上海浦东新区55岁及以上人口轻度认知功能障碍及影响因素的调查

Investigation of mild cognitive impairment and its risk factors among 55 years old and above residents in Shanghai

目的:探讨上海55岁及以上老年人轻度认知障碍(MCI)的患病率及危险因素的流行病学特征。方法:2011年7月至2012年7月实施抽样调查上海市浦东新区≥55岁户籍人群,应用PPS(probability proportional to size)抽样法,根据Petersen诊断标准、问卷调查及临床医师复核诊断,分析MCI患病率及危险因素。结果:抽取居民4 600人,实际调查4 086人,调查率88.83%。4 086人中,患有MCI者(MCI组)612例,占14.98%,患有阿尔茨海默病者(AD组)201例,占4.92%,正常智力者(正常智力组)3 273例。MCI患病率:女性高于男性(χ2=11.52,P=0.003),且随年龄增长而增高(χ2=196.80,P=0.000);文盲和小学文化程度者高于初中及以上者(χ2=227.03,P=0.000);体力劳动者高于脑力劳动者(χ2=16.76,P=0.000)。以罹患MCI作为应变量,将年龄、性别、高血压、糖尿病、高脂血症、吸烟史、受教育程度等因素中与MCI相关的变量作为自变量,进行二变量的线性Logistic回归分析显示,共病高血压、糖尿病、高脂血症及吸烟、受教育程度低、高龄等易感因素具有独立影响意义(P<0.05或P<0.01),其中共病高血压、受教育程度低及高龄与AD组的易感因素相同。结论:有效防治高血压、糖尿病及高脂血症等代谢性疾病有利于减少MCI的发生发展。

Objective：To investigate the epidemiological characteristics of prevalence and cerebral vascu-lar risk factors of mild cognitive impairment（MCI）in the aged 55 years old and above in Shanghai. Method：Eligible participants were Shanghai residents aged ≥55 years from July 1st 2007 to June 30th 2008. Probability proportional to size cluster sampling was used in this study. Diagnosis of MCI was made by questionnaire screen-ing and clinician review according to Petersen criteria. The prevalence and risk factors of MCI in Shanghai elder-ly was analized. Results：This study consisted of 4 086 among 4 600（88. 83% ）elderly residents and the prevalence of MCI was 14. 98%（612 / 4 086）,AD was 4. 92%（201 / 4 086）,and the others were normal cog-nition（3 273 / 4 086）. Higher prevalence of MCI were found in females（χ2 = 11. 52,P = 0. 003）,with older age （χ2 = 196. 80,P = 0. 000）,having primary education or lower（χ2 = 227. 03,P = 0. 000）,being physical worker before retirement（χ2 = 16. 76,P = 0. 000）. The positive MCI was taken as dependent variable,and the related demographic factors,such as age,gender,hypertension,diabetes,hyperlipidemia,smoking history,education level were as independent variables,two variable linear Logistic regression analysis were applied. And the results showed that hypertension,diabetes,hyperlipidemia,smoking,low education level,and older age are independent risk factors of MCI（P ﹤ 0. 05 or P ﹤ 0. 01）,among which hypertension,low education level,and older age were shared vulnerable variables for AD. Conclusion：Effective prevention and treatment of hypertension,hyperlip-idemia,diabetes and other metabolic diseases can help against the onset and development of MCI.