摘要
目的 探讨轻度认知功能障碍(MCI)与社区老年人群全死因死亡风险的关联,为早期识别高危人群提供参考。方法 2011年9月—11月采用典型抽样法选择5个城市社区55岁及以上居民作为研究对象,对其开展一般情况问卷、简易智能量表、日常生活能力量表、老年人抑郁量表基线调查并完成体格检查,以基线是否患有轻度认知功能障碍为暴露,分别在2017年、2019年和2021年通过入户面访和搜索死因监测信息系统进行随访观察死亡情况。采用Cox回归模型分析死亡风险影响因素。结果 共1046例研究对象完成随访纳入研究,基线年龄(66.4±6.6)岁,符合MCI判定标准者199例(19.0%)。研究对象平均随访时间(112±16)个月,随访期间共观察到106例死亡,其中MCI组死亡40例(累计死亡率21.1%),认知功能正常组死亡66例(累计死亡率10.1%),两组差异有统计学意义(χ^(2)=26.80,P<0.001)。Kaplan-Meier法估计MCI组中位生存时间显著短于认知功能正常组[(108±1.5)月比(113±0.5)月,χ_(log-rank)^(2)=28.02,P<0.001]。COX回归模型控制了性别、年龄、民族等变量后,MCI组死亡风险显著高于认知功能正常组(HR=1.98,95%CI:1.30~3.02,P=0.023)。结论 轻度认知功能障碍是社区中老年人群全死因死亡风险独立的危险因素,提示早期识别并干预MCI对预防中老年人群早死、延长寿命可能有潜在价值。
Objective To explore the association between mild cognitive impairment(MCI)and the risk of all-cause death among community middle-aged and older adults,and to provide evidence for early identification of high-risk populations.Methods From September to November 2011,the residents aged 55 years and middle-aged and older in five urban communities were selected as the research objects by typical sampling method.The baseline survey of general information questionnaire,Mini-Mental State Examination(MMSE),activity of daily Living Scale(ADL),Geriatric Depression Scale(SDS)was carried out and the physical examination was performed.Mild cognitive impairment at the time of enrollment was the exposure factor.In 2017,2019 and 2021,Deaths were followed up through home visits and search for death surveillance information systems.COX regression model was used to analyze the influencing factors for death.Results A total of 1046 participants completed the follow-up and were included in the study.The baseline age was(66.4±6.6)years,and 199(19.0%)of them met the criteria for MCI.The average follow-up time was 112±16 months.During the follow-up period,106 deaths were observed.The mortality rate was higher in participants with MCI(40 deaths,21.1%)than those without MCI[(66 deaths,10.1%),χ^(2)=26.80,P<0.001].Participants with MCI had a shorter median survival time than those without MCI[(108.0±1.5)vs.(113.0±0.5)months,χ_(log-rank)^(2)=28.02,P<0.001]using the Kaplan-Meier method.Controlling for gender,age,and ethnicity,the Cox regression model revealed that MCI is associated with an increased risk of all-cause death(HR=1.98,95%CI:1.30-3.02,P=0.023).Conclusions Mild cognitive impairment is an independent risk factor for all-cause death among community older adults.Early identification and intervention of MCI may have potential value in preventing premature death and prolonging life in middle-aged and older adults.
作者
马万瑞
胡雪
王立群
王志忠
Ma Wanrui;Hu Xue;Wang Liqun;Wang Zhizhong(The Second School of Clinical Medicine of Guangdong Medical University,Dongguan 523808,China;Department of Epidemiology and Health Statistics,School of Public Health at Guangdong Medical University,Dongguan 523808,China;Department of Epidemiology and Health Statistics,School of Public Health and Management,Ningxia Medical University,Yinchuan 750004,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2023年第3期272-276,共5页
Chinese Journal of Geriatrics
基金
国家自然科学基金课题(81860599)。
