上海市郊区老年人认知障碍的相关因素分析

Analysis of cognitive impairment and associated factors of the elderly in Shanghai suburbs

目的调查上海市郊区老年人群认知障碍患病情况,探讨与之相关的影响因素。方法选择上海市青浦区华新镇和徐泾镇≥60岁并拥有居住地常住户籍的居民作为研究对象。采用事先拟定的调查问卷进行面对面询问和简易智能状态检查量表(MMSE)评价,记录人口一般资料、既往史、个人史和家族史,并对可能相关的影响因素进行调查。依据受试者受教育程度,文盲(未受过教育)、小学文化(受教育≤6年)以及中学及以上文化(受教育>6年)者中MMSE评分≤17分、≤20分及≤24分者均纳入认知障碍组,其余纳入正常对照组。对相关资料进行χ2检验、秩和检验及Logistic回归分析。结果实际接受调查并获得有效资料者共2809例,占符合研究对象条件者的73.36%(2809/3829),男1010例,女1799例;年龄60～92岁,平均(70.55±6.58)岁,男(70.72±6.36)岁,女(70.45±6.70)岁。单因素分析显示,女性、高龄、文盲、离婚和(或)丧偶、吸烟、饮酒、饮茶、饮食偏咸、体力活动[(60～)min/d]、记忆障碍及收缩压偏高等因素均与认知障碍有关(P<0.05);多因素分析显示,高龄和饮食偏咸为老年期认知障碍的危险因素(OR=2.204,95%CI:1.719～2.827;OR=1.362,95%CI:1.090～1.700)。结论老年期认知障碍与高龄及饮食偏咸有关,而饮酒和饮茶可能对老年人的认知功能具有一定的保护作用。

Objective To investigate the relationship of cognitive impairment and associated factors among the elderly in Shanghai suburbs. Methods Residents （ ≥ 60 year-old） with household registration in Huaxin town and Xujing town, Qingpu district, Shanghai were chosen. Face-to-face interview was conducted to collect relevant information with prepared questionnaires by specially trained investigators. The Mini-Mental State Examination （MMSE） was used to screen subjects with cognitive impairment. General data, past history, personal history and family history of subjects were recorded, and associated factors of the elderly were investigated. We adopted the following cut-off points of MMSE score according to the education level of participants for cognitive impairment： ≤ 17 for those without formal education, ≤ 20 for those with 1-6 years of education （primary school）, and ≤ 24 for participants with more than 6-year-education （middle school or higher）. The others were classified as normal controls. χ^2 analysis, rank sum test and Logistic regression analysis were performed to evaluate associated factors with cognitive impairment. Results In the population （n = 3829） accorded with the demands, 2809 （73.36%） subjects （male 1010, female 1799） with 60-92year-old [average （70.55± 6.58）; male （70.12±6.36）, female （70.45±6.70）] who had effective data were studied. In the univariate analysis, female, old age, illiteracy, divorced and （or） widowed, smoking, alcohol consumption, drinking tea, salty diet, physical activity [（60-） min/d], memory decline, high systolic blood pressure were found to be associated with cognitive impairment （P〈 0.05, for all）; but in multivariate Logistic regression analysis, only old age （OR = 2.204, 95% CI： 1.719-2.827） and salty diet （OR= 1.362, 95%CI： 1.090-1.700） were shown to be the risk factors for senile cognitive impairment. Conclusion Old age and salty diet are associated with senile cognitive impairment, while alcohol consumption and drinking tea may be protective factors for cognitive function.