北京老年人群轻度认知障碍患病情况及危险因素的抽样调查

Investigation of the incidence of mild cognitive impairment and its risk factors in an elderly population sample in Beijing area

目的抽样调查北京地区老年人群轻度认知障碍(MCI)的患病情况及其危险因素。方法2004年抽样调查北京地区≥60岁人群1865人,根据问卷调查及临床医师检查进行MCI诊断,分析其中资料完整的1750人的MCI患病情况及其危险因素。结果①1750人中,患MCI203例,患病率为11.6%。其中≥75岁者的患病率(123例,15.7%)高于<75岁者(80例,8.3%);文盲(130例,17.5%)高于非文盲(73例,7.2%);农村(92例,19.4%)高于城区(111例,8.7%);差异均有统计学意义(均P=0.000)。虽然女性患病率(111例,12.3%)高于男性(92例,10.8%);无配偶的老人(77例,13.7%)高于有配偶的老人(126例,10.6%),但差异无统计学意义。②在高血压、糖尿病、冠心病及卒中病史中,仅卒中对MCI患病率有影响(χ2=18.853,P=0.000)。经年龄、性别分层后,高血压、冠心病和糖尿病对年龄<75岁、≥75岁及不同性别人群的MCI患病率仍无明显影响(P>0.05);而卒中可增加老年男性(χ2=16.858,P=0.000)、女性(χ2=4.531,P=0.045)及<75岁(χ2=33.024,P=0.000)人群MCI的患病率。③随着患高血压、糖尿病、冠心病及卒中疾病种类的增加,在男性(χ2=11.119,P=0.004)和<75岁人群中(χ2=6.117,P=0.047),MCI的患病率也随之增加。④多因素Logistic回归分析显示,卒中(OR:2.134,95%CI:1.459～3.120)、居住在农村(OR:2.084,95%CI:1.502～2.893)、≥75岁(OR:1.853,95%CI:1.342～2.559)及文盲(OR:2.178,95%CI:1.517～3.128)是MCI患病的独立危险因素。结论卒中是老年人群患MCI的独立危险因素。对<75岁人群及男性老人,预防卒中对预防痴呆的发生更有意义。

Objective To investigate the incidence of mild cognitive impairment （MCI） and its risk factors in an elderly population sample in Beijing area. Methods A sampling survey in 1865 aged subjects （ ≥ 65 years old） was established in Beijing area in 2004. The diagnosis of MCI was established according to the questionnaires and clinicians＇examinations. 1750 subjects with complete data about MCI were selected in this study and the risk factors were analysis. Results （1）Of the 1750 subjects, 203 had MCI, and the over- all prevalence was 11.6%. Among them, the prevalence in ≥75 years old subjects （15.7%） was higher than that in 〈75 years old subjects （8. 3% ） ; the prevalence in the illiterate subjects （ 17.5% ） was high than that in the literate subjects （7.2%） ; and the prevalence in the rural subjects （7. 2% ） was higher than that in the urban subjects （ 8.7% ）. There were significant differences among them （ P = 0. 000 all ）. Although the incidence in females （ 12. 3% ） was higher than that in males （ 10. 8% ）, and the aged people without spouses （ 13.7% ） was higher than that who had spouses （ 10. 6% ）, but there were no significant differences. （2）Only stroke had effect on the incidence of MCI in patients with the history of hypertension, di- abetes mellitus, coronary artery disease and stroke （X2 = 18. 853, P =0. 000）. Hypertension, coronary artery disease and diabetes mellitus had no significant effects on the incidence of MCI in the different age and sex groups （ P 〉 0. 05 ） ; While that stroke increased the incidence of MCI in the populations of old male （X2 =16. 858,P=0.000）, female （X2 =4.531, P=0.045） and 〈75 years old subjects（x2 =33.024, P= 0. 000）. （3）With the increased coexistent diseases such as hypertension, diabetes mellitus, coronary artery disease and stroke （0, 1 and ≥2 diseases）, the incidence of MCI was also increased in the populations of male （X2 = 11. 119, P =0. 004） and 〈75 years old persons（x2 =6. 117, P =0. 047）. （2） The multiple logistic regression analysis showed that stroke （OR ：2. 134,95% CI, 1. 459 -3. 120）, living in countryside （OR： 2. 084,95% CI, 1. 502 - 2. 893 ）, t〉75 years old （ OR ： 1. 853,95% CI, 1. 342 - 2. 559 ） and illiterate （ OR ： 2. 178,95% CI, 1. 517 -3. 128） were the independent risk factors for MCI. Conclusion Stroke is an in- dependent risk factor for MCI in old populations. Prevention of stroke is more significant for preventing dementia in the 〈 75-year-old population and the aged males.