2型老年糖尿病患者认知功能水平及相关影响因素

The cognitive function level and related influencing factors in elderly patients with type 2 diabetes mellitus

目的探讨2型老年糖尿病(T2DM)患者认知功能水平及相关影响因素。方法回顾性分析2010年1月至2018年6月收治的310例老年T2DM患者临床资料,根据认知功能水平分为认知功能正常组(n=106)及认知功能障碍组(n=204)。比较两组一般资料、T2DM相关实验室指标、非T2DM因素,使用Logistics回归分析T2DM患者认知功能水平影响因素。结果两组性别、婚姻状况、人均月收入、吸烟史、饮酒史比例对比,差异均无统计学意义(P>0. 05);认知功能障碍组患者>75岁、文盲及小学比例、病程>10年、Hb Alc≥8. 00、低血糖发生频率≥5次/2个月、T2DM并发周围神经病变、并发肾病、并发冠心病比例均高于认知功能正常组(P<0. 05);且睡眠质量差、合并抑郁、合并焦虑、合并高血压者比例亦高于认知功能正常组(P<0. 05),经常参加社会活动比例低于认知功能正常组(P<0. 05)。Logistics回归分析显示:年龄、病程、高Hb Alc水平、低血糖发生率较高及合并抑郁均是影响T2DM患者认知功能的独立危险因素(P<0. 05);经常参加社会活动是影响T2DM患者认知功能的保护因素(P<0. 05)。结论老年T2DM认知功能影响因素较多,可定期监测高危人群认知功能并早期积极干预。

Objective To explore the cognitive function level and related influencing factors in elderly patients with type 2 diabetes mellitus( T2DM).Methods The clinical data of 310 elderly patients with T2DM admitted from January 2010 to June 2018 were retrospectively analyzed.According to the cognitive function level,the patients were divided into normal cognitive function group(n =106) and cognitive dysfunction group(n = 204). The general data,T2DM related laboratory indicators and non-T2DM factors were compared between the two groups.Logistic regression analysis was used to analyze the influencing factors of cognitive function level in these patients. Results There were no significant differences in gender,marital status,monthly income per capita,smoking history and drinking history between the two groups( P>0. 05).The proportions of patients with age >75 years old,illiterate and primary school patients with disease duration>10 years,Hb Alc≥8.00,hypoglycemia frequency ≥5 times/2 months,T2DM complicated with peripheral neuropathy,complicated nephropathy and complicated coronary heart disease in the cognitive dysfunction group were higher than those in the normal cognitive function group(P< 0. 05).The proportions of patients with poor sleep quality,combined depression,combined anxiety and hypertension in the cognitive dysfunction group were higher than those in normal cognitive function group(P<0. 05),and the proportion of regular participation in society activities was lower than that in the normal cognitive function group(P<0. 05).There was no significant difference in the proportion of combined hyperlipidemia between the two groups(P>0. 05).Logistics regression analysis showed that age,disease duration,high Hb Alc level,high incidence rate of hypoglycemia and combined depression were independent risk factors for cognitive function in T2DM patients(P< 0. 05). Regular participation in social activities was a protective factor for cognitive function in T2DM patients(P<0. 05).Conclusion There are many influencing factors for cognitive function in elderly T2DM patients,and the cognitive function of high-risk population can be monitored regularly and actively intervened early.