Older people with chronic diseases in the community have a higher risk of impaired cognitive function, which seriously threatens their quality of life. Improving cognitive function is crucial for enhancing their quality of life. However, there is heterogeneity in the forms of individual cognitive impairment, and how to effectively improve their cognitive function needs to be further explored.

To explore the Latent class of cognitive function among older people with chronic diseases in the community, and analyze the influence factors of different categories, to provide a reference for formulating targeted cognitive function improvement strategies for older people with chronic diseases in the community.

Convenience sampling was used to recruit 502 older people with chronic diseases in the community who visited the Tianjin University of Traditional Chinese Medicine Affiliated Baokang Hospital from September to December 2022, using the General Information Questionnaire, Mini-mental State Examination (MMSE), Activity of Daily Living Scale (ADLS), Social Support Rating Scale (SSRS), and Cognitive Reserve Questionnaire (CR). Mplus 8.3 was used to conduct a latent class analysis of cognitive function among older people with chronic diseases in the community and establish a subgroup model. Univariate analysis and unordered multiple Logistic regression were used to analyze the influence factors of cognitive function among older people with chronic diseases in different categories.

In this study, a total of 526 questionnaires were distributed and 502 valid questionnaires were recovered, with an effective response rate of 95.44%. The cognitive function among 502 older people with chronic diseases in the community was classified into three categories: high cognition with memory impairment group (n=253), moderate cognition with attention impairment group (n=158), and low cognition with overall impairment group (n=91). Unordered multivariate Logistic regression analysis showed that the high cognition with memory impairment group compared to the low cognition with overall impairment group, older people aged 60-74 years (OR=2.315, 95%CI=1.163-4.608, P=0.017), with two chronic diseases (OR=4.105, 95%CI=1.807-9.327, P=0.001), normal blood pressure (OR=2.763, 95%CI=1.414-5.400, P=0.003), normal blood lipids (OR=2.016, 95%CI=1.014-4.008, P=0.046), higher CR scores (OR=1.031, 95%CI=1.005-1.057, P=0.018), and higher SSRS scores (OR=1.055, 95%CI=1.007-1.105, P=0.023) were more likely to belong to the high cognition with memory impairment group, while those with higher ADLS scores (OR=0.920, 95%CI=0.885-0.957, P<0.001) were more likely to belong to the low cognition with overall impairment group. Similarly, in the moderate cognition with attention impairment group compared to the low cognition with overall impairment group, older people with chronic diseases in the community with two chronic diseases (OR=2.862, 95%CI=1.254-6.529, P=0.012), normal blood pressure (OR=2.655, 95%CI=1.350-5.225, P=0.005), normal blood lipids (OR=2.310, 95%CI=1.147-4.652, P=0.019), and higher SSRS scores (OR=1.077, 95%CI=1.027-1.129, P=0.002) were more likely to belong to the moderate cognition with attention impairment group, while those with higher ADLS scores (OR=0.948, 95%CI=0.913-0.984, P=0.005) were more likely to belong to the low cognition with overall impairment group.

There are significant differences in the classification characteristics of cognitive function among older people with chronic diseases in the community. Age, number of chronic diseases, blood pressure, blood lipids, cognitive reserve, social support, and activities of daily living are the influencing factors of the latent classes of cognitive function. Medical staff should actively identify the cognitive function characteristics of different categories of older people with chronic diseases in the community, and provide timely and effective intervention measures to improve the cognitive function level of older people with chronic diseases in the community.

患有慢性病的社区老年人认知功能受损风险更高，严重威胁其生活质量，而提高认知功能是改善其生活质量的重要手段，但不同特征社区慢性病老年人群体间认知功能受损形式存在异质性，如何有效提升其认知功能有待进一步探索。

探讨社区慢性病老年人认知功能潜在类别，并分析不同类别影响因素，以期为针对性制订认知功能提升策略提供参考。

采用便利抽样法，于2022年9—12月使用一般情况调查表、简易精神状态量表（MMSE）、日常生活活动能力量表（ADLS）、社会支持量表（SSRS）、认知储备问卷（CR）抽取在天津中医药大学附属保康医院就诊的社区慢性病老年人进行问卷调查。利用Mplus 8.3进行潜在类别分析，建立亚组模型。通过单因素分析和无序多元Logistic回归分析探究不同类别社区慢性病老年人认知功能影响因素。

本研究共发放问卷526份，回收有效问卷502份，有效回收率为95.44%。502例社区慢性病老年人认知功能可分为3个类别：高认知-回忆受损组（n=253）、中认知-注意障碍组（n=158）和低认知-普遍不良组（n=91）。无序多元Logistic回归分析结果显示，高认知-回忆受损组与低认知-普遍不良组相比，年龄段为60~74岁（OR=2.315，95%CI=1.163~4.608，P=0.017）、慢性病数量为2种（OR=4.105，95%CI=1.807~9.327，P=0.001）、血压正常（OR=2.763，95%CI=1.414~5.400，P=0.003）、血脂正常（OR=2.016，95%CI=1.014~4.008，P=0.046）、CR总分越高（OR=1.031，95%CI=1.005~1.057，P=0.018）、SSRS总分越高（OR=1.055，95%CI=1.007~1.105，P=0.023）的社区慢性病老年人更容易进入高认知-回忆受损组，而ADLS总分越高（OR=0.920，95%CI=0.885~0.957，P<0.001）的老年人更容易进入低认知-普遍不良组；中认知-注意障碍组与低认知-普遍不良组相比，慢性病数量为2种（OR=2.862，95%CI=1.254~6.529，P=0.012）、血压正常（OR=2.655，95%CI=1.350~5.225，P=0.005）、血脂正常（OR=2.310，95%CI=1.147~4.652，P=0.019）、SSRS总分越高（OR=1.077，95%CI=1.027~1.129，P=0.002）的社区慢性病老年人更容易进入中认知-注意障碍组，而ADLS总分越高（OR=0.948，95%CI=0.913~0.984，P=0.005）的老年人更容易进入低认知-普遍不良组。

社区慢性病老年人认知功能存在明显不同的分类特征，年龄、慢性病数量、血压、血脂、认知储备、社会支持、日常生活活动能力是其认知功能潜在类别的影响因素，医护人员应积极识别不同类别社区慢性病老年人认知功能特征，及时给予有效的干预措施，以提高社区慢性病老年人认知功能水平。