不同痴呆风险评估工具对中国老年居民阿尔茨海默病预测价值的比较研究

Comparison of predictive power of different dementia risk assessment tools for Alzheimer's disease in Chinese elders

目的比较3种痴呆风险评估工具在老年人群阿尔茨海默病风险评估中的预测和应用价值.方法开展病例对照研究,采用便利抽样法,选取北京市5所医院2013年5月—2018年8月期间住院确诊为阿尔茨海默病的80例老年患者为病例组,同地区随机选取80例认知功能正常的老年人为对照组.收集两组研究对象临床资料,分别应用Barnes、ANU-ADRI、自制C-ADRA模型3种风险评估工具对研究对象进行阿尔茨海默病发病风险评估,从而探讨不同评估工具的预测价值.结果病例组与对照组患者在痴呆家族史、颅脑损伤、听力障碍、抑郁状态、生活行为方式、部分生理及生化指标等方面差异较大,C-ADRA模型预测老年人阿尔茨海默病风险的准确性、灵敏性、特异性优于Barnes、ANU-ADRI模型.结论C-ADRA模型对中国老年人发生阿尔茨海默病风险的预测效果更佳,根据风险评估结果对患者实施针对性预防,为阿尔茨海默病防治提供有力保障,可在社区护理预防工作中推广使用.

Objective To compare the predictive and applicable power of 3 dementia risk assessment tools for Alzheimer's disease in Chinese elders.Methods In this case-control study,totally 80 elderly patients with Alzheimer's disease hospitalized in 5 hospitals in Beijing from May 2013 to August 2018 were selected by convenient sampling as the case group,while 80 elders with normal cognitive function were randomly selected as the control group from the same region.Clinical data of both groups were collected,and the subjects'morbidity risk of Alzheimer's disease was assessed using Barnes Model,Australian National University Alzheimer's Disease Risk Index(ANU-ADRI)and Chinese Alzheimer's Disease Risk Assessment Model(C-ADRA).The predictive power of different assessment tools was thus compared.Results There was significant difference in family history of dementia,craniocerebral injury,hearing disorder,depression,lifestyle as well as some physiological and biochemical criteria between case and control groups.The accuracy,sensitivity and specificity of C-ADRA in predicting Alzheimer's disease in Chinese elders was better than that of Barnes and ANU-ADRI models.Conclusions C-ADRA has a better predictive power for Alzheimer's disease in Chinese elders.Targeted prevention may be provided for patients according to the results of risk assessment,thus promising a guarantee for the prevention and control of Alzheimer's disease in clinical nursing and prevention.