摘要
背景运动认知风险综合征(MCR)及主观认知下降(SCD)均为老年人认知下降的早期阶段,MCR目前被认为是一种新型的痴呆前期有效预测综合征,早期对SCD老年人群进行MCR筛查,确定其影响因素,对减少老年人群痴呆及相关不良健康事件的发生具有重要意义。目的了解社区SCD老年人的MCR发生情况,并分析其影响因素。方法从2019年1月至2022年1月于北京某社区开展的长期队列研究中选取SCD老年人(≥60岁)459例为研究对象。SCD的评估联合使用了简版老年抑郁量表(GDS-15)中有关记忆的问题和蒙特利尔认知评估基础量表中文版(MoCA-B)。采用6 m步速测定法评估老年人的步速,以同时存在SCD和步速下降者为MCR组,以不存在步速下降者为非MCR组。采用自设问卷收集患者一般资料、生理因素、生活方式指标、心理因素、营养状态、患病情况、用药史等信息。采用多因素Logistic逐步回归分析SCD老年人发生MCR的影响因素。结果459例社区SCD老年人中,发生MCR者125例(27.23%)。MCR组和非MCR组老年人的年龄、基础性日常生活活动能力(BADL)、工具性日常生活活动能力(IADL)、每周运动时长、焦虑情况、营养状态、患病情况〔高血压、慢性心力衰竭、心律失常、脑卒中/短暂性脑缺血发作(TIA)、多发腔隙性脑梗死、2型糖尿病、周围血管病、肿瘤、骨关节炎、近2年骨折史、眼部疾病、口腔疾病〕、多重用药史比较,差异有统计学意义(P<0.05)。多因素Logistic逐步回归分析结果显示,年龄〔OR(95%CI)=1.083(1.034,1.134)〕、BADL〔OR(95%CI)=0.952(0.914,0.991)〕、IADL〔OR(95%CI)=0.623(0.486,0.798)〕、每周运动时长〔OR(95%CI)=0.505(0.295,0.864)〕、焦虑情况〔OR(95%CI)=2.442(1.225,4.866)〕、高血压患病情况〔OR(95%CI)=1.948(1.086,3.497)〕、脑卒中/TIA患病情况〔OR(95%CI)=3.154(1.745,5.699)〕是社区SCD老年人发生MCR的影响因素(P<0.05)。结论社区SCD老年�
Background Both motoric cognitive risk(MCR)syndrome and subjective cognitive decline(SCD)are early stages of cognitive decline in the elderly.MCR syndrome is currently considered as a new effective predictor of preclinical dementia.Identifying the risk factors of dementia in older people with SCD by early MCR syndrome screening is of great significance for reducing the incidence of dementia and related adverse health events in this group.Objective To investigate the prevalence and influencing factors of MCR syndrome in the elderly with SCD in the community.Methods A long-term cohort study conducted from January 2019 to January 2022 in a community in Beijing selected 459 cases of the elderly(≥60 years old)with SCD as the study population.SCD was assessed using the memory-related questions in the Geriatric Depression Scale-15 and the Chinese version of Montreal Cognitive Assessment-Basic.The the 6-metre walking test was used to assess gait status.MCR syndrome was defined as SCD in combination with gait decline.A self-designed questionnaire was used to collect the demographic data,physiological factors,psychological factors,lifestyle indicators,psychological factors,nutritional status,conditions of illness and medication history.Stepwise multinomial Logistic regression was used to explore the influencing factors of MCR syndrome.Results The prevalence of MCR syndrome was 27.2%(125/459).The elderly in the MCR and non-MCR groups were compared for age,basic activities of daily living(BADL),instrumental activities of daily living(IADL),weekly exercise hours,anxiety status,nutritional status,conditions of illness〔hypertension,chronic heart failure,arrhythmia,stroke/transient ischaemic attack(TIA),multiple lacunar infarction,diabetes mellitus,peripheral vascular disease,cancers,osteoarthritis,history of fracture in the last 2 years,oculopathy,oral disease〕,and medication history,and the difference was statistically significant(P<0.05).Stepwise multinomial Logistic regression analysis showed that older age〔OR(95%CI)
作者
杨存美
舒刚明
胡亦新
马虹颖
李佳黛
张天一
毛鑫
吴冰
闫瑾
李天志
YANG Cunmei;SHU Gangming;HU Yixin;MA Hongying;LI Jiadai;ZHANG Tianyi;MAO Xin;WU Bing;YAN Jin;LI Tianzhi(No.4 Healthcare Department,the Second Medical Center of the Chinese PLA General Hospital,Beijing 100853,China;National Clinical Research Center for Geriatric Diseases,Beijing 100853,China;Hospital Management Institute,Chinese PLA General Hospital,Beijing 100853,China;Radiology Department,Peking University Third Hospital,Beijing 100191,China;Graduate Team,Chinese PLA General Hospital,Beijing 100853,China;The Second Medical Center of the Chinese PLA General Hospital,Beijing 100853,China)
出处
《中国全科医学》
CAS
北大核心
2022年第34期4278-4285,共8页
Chinese General Practice
基金
军队保健专项课题(20BJZ30)。
关键词
认知障碍
主观认知下降
运动认知风险综合征
步速下降
社区筛查
影响因素分析
Cognition disorders
Subjective cognitive decline
Motor cognitive risk syndrome
Decreased gait speed
Community-based screening
Root cause analysis
