社会资源对老年人轻度认知功能损害发病影响

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

目的了解社会网络和社会活动2种社会资源对老年人轻度认知功能损害(MCI)及其不同亚型发病的影响,为采取干预措施提供参考依据。方法采用前瞻性研究的方法,对贵州省贵阳市城区老年人认知功能状况基线调查中认知功能正常,且完整填写社会资源情况的2 144名≥60岁老年人进行认知功能状态的随访调查,采用Cox回归模型分析不同社会资源情况对随访老年人MCI及其亚型发病的影响。结果 2 144名预期随访对象中,实际随访到1 401人,其中新发MCI病例102例,发病密度为15.21/1 000人年,其中遗忘型MCI(aMCI)71例,非遗忘型MCI(naMCI)31例,发病密度分别为10.59/1 000人年和4.62/1 000人年;1 401名老年人中,与子女、亲戚、朋友和邻居有相聚的老年人分别占58.7%、55.8%、64.1%和68.2%,在婚且非独居老年人占66.9%,社会资源丰富程度为不良、较小、适量和丰富的老年人分别占3.7%、20.2%、48.0%和28.0%,不参加集体活动、参与智力活动、参与体力活动和参与其他类型活动的老年人分别占12.9%、16.2%、57.6%和13.3%,偶尔和经常活动的老年人分别占35.8%和51.3%;Cox单因素回归分析结果表明,有子女看望和与朋友相聚是MCI(RR子女=0.647,95%CI=0.437～0.957;RR朋友=0.657,95%CI=0.445～0.972)及aMCI(RR子女=0.504,95%CI=0.316～0.805;RR朋友=0.600,95%CI=0.376～0.956)发病的保护因素;Cox多因素回归分析结果表明,有子女看望是MCI及aMCI发病的保护因素,与朋友相聚是aMCI发病的保护因素。结论有子女看望和与朋友相聚等社会资源是aMCI的保护因素。

Objective To analyze the effect of social resources,including social network and social activity,on mild cognitive impairment（MCI） and its subtypes in community elderly of Guiyang city.Methods A total of 2 144 persons aged 60 years and older with normal cognitive function and social resources was followed up with questionnaire and scale surveys in Guiyang city.The influences of social resources on the incidence of MCI and its subtypes were analyzed with Cox regression model.Results At the beginning the survey,there were 2 144 participants and at the end of the survey,the number of participants was 1 401,of wihic there were 102 new MCI（71 amnesic MCI and 31 nonamnesic MCI）.The incidence density of MCI was 15.21/1 000 person years and those of amnesic MCI and nonamnesic MCI were 10.59/1 000 person years and 4.62/1 000 person years.In the 1 401 respondents,the number of elders contacting with their children,relatives,friends,and neighbors were 822（58.7%）,782（55.8%）,898（64.1%）,and 956（68.2%）,respectively.There were 937（66.9%）elders married and lived with others.The number of the elders with poor,less,moderate,and abundant social resource was 52（3.7%）,283（20.2%）,673（48.0%）,and 392（28.0%）,respectively.There were 180（12.9%）elders not taking part in congregate activity,227（16.2%） elders taking part in intellectual activity,807（57.6%） elders taking part in physical activity,and 187（13.3%）taking part in other activities.There were 501（35.8%） elders having activity occasionally and 719（51.3%） elders having activity usually.Keeping contact with children and friends were protective factors for amnestic MCI（relative riskchildren=0.510,95%confidence interval：0.317-0.820;P=0.005;RRfriends=0.611,95%CI：0.380-0.982;P=0.042）.There was no influence on the incidence of MCI subtypes for other social resources.Conclusion The results show that adequate social resources are helpful to decrease the incidence of amnestic MCI.