社区老年人可逆与潜在可逆性认知衰弱情况及影响因素研究
Status and Influencing Factors of Reversible and Potentially Reversible Cognitive Frailty among the Community-dwelling Elderly
背景 ?认知衰弱（CF）是老年人常见的临床综合征，分为可逆性认知衰弱（RCF）和潜在可逆性认知衰弱（PRCF），易导致跌倒、残疾和死亡等不良健康结局的发生，而目前社区老年人群不同分型CF患病情况及影响因素的研究相对较少。目的 ?了解社区老年人RCF与PRCF患病情况，探讨RCF与PRCF的影响因素，为CF（尤其是RCF）的早期识别与预防提供理论基础。方法 ?于2023年6—8月，采取便利抽样法抽取天津市北辰区某社区体检的3916名老年人进行“面对面”问卷调查，调查工具包括社区居民一般情况调查表、FRAIL衰弱量表、简易精神状况检查量表（MMSE）、主观认知下降问卷（SCD-Q9）等。评估社区老年人不同分型CF的发生情况，采用多因素Logistic回归分析探讨老年人发生不同分型CF的影响因素。结果 ?3916名老年人中，RCF老年人679名（17.34%），PRCF老年人440名（11.24%）。不同CF分型老年人的性别、年龄、受教育程度、锻炼情况、吸烟史、饮酒史、睡眠障碍、高血压患病情况、糖尿病患病情况、脑卒中患病情况、血红蛋白（Hb）水平、慢性病用药数量比较，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，以无CF为参照，女性（OR=2.186，95%CI=1.713~2.791）、年龄≥70岁（OR=3.056，95%CI=2.519~3.708）、有吸烟史（OR=1.753，95%CI=1.431~2.146）、有睡眠障碍（OR=1.275，95%CI=1.046~1.555）、Hb水平异常（OR=1.531，95%CI=1.026~2.284）、慢性病用药数量≥3种（OR=2.168，95%CI=1.490~3.156）与老年人较高的RCF风险有关（P<0.05），锻炼（OR=0.459，95%CI=0.382~0.551）与老年人较低的RCF风险有关（均P<0.05）；女性（OR=1.941，95%CI=1.465~2.573）、年龄≥70岁（OR=1.830，95%CI=1.460~2.292）、有饮酒史（OR=2.270，95%CI=1.734~2.970）、有睡眠障碍（OR=1.996，95%CI=1.557~2.560）、有脑卒中（OR=2.114，95%CI=1.026~4.355）、Hb水平异常（OR=1.991，95%CI=1.288~3.078）、慢性病用药数量≥3种（OR=1.626，95%CI=1.050~2.518）与老年人较高的PRCF风险有关，锻炼（OR=0.522，95%CI=0.423~0.644）与老年人较低的PRCF风险有关（P<0.05）。结论 ?天津市北辰区社区老年人RCF与PRCF的发生率较高，建议在社区体检中加入CF评估，通过制定并执行多维度的有效方案来延缓CF发生、发展。
Background ?Cognitive frailty is a prevalent clinical syndrome in the elderlywith subtypes of reversible and potentially reversible cognitive frailty. It is associated with adverse health outcomes such as fallsdisabilityand mortality. Howeverthere is limited research on the current prevalence of cognitive frailty subtypes and their influencing factors in the elderly population. Objective ?To investigate the current status of cognitive frailtyCF among community elderly in Beichen District in Tianjinand to explore the influencing factors of different subtypes of cognitive frailtyso as to provide references for the early identification and intervention of reversible cognitive frailtyRCF. Methods ?From June to August 2023totally 3 916 community residents in Beichen DistrictTianjin were recruited with convenience samplingand a face-to-face questionnaire survey was conducted using the demography questionnaireFRAIL Frailty Scalethe Brief Mental Status Examination ScaleMMSEand the Subjective Cognitive Decline QuestionnaireSCD-Q9 to assess the incidence of different types of cognitive frailty and analyze the influencing factors among older people using a multivariate Logistic regression model. Results ?Among 3 916 participants67917.34% with RCF and 44011.24% with PRCF. There were significantly differences in CF prevalence among the elderly with different gendersageseducational backgroundssleep disordersthe prevalence of various types of chronic illnessesexercisesmoking historiesdrinking historiesthe number of medications used for chronic illnessesand hemoglobin levelsP<0.05. Multifactorial Logistic regression analysis showed that with no cognitive frailty as a controlbeing femaleOR=2.18695%CI=1.713-2.791age 70 yearsOR=3.05695%CI=2.519-3.708smokingOR=1.75395%CI=1.431-2.146having a sleep disorderOR=1.27595%CI=1.046-1.555low hemoglobin levelsOR=1.53195%CI=1.026-2.284and 3 medications for a chronic conditionOR=2.16895%CI=1.490-3.156 were associated with a higher risk of RCFand exerciseOR=0.45995%CI=0.382-0.551 was associated with a lower risk of RCFP<0.05 being femaleOR=1.94195%CI=1.465-2.573age 70 yearsOR=1.83095%CI=1.460-2.292drinkingOR=2.27095%CI=1.734-2.970having a sleep disorderOR=1.99695%CI=1.557-2.560strokeOR=2.11495%CI=1.026-4.355low hemoglobin levelsOR=1.99195%CI=1.288-3.078 and 3 medications for a chronic conditionOR=1.62695%CI=1.050-2.518were associated with a higher risk of PRCFand exerciseOR=0.52295%CI=0.423-0.644 was associated with a lower risk of PRCF in the agedP<0.05. Conclusion ?The prevalence of reversible and potentially reversible cognitive frailty is high among the elderly in the community of Beichen District in Tianjin. It is recommended to add the assessment of CF into community physical examinations and implement multidimensional effective strategies to delay the onset and progression of CF.
???àá?、??D?è?、??à?、á???、?ü?á3?、2üá￠′o
医药卫生理论预防医学神经病学、精神病学
衰弱认知障碍老年人精神状态和痴呆测验患病率影响因素分析
???àá?,??D?è?,??à?,á???,?ü?á3?,2üá￠′o.社区老年人可逆与潜在可逆性认知衰弱情况及影响因素研究[EB/OL].(2024-11-26)[2025-04-02].https://chinaxiv.org/abs/202411.00263.点此复制
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