中国全科医学 ›› 2022, Vol. 25 ›› Issue (34): 4278-4285.DOI: 10.12114/j.issn.1007-9572.2022.0395

所属专题: 运动相关研究最新文章合集 老年问题最新文章合集

• 论著·人群健康研究 • 上一篇    下一篇

社区主观认知下降老年人的运动认知风险综合征发生情况及影响因素研究

杨存美1, 舒刚明1, 胡亦新1,2, 马虹颖1, 李佳黛1, 张天一3, 毛鑫4, 吴冰5, 闫瑾5, 李天志2,6,*()   

  1. 1.100853 北京市,解放军总医院第二医学中心保健四科
    2.100853 北京市,国家老年疾病临床医学研究中心
    3.100853 北京市,解放军总医院医院管理研究所
    4.100191 北京市,北京大学第三医院放射科
    5.100853 北京市,解放军总医院研究生队
    6.100853 北京市,解放军总医院第二医学中心
  • 收稿日期:2022-06-20 修回日期:2022-09-02 出版日期:2022-12-05 发布日期:2022-09-29
  • 通讯作者: 李天志
  • 杨存美,舒刚明,胡亦新,等.社区主观认知下降老年人的运动认知风险综合征发生情况及影响因素研究[J].中国全科医学,2022,25(34):4278-4285.[www.chinagp.net]
    作者贡献:
    杨存美、胡亦新提出研究思路、负责统计学分析,并撰写论文;杨存美、李佳黛、毛鑫、吴冰、闫瑾负责数据收集与整理;舒刚明、马虹颖负责论文修订;张天一负责统计分析指导;李天志负责设计研究方案及指导研究实施。
  • 基金资助:
    军队保健专项课题(20BJZ30)

Prevalence and Influencing Factors of Motoric Cognitive Risk Syndrome in the Elderly with Subjective Cognitive Decline in the Community

YANG Cunmei1, SHU Gangming1, HU Yixin1,2, MA Hongying1, LI Jiadai1, ZHANG Tianyi3, MAO Xin4, WU Bing5, YAN Jin5, LI Tianzhi2,6,*()   

  1. 1.No.4 Healthcare Department, the Second Medical Center of the Chinese PLA General Hospital, Beijing 100853, China
    2.National Clinical Research Center for Geriatric Diseases, Beijing 100853, China
    3.Hospital Management Institute, Chinese PLA General Hospital, Beijing 100853, China
    4.Radiology Department, Peking University Third Hospital, Beijing 100191, China
    5.Graduate Team, Chinese PLA General Hospital, Beijing 100853, China
    6.The Second Medical Center of the Chinese PLA General Hospital, Beijing 100853, China
  • Received:2022-06-20 Revised:2022-09-02 Published:2022-12-05 Online:2022-09-29
  • Contact: LI Tianzhi
  • About author:
    YANG C M, SHU G M, HU Y X, et al. Prevalence and influencing factors of motoric cognitive risk syndrome in the elderly with subjective cognitive decline in the community[J]. Chinese General Practice, 2022, 25 (34) : 4278-4285.

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老年人MCR发生率较高,社区医护人员对社区SCD老年人进行MCR筛查时应更关注年龄、BADL、IADL、每周运动时长、焦虑情况、高血压、脑卒中/TIA等影响因素,协助控制慢性病并建立健康的生活方式,从而改善患者认知情况。

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

Abstract:

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) =1.083 (1.034, 1.134) 〕, lower ability to perform BADL〔OR (95%CI) =0.952 (0.914, 0.991) 〕, lower ability to perform IADL〔OR (95%CI) =0.623 (0.486, 0.798) 〕, weekly exercise hours〔OR (95%CI) =0.505 (0.295, 0.864) 〕, anxiety status〔OR (95%CI) =2.442 (1.225, 4.866) 〕, conditions of hypertension〔OR (95%CI) =1.948 (1.086, 3.497) 〕, and conditions of stroke/TIA〔OR (95%CI) =3.154 (1.745, 5.699) 〕were associated with MCR syndrome (P<0.05) .

Conclusion

The prevalence of MCR syndrome was high in older adults with SCD in the community. In view of this, during the MCR syndrome screening in this population, attention should be paid to risk factors such as older age, the ability to perform BADL and IADL, weekly exercise hours, anxiety status, conditions of hypertension, and conditions of stroke/TIA, and support should be provided for these people to control chronic disease and develop a healthy lifestyle, thereby improving their cognitive status.

Key words: Cognition disorders, Subjective cognitive decline, Motor cognitive risk syndrome, Decreased gait speed, Community-based screening, Root cause analysis