老年人轻度认知功能损害与社会支持关系

Influence of social support on incidence of MCI and its subtypes among the elderly

目的了解不同社会支持情况对贵州省贵阳市城区≥60岁老年人轻度认知功能损害(MC I)及其不同亚型发病的影响。方法采用前瞻性研究的方法,对基线调查时认知功能正常且完整填写社会支持情况的2 156名≥60岁贵阳市城区老年人进行认知功能状态随访,采用Cox回归模型分析不同社会支持情况对随访老年人MC I及其亚型发病的影响。结果拥有客观支持是避免MC I(ID=14.76/1 000人年,RR=0.424,95%CI:0.220～0.819)及遗忘型MC I(ID=10.22/1 000人年,RR=0.366,95%C:I 0.174～0.767)发病的保护因素;遗忘型MC I中收入来源数量≥2种者发病密度(ID)较高(ID=12.29/1 000人年),而在非遗忘型MC I中发病密度较低(ID=3.35/1 000人年);靠夫妇双方收入作为家庭经济收入的老年人发生非遗忘型MC I的危险性(ID=3.05/1 000人年)低于收入仅靠他人的老年人(ID=10.39/1 000人年,RR=0.253,95%C:I 0.106～0.601);未发现其他社会支持情况对不同亚型MC I发病有影响(P>0.05)。结论社会支持是MC I及其亚型的保护因素;分型研究发现影响各型MC I发生的因素有差别,说明分型研究MC I有必要,可为制定更有针对性的预防措施提供科学依据。

Objective To investigate the influence of social support on the incidence of mild cognitive impairment（MCI） and its subtypes among the elderly in communities of Guiyang city.Methods A total of 2 159 persons aged 60 years or older with normal cognitive function were followed-up and surveyed with questionnaires and scales in Guiyang city.The study analyzed the influence of social support on the incidence of MCI and its subtypes by Cox regression model.Results Objective support was a protective factor for MCI（relative risk=0.424,95% confidence interval：0.220-0.819） and amnestic MCI（RR=0.366,95%CI：0.174-0.767）.With economic support source≥2,the incidence of amnestic MCI（icidence density=12.29/1 000 person years） was higher than that of nonamnestic MCI（ID=3.35/1 000 person years）.Economic support from the spouse reduced the risk of amnestic MCI＇s incidence（RR=0.253,95%CI：0.106-0.601）.Other social support had no influence on the incidence of MCI subtypes（P0.05）.ConclusionThe results suggest that social support is helpful to decrease MCI incidence.The determinants of nonamnestic MCI are different from tha of MCI and amnestic MCI.It is necessary to study the feature of MCI subtypes for developing preventive strategies.