老年住院病人肌少症合并认知功能障碍的影响因素分析

Analysis of influencing factors of sarcopenia complicated with cognitive impairment in elderly inpatients

目的了解老年住院病人肌少症合并认知功能障碍的现状及相关影响因素。方法选取2018年11月至2020年1月我院老年医学科住院的老年病人445例,对其进行生物电抗阻分析测量、6 m步速测试、握力测量及MMSE量表评估。根据病人有无肌少症和认知功能障碍将其分为4组无肌少症、无认知障碍组(n=222);仅有肌少症组(n=121);仅有认知障碍组(n=50);肌少症合并认知障碍组(n=52)。采用ANOVA及无序Logistic回归模型探讨老年住院病人肌少症合并认知功能障碍的影响因素。结果入组病人肌少症的检出率为38.88%(173/445),认知功能障碍的检出率为22.92%(102/445),肌少症合并认知功能障碍的检出率为11.69%(52/445)。单因素分析结果显示,4组在年龄、BMI、高血压、DM、脑血管疾病、骨质疏松症、教育程度、抑郁情绪、营养不良方面差异均有统计学意义(P<0.05或P<0.01)。Logistic回归分析显示,年龄(OR=1.259,95%CI1.138~1.392,P<0.001)、抑郁情绪(OR=10.815,95%CI2.345~49.885,P=0.002)、营养状况差(OR=4.876,95%CI1.685~14.108,P=0.003)、BMI低(OR=0.649,95%CI0.549~0.768,P<0.001)是老年住院病人肌少症合并认知功能障碍的独立影响因素。结论临床上应关注高龄、抑郁、营养不良及BMI低的老年住院病人,对其进行早期干预,从而延缓身体功能衰退,提高生活质量。

Objective To obtain the prevalence and related influencing factors of sarcopenia complicated with cognitive impairment in the elderly inpatients.Methods A total of 445 elderly inpatients in our hospital from November 2018 to January 2020 were selected.All the subjects completed the measurement of bioelectrical impedance analysis,6 m walk speed test,grip strength test and Mini Mental State Examination,and they were divided into four groups no sarcopenia and no cognitive impairment group(n=222),sarcopenia group(n=121),cognitive impairment group(n=50),sarcopenia complicated with cognitive impairment group(n=52).Variance analysis and Logistic regression analysis were used to explore the influencing factors of sarcopenia complicated with cognitive impairment in the elderly inpatients.Results The detection rates of sarcopenia,cognitive impairment and the two combined were 38.88%(173/445),22.92%(102/445)and 11.69%(52/445),respectively.Univariate analysis showed that there were significant differences in age,body mass index(BMI),hypertension,diabetes,cerebrovascular disease,osteoporosis,education level,depression and nutrition status among the four groups(P<0.05 or P<0.01).Multivariate Logistic regression analysis showed that advanced age(OR=1.259,95%CI 1.138-1.392,P<0.001),depression(OR=10.815,95%CI 2.345-49.885,P=0.002),poor nutritional status(OR=4.876,95%CI 1.685-14.108,P=0.003),lower BMI(OR=0.649,95%CI0.549-0.768,P<0.001)were the independent influencing factors of sarcopenia complicated with cognitive impairment in the elderly inpatients.Conclusions In geriatrics ward,patients with advanced age,depression,poor nutritional status,lower BMI should be screened for sarcopenia and cognitive impairment in time.Intervention measures such as nutrition and exercise should be taken for these patients,so as to help them delay the body functional decline and improve the quality of life.