社区阿尔茨海默病影响因素分析

Analysis of the factors affecting the community of Alzheimer＇s disease

目的 了解浙江省海宁市社区老年人阿尔茨海默病患病的影响因素.方法 采取整群抽样方法抽取海宁市海昌街道7 437名年龄≥60岁的老年人作为研究对象,采用自行设计的《阿尔茨海默病患者发病原因》问卷调查及临床痴呆评定量表,了解阿尔茨海默病的可能影响因素及加重因素,并对资料进行多因素回归分析.结果 多因素Logistic回归分析结果显示,女性（Wald χ^2=19.96,P＜0.01）、高龄（Wald χ^2=96.01,P ＜0.01）、丧偶（Wald χ^2=5.09,P＜0.05）、吸烟/饮酒（Wald χ^2=47.77,P＜0.01）、独居（Wald χ^2=16.14,P＜0.01）、抑郁（Wald χ^2=12.05,P＜0.01）是患阿尔茨海默病危险因素;农村（Wald χ^2=458.11,P＜0.01）、文化低（Wald χ^2=121.39,P＜0.01）是患阿尔茨海默病的保护因素;根据临床痴呆评定量表评定的疾病严重程度与发病原因进行有序多分类Logistic回归,结果显示：高龄（Wald χ^2=50.37,P＜0.01）、文化低（Wald χ^2=30.39,P＜0.01）、丧偶（Wald χ^2=5.20,P＜0.05）、独居（Wald χ^2=16.5,P＜0.01）、躯体疾病（Wald χ^2=16.58,P＜0.01）和母孕期年龄过大（Wald χ^2=10.53,P＜0.01）是加重疾病的危险因素.结论 年龄、丧偶、独居是阿尔茨海默病患病和加重的共同危险因素,应结合危险因素积极采取针对性慢病管理措施,预防和延缓阿尔茨海默病的发生、发展.

Objective To understand the risk factors of the elderly in community of Haining city in patients with Alzheimer＇s disease.Methods Take the elderly Chang street Haining city selected cluster sampling method 7 437 ≥60 years as the research subjects,by using a self-designed questionnaire ＂Alzheimer＇s disease causes＂ and clinical dementia rating scale,understanding the factors that may affect Alzheimer＇s disease and aggravating factors,and the data of multi factor regression analysis.Results Multivariate Logistic regression analysis showed that women （Wald χ^2=19.96,P 〈 0.01）,aged （Wald χ^2=96.01,P 〈 0.01）,widowed （Wald χ^2=5.09,P 〈 0.05）,smoking/drinking （Wald χ^2=47.77,P 〈 0.01）,living alone （Wald χ^2=16.14,P 〈 0.01）,depression （Wald χ^2=12.05,P 〈 0.01） were the risk factors of Alzheimer＇s disease; Rural （Wald χ^2=458.11,P 〈 0.01） ; Lowculture （Wald χ^2=121.39,P 〈0.01） were protective factors for Alzheimer＇s disease.According to the clinical dementia rating scale of disease severity assessment and pathogenesis of polytomous Logistic regression,the results showed that the elderly （Wald χ^2=50.37,P 〈 0.01）,lowculture （Wald χ^2=30.39,P 〈 0.01）,widowed （Wald χ^2=5.20,P 〈 0.05）,living alone （Wald χ^2=16.50,P 〈 0.01）,somatic diseases （Wald χ^2=16.58,P 〈 0.01） and large maternal age （Wald χ^2=10.53,P 〈 0.01） were risk factors for disease.Conclusion Age,widowed,solitude are common risk factors of Alzheimer＇s disease and aggravating factors,should be combined with risk factors for chronic disease management actively take measures to prevent and delay the occurrence,the development of Alzheimer＇s disease.