成功老龄化机制的系列研究:随访部分

Serial study on the mechanism of successful aging:analysis of follow-up data

目的探索成功老龄(SA)化的可能机制。方法 (1)样本来源于社区≥65岁老年人。共完成随访156例,其中成功老龄(SA)组73例,常态老龄(UA)组57例,轻度认知功能损害(MCI)组26例。(2)研究工具采用中国老年成套神经心理测验和上海市社区老年人群健康问卷 SA2004等。结果 (1)SA 组老年人在即刻记忆、延迟记忆、长时记忆提取相关测验成绩随访前后差异无统计学意义(P>0.05),执行功能、序列学习和逻辑推理相关测验成绩随访前后差异有统计学意义(P<0.05);UA 组老年人在工作记忆、执行功能方面的下降有统计学意义(P<0.05);MCI 组老年人成绩的下降项目仅4项。(2)按年龄分组后,神经心理项目测验成绩随访前后比较,差异有统计学意义(P<0.05)的分量表有10项,其中有9项在71～75岁组下降数值相对最大。(3)躯体活动能力、心理状况及认知功能等基线指标与随访结局指标(健康状况调查问卷各分量表评分)的差异有统计学意义(P<0.05)。结论 (1)SA 老年人的高认知水平与大脑的整合功能及有效代偿相关,认知老化过程中执行功能可能属于易感领域,而71～75岁则可能是老年人认知老化的敏感时期。(2)UA、MCI 老年人的认知功能仍具一定的可塑性,SA 化干预具有现实意义。

Objective To explore the possible mechanism of successful aging. Methods Altogether 156 community elderly aged 65 years or over were interviewed in follow-up phase （from April 2004 to May 2005, mean follou-up time 2. 5 years）, among which there were 73 in successful aging （SA） group, 57 in usual aging （UA） group, 26 in mild cognitive impairment （MCI） group. All were assessed with the Neuropsychological Test Battery for Elderly （NTBE）. Results （ 1 ） Among SA group, the decline in the immediate recall, delayed recall probability and retrieval from long-term memory were little and the decline in perceptive speed and executive function was distinct. The decline in work memory and executive function was distinct among UA group. The item number in which decline significantly was very little in MCI group. Almost items declined steeper in 71 -75 aged people. （2） Physical activity, cognitive function and mental status significantly correlated to the changes of outcome measurement of the short-form 36 health survey （SF-36）. Conclusions （ 1 ） The high cognitive level of SA is correlated to integrated ability of brain and effective compensation, executive function may be an impressionable field in cognitive aging, 71 -75 year old may be the susceptive phase of cognitive aging. （2） The cognition of UA and MCI still have somewhat plasticity, successful aging interventions have realistic significance.