认知障碍对老年人健康预期寿命的影响

Impact of cognitive impairment on the active life expectancy in the elderly

目的研究认知障碍对北京市城乡≥60岁人群的预期寿命(LE)、健康预期寿命(ALE)及ALE/LE比值的影响。方法纳入的样本来自"北京老龄化多维纵向研究"课题,对象为宣武区(城区)、大兴区(近郊平原)、怀柔区(远郊山区)≥60岁老年人群。于2009年采用简易精神状态量表对2111人行认知功能的评估。2011年对该样本进行随访。根据能否独立完成日常生活活动(ADL),评定健康与否。应用多状态寿命表IMaCH软件计算各年龄段认知障碍组与非认知障碍组的LE、ALE和ALE/LE比值。结果基线调查的2111人中认知障碍者有312例。①北京市老年人总体LE和ALE趋势为女性高于男性,城市高于农村。认知障碍组的LE和ALE均明显低于认知正常组。②认知障碍组中,城市低龄组(<70岁)男性LE和ALE均明显低于同龄段女性。男、女,城、乡均为高龄组(≥80岁)的LE和ALE最低,但与认知正常组比较,城、乡均为女性的LE和ALE下降程度大于男性。③ALE/LE比值总体趋势为男性高于女性,城市高于农村。ALE/LE比值在两组均随年龄的增长而下降,但是认知障碍组的比值下降速度更快,尤其以农村高龄(≥80岁)女性ALE/LE比值最低。结论认知障碍对北京市老年人的LE、ALE、ALE/LE比值均有显著影响,特别是对农村高龄女性影响更显著。

Objective To study impact of cognitive impairment on the life expectancy（LE）,active life expectancy（ALE） and ALE/LE ratios in ≥ 60-year Beijing urban and rural population.Methods The samples were derived from Beijing Multidimensional Longitudinal Study on Aging.The subjects were the ≥ 60-year population from Xuanwu district（urban areas）,Daxing district（plain） and Huairou district（mountain areas） in Beijing.The assessment of cognitive function was conducted in 2111 subjects in 2009 by using the Mini Mental State Scale.The samples were followed up in 2011.Health or not was assessed according to whether the patients independently completed the activities of daily living（ADL）.The LE,ALE and ALE/LE in each age stage in a cognitive impairment group and the non-cognitive impairment group were calculated by using the multi-state life table（IMaCH software）.Results There were 312 old people with cognitive impairment among the 2111 elderly.①Both LE and ALE of the elderly women in Beijing were higher than men,and urban population had a higher LE and ALE than rural areas.The LE、ALE and ALE/LE of the elderly with cognitive impairment were lower than normal cognitive group.②In the cognitive impairment group,the LE and ALE of the urban younger aged male（70 years） were significantly lower than the same age group of women.Regardless of region and gender,people over 80 years had the lowest LE and ALE.LE and ALE of the female decreased more than that of male.③The ratio of ALE/LE of male was higher than female,as well as higher in urban elderly.The ALE/LE ratio was descending along with ageing in both cognitive impairment group and normal cognitive group,and the speed of reduction was much faster in the cognitive impairment group,especially in suburban female population over 80 years old had the lowest ALE/LE ratio.Conclusion Cognitive impairment remarkably impacted the active life expectancy on senior citizens living in Beijing,especially for the elderly.