老年人生活方式与老年痴呆关系对照研究

Lifestyle and risk of dementia:a case-control study

目的分析生活方式相关因素和老年痴呆的关系,从生活方式中寻找老年痴呆的防治及干预措施,降低老年痴呆发病风险。方法在平湖市第一人民医院神经内科和宁波市康宁医院老年科2010年1月～2011年12月间就诊的老年期痴呆患者,共入组120例,对照组按照性别、年龄(±3岁)、文化程度作为配对条件,1∶2配比在病患同社区选择健康老年人入组,共入组240例,完成基线调查。对全部入组对象进行神经心理学测验,包括简易精神状态量表(MMSE)、临床痴呆评定量表(CDR)等。采用SPSS15.0进行数据分析,采用t检验、χ2检验进行单因素分析,logistic回归进行多因素分析。结果单因素分析发现病例组每天抽烟20支以上、每周至少一次家庭活动、退休后继续工作、旅游、积极参与社会活动、规律体育锻炼、休闲活动、棋牌、阅读、使用电脑、饮茶、食用咸菜及腌制品、认知功能训练、食用不饱和脂肪酸油类、食用鱼类及海产品、每天食用蔬菜和老年痴呆相关(P<0.05)。多因素分析证实:棋牌、每年旅游、退休后继续工作、阅读(>30min/d)、使用电脑(>30min/d)、缺少体育锻炼、认知功能训练、不参与社会活动、少食用不饱和脂肪酸油类、经常食用鱼及海产品、每天食用蔬菜水果为老年痴呆的发病影响因素,OR值分别为0.613(0.364～0.873)、0.671(0.367～0.782)、0.531(0.326～0.724)、0.572(0.374～0.828)、0.536(0.316～0.869)、3.532(1.016～5.316)、0.352(0.191～0.524)、3.256(1.485～6.765)、3.624(1.468～6.587)、0.224(0.173～0.592)、0.285(0.116～0.565)。结论实行积极、休闲生活方式和健康合理饮食,避免危险因素,可有效地降低老年痴呆发病风险。

Objective To assess the lifestyle of seniors and to evaluate the risk factors of Dementia.Methods A case-control study was conducted.A total of 120 patients with dementia and 240 healthy seniors from the same community whose background matched with those of patients were enrolled in to the study.All subjects were tested neuropsychologically including MMSE and CDR.The data was analyzed by statistical technique of Chi-square test and conditional logistic regression by SPSS 15.0.Results Multiple factor analysis confirmed that playing chess,travelling,working after retirement,reading,using computer,physical excising,cognitively stimulating activities,social activities,consuming saturated fatty acids,eating seafood,daily consumption of fruits and vegetables were closely related factors to dementia with the OR values of 0.613（0.364-0.873）,0.671（0.367-0.782）,0.531（0.326-0.724）,0.572（0.374-0.828）,0.536（0.316-0.869）,3.532（1.016-5.316）,0.352（0.191-0.524）,3.256（1.485-6.765）,3.624（1.468-6.587）,0.224（0.173-0.592）,0.285（0.116-0.565）.Conclusions A positive,joyful lifestyle combined with healthy diet may effectively reduced the risk of dementia among the elderly.