As the primary place of treatment for mild cognitive impairment (MCI), community primary medical institutions need to carry out cognitive function health management for the MCI population. At present, the community still lacks the specific process and program of MCI cognitive function health management. Based on the "Structure-Process-Results" three-dimensional quality structure theoretical model, this study reviewed the community MCI cognitive function health management strategies from three dimensions of functional departments and organizational structure (Structure), health management program (Process) and effect evaluation system and methods (Results), aiming to provide support and reference for the standardized and process-oriented MCI cognitive function health management practice in Chinese communities.
In recent years, physical impairment (PI) combined with cognitive impairment (CI) is a common comorbidity in the elderly. An early detection of PI combined with CI in the elderly and timely interventions may help to improve the quality of life of the elderly and reduce the burden on their families and society. However, relevant studies on the comorbidity of PI and CI in the elderly and its influencing factors have been rarely reported.
To observe the clinical characteristics of the comorbidity of PI and CI in the elderly and the influencing factors.
Elderly patients hospitalized in Peking University People's Hospital from September 2018 to November 2019 were selected. A total of eligible 244 subjects meeting the inclusion criteria were surveyed for the physical function and cognitive function using the Short Physical Performance Battery (SPPB) and the Mini-mental State Examination (MMSE), respectively. PI was diagnosed with lower than 10 points of the SPPB, and CI was diagnosed with lower than 27 points of the MMSE. Patients were divided into non-PI+non-CI, PI+non-CI, non-PI+CI, PI+CI. Social demographic, anthropometric, laboratory examination and other indicators of patients were collected, and Logistic regression analysis was used to explore the influencing factors for PI combined with CI in the elderly.
Among the 244 patients, there were 102 (41.80%), 64 (26.23%), 26 (10.66%) and 52 (21.31%) cases of non-PI+non-CI, PI+non-CI, non-PI+CI and PI+CI, respectively. Multivariate binary Logistic regression analysis showed that compared with non-PI+non-CI cases, age (P<0.001, OR=1.216, 95%CI=1.217-1.312) and grip strength (P<0.001, OR=0.875, 95%CI=0.813-0.941) were independent influencing factors for PI+CI cases. Compared with PI+non-CI cases, fatty liver disease (P=0.007, OR=0.200, 95%CI=0.062-0.646), hypertension (P=0.007, OR=3.596, 95%CI=1.414-9.143), and grip strength (P=0.038, OR=0.943, 95%CI=0.891-0.997) were independent influencing factors for PI+CI cases. Compared with non-PI+CI cases, age (P=0.008, OR=1.104, 95%CI=1.026-1.189) and grip strength (P=0.004, OR=0.889, 95%CI=0.821-0.963) were independent influencing factors for PI+CI cases.
Grip strength is the independent influencing factor for PI combined with CI in the elderly. Among the elderly patients without PI and CI, age and grip strength were the influencing factors of PI and CI. In elderly patients with PI and no CI, fatty liver, hypertension and grip strength were the influencing factors of PI and CI.
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.
With the intensifying trend of population aging, cognitive impairment has become one of China's significant public health challenges. The impact of lifestyle on cognitive impairment warrants further exploration.
This study aims to ascertain the prevalence of cognitive impairment among the elderly in the Baoshan District of Shanghai and analyze how educational level, economic status, lifestyle, and comorbidities affect cognitive impairment, providing a scientific basis for early prevention and control.
From July 2020 to August 2020, a stratified random sampling method was employed to survey 374 residents aged 65 and older in the Dachang Community of Baoshan District, using the Montreal Cognitive Assessment Basic Scale (MoCA-B) for cognitive evaluation. Multivariate Logistic regression analysis was used to explore the factors influencing cognitive impairment among the elderly.
A total of 374 valid questionnaires were retrieved, with a response rate of 100.0%. The prevalence of cognitive impairment among the suburban elderly population over the age of 65 in Shanghai was 37.7% (141/374). The multivariate Logistic regression analysis indicated that socializing and chatting (OR=0.574, 95%CI=0.350-0.941) were protective factors against cognitive impairment (P<0.05), while aging (OR=1.568, 95%CI=1.207-2.307), living alone (OR=3.569, 95%CI=1.079-11.807), and daily sedentary time of ≥3 hours (OR=1.944, 95%CI=1.091-3.462) were risk factors (P<0.05) .
Over one-third of the elderly in the suburban areas of Shanghai suffer from cognitive impairment; advanced age, living alone, and prolonged daily sedentary behavior are significant risk factors that should be closely monitored.
