广州市城乡养老院不同认知水平老年人八年后随访死亡率调查

Mortality rate in elders with different cognition in the urban or rural resthomes in Guangzhou

目的 了解养老院正常老人、轻度认知障碍和痴呆患者的死亡率及相关影响因素.方法 2001年12月至2002年1月采用整群抽样方法对广州市城乡养老院≥60岁老人进行了痴呆患病情况的基线调查,2010年2月对完成了基线调查的1105名老人进行随访,了解老人的死亡情况,比较各组内、组间死亡率,并采用Cox回归分析各因素对死亡率的影响.结果 （1）正常、轻度认知障碍和痴呆患者8年后随访时的死亡率分别为：15.5％人年（502人）、20.2％人年（39人）、32.9％人年（291人）,Х^2=60.28,P＜0.001. （2） Cox回归分析显示：痴呆[相对危险度（RR）=2.078,P＜0.00l]、男性（男性=l、女性=2,RR=0.792,P＜0.01）、年龄（每5岁为一年龄段,RR=1.346,P＜0.001）、慢性躯体疾病（RR =1.251,P＜0.01）是老人死亡的危险因素;在各因素中,只有重度痴呆是影响痴呆患者死亡的危险因素（RR=1.318,P＜0.05）.结论 养老院老人的死亡率随着认知功能的下降而升高,减少慢性躯体疾病的出现、预防痴呆发生、加强对痴呆患者的护理和关照,能降低老年人和痴呆患者的死亡率.

Objective To investigate the mortality rate and related factors of the eiders with different cognition in the resthomes in urban and rural areas in Guangzhou.Methods From Dec.2001 to Jan.2002,1105 persons aged 60 years or over in the urban and rural resthomes in Guangzhou were sampled out with the cluster sampling method.In Feb.2010,the follow-up investigation was carried out,and the mortality in the elderly with different levels of cognition was ealculated and Cox regression was used to analyze the impact of various factors on the mortality.Results ① The mortality rates of normal elderly,ones with MCI and dementia were 15.5% person-year （502 persons）,20.2% person-year （39 persons） and 32.9% person-year （291 persons）,respectively （Х^2 =60.28,P 〈 0.001）.② Cox regression analysis found dementia （RR =2.078,P 〈 0.001）,men （men =1,women =2,RR-0.792,P 〈 0.01）,age （5 years for a age period,RR =1.346,P 〈 0.001） and chronic physical disease （RR =1.251,P 〈 0.01） to be the major risk factors for death of the elderly.In all these factors,only severe dementia was the risk factors of death in patients with dementia.Conclusions In the aged in resthomes,the mortality rate is increased with the decline of cognitive function,which indicates that reducing the incidence of chronic physical illness and preventing dementia and better caring and nursing patients with dementia could lower the mortality of the elderly.