老年2型糖尿病患者认知功能损害的发生率和危险因素分析

目的：研究上海市老年2型糖尿病患者认知功能损害的发生率,分析影响认知功能损害的相关因素为痴呆高危人群的预防提供依据。方法：设计问卷调查表,对上海市徐汇区天平街道社区≥60岁的2型糖尿病患者进行筛选,符合入选标准的研究对象共214例。进行问卷调查,采用MMSE、CDR、GDS量表评价其总体认知功能情况。根据认知功能评分将研究对象分为认知功能正常（正常组）、轻度认知功能损害（轻度组）和重度认知功能损害（重度组）,观察不同程度认知功能损害的发生率;分析人口学资料、血管危险因素、糖尿病等因素对不同程度认知功能损害的影响。结果：轻度组认知功能损害的发生率为42.99%,重度组认知功能损害的发生率为21.50%。年龄、受教育程度、脑卒中发生率、糖尿病病程、糖尿病微血管病变和低血糖反应等影响因素在3组间的差异有统计学意义（P〈0.01）;正常组和轻度组的影响因素为年龄、脑卒中发生率、糖尿病病程和低血糖反应,组间差异有统计学意义（P〈0.016 7）;轻度和重度组的影响因素为受教育程度、脑卒中发生率和糖尿病微血管病变,组间差异有统计学意义（P〈0.016 7）。结论：上海市社区老年2型糖尿病患者不同程度认知功能损害的发生率较高,影响认知功能损害的相关因素包括糖尿病相关指标和非糖尿病的相关因素。

Prevalence and Risk Factors of Cognitive Impairment in Elderly Patients with Type 2 Diabetes in Shanghai

Aim：To study the prevalence of different degrees of cognitive impairment and its risk factors in elderly patients with type 2 diabetes so as to provide some basis for the prevention of dementia for the people with high risks.Methods：In the questionnaire,214 subjects were selected from elderly patients with type 2 diabetes aged 60 and over in Tianping community in Xuhui District,Shanghai.The basic medical history and cognitive function status assessed by the Mini-Mental State Examination（MMSE）,Clinical Dementia Rating（CDR） and Global Deterioration Scale（GDS） were collected.The cases were divided into three groups,normal cognitive function（NCF）,mild cognitive impairment（MCI） and severe cognitive impairment （SCI）.Factors relevant with cognitive impairment in different groups were thus analyzed.Results：The prevalence of MCI in the elderly patients with type 2 diabetes was 42.99%,the prevalence of SCI was 21.50%. The differences of all the factors,including age,education,stroke,hypoglycemia,duration of type 2 diabetes,and the diabetic microangiopathy among the three different groups were statistically significant（P0.01）. The differences of age,stroke,duration of type 2 diabetes,and hypoglycemia between NCF and MCI groups, were statistically significant（P0.016 7）.The differences of education,stroke,and the diabetic microangiopathy between MCI and SCI groups were statistically significant（P0.016 7）.Conclusion：The cognitive impairment in elderly patients with type 2 diabetes in communities of Shanghai is highly prevalent,which is associated with diabetes and other risk factors.