上海市残疾人群轻度认知功能障碍患病率及相关因素分析

Mild cognitive impairment among the disabled and related risk factors

目的调查残疾人群轻度认知功能障碍(mild cognitive impairment, MCI)患病率并探讨相关危险因素。方法连续性纳入门诊残疾成人作为研究对象,使用蒙特利尔认知评估量表(MoCA)评估受试者的认知功能,采用Logistic回归模型探讨残疾人群MCI的相关危险因素。结果共有309名残疾患者参与了本研究,其中男性165例,女性144例,MCI患病率为81.9%。单因素分析显示,年龄、受教育程度、家庭人均月收入、饮酒、吸烟、高血压史等指标均与认知功能显著相关(P均<0.05)。Logistic回归结果表明,在校正了性别和受教育程度后,高龄、高收缩压、高舒张压、吸烟、饮酒、高血压史和贫血史是MCI的危险因素,其对应的OR值和95%CI分别为1.056(1.027~1.087)、1.022(1.002~1.041)、1.051(1.013~1.089)、2.084(1.232~6.545)、3.102(1.337~7.194)、3.685(1.719~7.901)和3.435(1.555~7.690)。与肢体残疾者相比,视力残疾者更易出现较差的命名能力(OR=3.369,95%CI:1.675~6.777)和定向力(OR=4.752,95%CI:1.265~17.849),听力残疾者更易出现较差的语言能力(OR=3.534,95%CI:1.320~9.461)、抽象能力(OR=2.941,95%CI:1.017~9.502)和定向力(OR=6.371,95%CI:1.355~29.946)。与四级残疾者相比,一级残疾者的命名能力(OR=4.082,95%CI:1.064~15.655)较差。结论上海市残疾人群MCI患病率较高,高龄、吸烟、饮酒、高血压史、贫血史、视力残疾、听力残疾、残疾等级较高可能是导致MCI的危险因素。

Objective To investigate the prevalence and risk factors of mild cognitive impairment(MCI) among people with disabilities. Methods Disabled adult patients who visited outpatient clinics of Shanghai Yangzhi Rehabilitation Hospital from May to August 2019 were enrolled in the study. Montreal cognitive assessment(MoCA) was used to evaluate cognitive function, and the Logistic regression model was used to explore the risk factors related to MCI of the disabled. Results Among 309 patients with disabilities(165 males and 144 females), where were 253 cases with MCI, accounting for 81.9%. Univariate analysis showed that age, education level, family monthly income per capita, smoking, drinking, history of hypertension were significantly associated with cognitive function(all P<0.05). Multivariate Logistic regression showed that after adjusting for gender and education level, older age(OR=1.056, 95%CI: 1.027-1.087, P<0.05), high systolic blood pressure(OR=1.022, 95%CI: 1.002-1.041, P<0.05), high diastolic blood pressure(OR=1.051, 95%CI: 1.013-1.089, P<0.05), smoking(OR=2.084, 95%CI: 1.232-6.545, P<0.05), drinking(OR=3.102, 95%CI: 1.337-7.194, P<0.05), history of hypertension(OR=3.685, 95%CI: 1.719-7.901, P<0.05) and anemia(OR=3.435, 95%CI: 1.555-7.690, P<0.05) were risk factors for MCI. Compared to patients with physical disabilities, patients with visual disabilities were more likely to have poor naming skills(OR=3.369, 95%CI: 1.675-6.777) and orientation(OR=4.752, 95%CI: 1.265-17.849);while patients with hearing disabilities were more likely to have poor language ability(OR=3.534, 95%CI: 1.320-9.461), abstract ability(OR=2.941, 95%CI: 1.017-9.502) and orientation(OR=6.371, 95%CI: 1.355-29.946). The naming ability of grade I disabled was worse than that of patients with grade IV disabilities(OR=4.082, 95%CI: 1.064-15.655). Conclusion The disabled patients are likely to have mild cognition impairment;and the old age, smoking, drinking, history of hypertension, anemia, visual disability, hearing disability and higher disability level may be risk factors for MCI.