重大生活事件对老年人认知功能的影响

The effect of severe life events on cognitive function in elderly people

目的探讨重大生活事件对年龄≥60岁老年人认知功能及轻度认知损害（MCI）患病倾向性的影响。方法采用认知评估及生活事件问卷调查对3098名年龄≥60岁老年被试者进行评估，筛选1307例MCI倾向（MCI倾向组）和1092名正常对照（对照组），通过分析生活事件在2组老年人的暴露情况来探讨其对认知功能及MCI患病倾向的影响。结果丧失配偶[Х^2=55．131，OR=2．416，95％可信区间（CI）=1．905—3．063]、丧失父母子女（Х^2=13．570，OR=1．355，95％CI=1．153—1．594），经济困难（X^2=41．490，OR=1．990，95％CI：1．610～2．459），意外事故（Х^2=19．669，OR=1．513，95％CI=1．259～1．818）与MCI患病倾向性有明显相关性（P〈0．01）；而财产损失及犯罪事件（√=5．249，OR=1．605，95％CI=1．067—2．413）和其他生活事件（Х^2=4．305，OR=1．400，95％C1=1．018—1．925）与MCI患病倾向性有关（P〈0．05）；离异（Х^2=0．377，OR=0．754，95％CI=0．305～1．863）和失业（Х^2=3．559，OR=1．524，95％CI=0．981—2．368）与MCI患病倾向无明显相关（P〉0．05）。Logistic多元回归分析显示，年龄、经济困难、意外事故和其他生活事件对MCI患病倾向有显著影响（P〈0．01）；受教育程度可能对MCI患病倾向有保护作用（β=-1．236，SE=0．074，Wald=278．597，OR=0．290，95％Cl=0．251～0．336）。MCI倾向性比率随着经历生活事件的个数而增加。结论部分生活事件可能是导致老年人认知功能损害的危险因素。

Objective To explore the effects of severe fife events on the cognitive function and tendency of mild cognitive impairment （MCI） in elderly people. Methods The cognitive function and life events of 3098 people aged 60 years or above were assessed, and 1307 with MCI tendency and 1092 normal controls were selected out. Results Spouse death （ X^2 = 55. 131, OR = 2. 416, 95 % CI = 1. 905 - 3. 063 ）, parents and children＇s death （X^2 = 13. 570, OR = 1. 355, 95% CI = 1. 153 - 1. 594）, financial diffieuhies （ X^2 =41. 490, OR = 1. 990, 95% CI = 1. 610 - 2. 459） and accidents and disasters （ X^2 = 19. 669, OR = 1. 513, 95% CI = 1. 259 - 1. 818） were significantly relevant to cognitive dysfunction and MCI tendency （P 〈 0. 01 ）. Property loss and criminal experiences（ X^2 = 5. 249, OR = 1. 605, 95% CI = 1. 067 - 2. 413 ） and other life events （ X^2 = 4. 305, OR = 1. 400, 95% CI = 1. 018 - 1. 925 ） were relevant to cognitive dysfunction and MCI tendency （P 〈0. 05） , however, divorce （X^2 =0. 377, OR =0. 754, 95% CI =0. 305 - 1. 863） and unemployment （ X^2 = 3. 559, OR = 1. 524, 95% CI = 0. 981 - 2. 368 ） might not be relevant to MCI tendency （P 〉 0.05 ）. The logistic multiple regression analysis showed that age, education, financial difficulties, accidents and disasters and other life events were the related factors to the tendency of MCI （ P 〈 0; 01 ）. Conclusions Some severe life events might be the risk factors of elderly cognitive impairment.