上海市社区老年人轻度认知障碍的潜在危险因素

Potential risk factors for mild cognitive impairment in the elderly population in communities of Shanghai

目的探寻社区老年人轻度认知功能障碍(MCI)的潜在危险因素,为MCI的一级预防提供依据。方法对上海市社区的老年人进行一项横断面研究。选择了368名年龄在65~80岁的受试者,完成简易智力状态检查量表(MMSE)、基本信息问卷调查和体格检查。采用Logistic回归分析MCI的潜在危险因素。结果所有参与调查的368名受试者中,共53例MCI患者,患病率为14.4%。单因素分析发现:高龄,受教育程度低,无叶酸补充,中风,骨质疏松症和高脂血症是MCI的危险因素。Logistic回归分析显示,高龄[OR=1.146(95%CI:1.052~1.249)]和骨质疏松症[OR=2.371(95%CI:1.042~5.396)]是MCI独立危险因素,高教育程度[OR=0.073(95%CI:0.011~0.478)]是保护因素。年龄可以影响MMSE评分各方面(所有P值<0.05)。定期补充叶酸的受试者MMSE评分更高,特别是语言能力得分(P=0.002)。骨质疏松症患者注意力和计算力得分较低(P=0.022)。结论MCI患病率随年龄增长而增加,教育程度低、骨质疏松症可能是老年人MCI的独立危险因素。叶酸补充剂虽与MCI间未观察到相关性,但可以改善其语言和实践表现。

Objective To investigate the potential risk factors for mild cognitive impairment(MCI)in the elderly population in the community,and to provide a basis for the primary prevention of MCI.Methods A cross-sectional study of elderly population in communities of Shanghai,China was conducted.A total of 368 subjects including both males and females,aged 65-80 years old,were selected to complete the mini-mental state examination(MMSE),basic information questionnaires,and physical examinations.Logistic regression analysis was used to analyze the potential risk factors of MCI.Results Of the 368 subjects participating in the study,53 were found to have MCI and the prevalence rate was 14.4%.Univariate analysis found that older age,low education,no folic acid supplementation,stroke,osteoporosis and hyperlipidemia were risk factors of MCI.Multiple logistic regression analysis showed that advanced age[OR=1.146(95%CI:1.052-1.249)]and osteoporosis[OR=2.371(95%CI:1.042-5.396)]were the independent risk factors for MCI,while higher education[OR=0.073(95%CI:0.011-0.478)]was a protective factor.Age influenced all the aspects of MMSE scores(all P values<0.05).In addition,the analysis of the results suggested that subjects with regular folic acid supplementation got higher MMSE scores,especially in the aspect of language and praxis(P=0.002).On the contrary,patients with osteoporosis had lower attention and computing power scores(P=0.022).Conclusion The prevalence of MCI increased with age.Low education and osteoporosis may be the independent risk factors for MCI in the elderly population.Although no association was observed between folic acid supplementation and MCI,folic acid supplementation could improve the performance of language and praxis.