摘要
目的:用多水平分析方法探讨中国高龄老人认知功能的影响因素。方法:对1998、2000和2002年中国高龄老人健康长寿服务监测纵向调查的2251例数据,以简明精神状态检查(MMSE)量表评分为因变量,进行重复测量资料两水平模型分析,其中水平2单位为不同老人,水平1单位为同一老人的不同测量。结果:1998年基线调查时男性平均认知水平高于女性(27.0±3.7/24.4±5.6,P<0.001);不同年龄组老人的平均认知水平各不相同(80-89岁:26.6±3.8,90～99岁:24.6±5.4,100～105岁:21.1±7.4,两两间均P<0.001),未念过书的老人的平均认知水平低于念过1～4年和5年及以上的老人(24.4±5.6/27.1±3.2、27.7±3.3,P<0.001);老人的既往职业、婚姻状况、生活习惯及性格特征也与其认知功能存在一定的关系。两水平分析显示,所拟合的零模型存在水平2上的随机效应(x^2=355.6,P<0.001),把基线年龄分组、性别等指标代入模型后,发现除基线年龄外,女性、未念过书、务农或做家务、丧偶、遇到事情经常想不开、经常觉得孤独的老人的认知水平相对较低(β=-0.7、-1.2、-0.6、-0.6、-0.9、-0.6),而经常从事体育锻炼,经常饲养家禽,经常看电视,经常打牌玩麻将的老人的认知水平则相对较高(β=0.7、1.3、1.1、1.0)。结论:中国高龄老人认知功能的变化存在个体差异,受到年龄、性别、受教育程度、职业、婚姻、个人生活习惯及性格特征等多种因素影响。
Objective： To explore the influential factors of cognitive change among Chinese oldest-old. Method： Three waves of data from the Chinese Longitudinal Healthy Longevity Survey （ CLHLS） were analyzed with a two-level repeated measures model. Results： In baseline, the male had a higher mean MMSE score than the female （27. 0 ± 3.7/24. 4 ±5.6, P 〈0. 001 ） . There were significant differences in the mean score of 80 - 89, 90 - 99 and 100 105 years old （26. 6±3.8, 24.6 ±5.4, 21.1±7.4, P 〈0.001 ） . According to the years of schooling, the old were classified into three groups （ 0, 1 - 4, 5 years and more ） . The mean MMSE score of the 0 year＇s group statistically differed from the other two groups （ 24. 4±5.6/27. 1 ± 3.2, 27. 7± 3.3, P 〈 0. 001 ） . In addition, the main occupation before age 60, current status of the marriage, living habits, individual characteristics were also associated with the old＇s cognitive functions. The two-level analysis showed the variance estimate between oldest-olds was highly significant in zero model. We elaborated the model by adding more explanatory variables such as age-group in baseline, gender and so on, and found that the cognition functioning of oldest-olds who were elder, female, non-educated, peasant or housework as occupation, widow or had passive feelings was lower （ β = -0.7, - 1.2, -0. 6, -0. 6, -0. 9 and -0. 6, respectively ）, but oldest-olds who had habits of exercising, raising domestic animals, watching TV or listening to radio, playing cards/Mah-jong regularly had higher cognition （β= 0. 7, 1.3 , 1.1 and 1.0, respectively ） . Conclusion ： Cognitive decline among Chinese oldest-old is correlated with biological, social and psychological factors.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2008年第7期538-542,共5页
Chinese Mental Health Journal
关键词
中国高龄老人
认知功能
纵向研究
多水平分析
Chinese oldest-old
cognitive function
longitudinal study
multilevel analysis
