住院老年高血压病人认知衰弱现状及影响因素

Cognitive frailty and its influencing factors in hospitalized elderly patients with hypertension

目的探讨住院老年高血压病人认知衰弱的患病情况及其影响因素,为老年高血压合并认知衰弱的早期评估、干预提供依据。方法回顾性分析2019年1~10月在我院全科医学科住院的老年高血压病人106例。采用Fried标准评估衰弱状态,采用MMSE评估病人的认知情况,同时存在衰弱及认知功能障碍者定义为认知衰弱。将106例病人分为认知衰弱组(26例)和非认知衰弱组(80例),对2组病人的一般人口学资料、老年综合征及慢性病病史进行对比分析。采用多因素Logistic回归法分析老年高血压病人发生认知衰弱的独立相关因素。结果老年高血压病人合并认知衰弱的发生率为24.5%。与非认知衰弱组相比,认知衰弱组的病人年龄更大(P<0.01),高血压3级更多见(P<0.01);认知衰弱组营养不良或存在营养不良风险、跌倒、慢性疼痛、多重用药、T2DM、CHD及慢性肾脏病更为多见(P<0.05);多因素Logistic回归分析显示,年龄(OR=7.828,95%CI1.558~39.321)、营养不良或存在营养不良风险(OR=20.364,95%CI3.724~111.346)及慢性肾脏病(OR=5.699,95%CI1.172~27.716)是老年高血压病人合并认知衰弱的独立危险因素(P均<0.05)。结论老年高血压病人合并认知衰弱的发生率较高。年龄、营养不良或存在营养不良风险及慢性肾脏病是老年高血压病人合并认知衰弱独立的危险因素。

Objective To investigate the prevalence of cognitive frailty and its influencing factors and to provide evidence for early evaluation and intervention of cognitive frailty in the elderly patients with hypertension.Methods The clinical data of 106 elderly patients with hypertension hospitalized in our hospital from January to October 2019 were enrolled.Fried standard was used to evaluate the state of frailty,and Mini-Mental State Examination scale(MMSE)was used to evaluate the cognitive status of patients.The patients with frailty and cognitive impairment were defined as cognitive frailty.A total of 106 hospitalized elderly patients with hypertension were divided into cognitive frailty group(n=26)and non-cognitive frailty group(n=80).The general demographic data,geriatric syndrome and chronic disease history of the two groups were observed and analyzed.Multivariate Logistic regression was used to analyze the independent related factors of cognitive frailty.Results The incidence of hypertension complicated with cognitive frailty in the elderly was 24.5%.The age in the cognitive frailty group was older and the third grade of hypertension was more common than that in the non-cognitive frailty group(P<0.01).The ratio of malnutrition or the risk of malnutrition,falls,chronic pain,multiple drugs,coronary heart disease,type 2 diabetes and chronic kidney disease in the cognitive frailty group were significantly higher than those in the non-cognitive frailty group(P<0.05).Multivariate Logistic regression analysis showed that the age(OR=7.828,95%CI1.558-39.321),malnutrition or the risk of malnutrition(OR=20.364,95%CI3.724-111.346)and chronic kidney disease(OR=5.699,95%CI1.172-27.716)were the independent risk factors of cognitive frailty in the elderly patients with hypertension(all P<0.05).Conclusions The incidence of cognitive frailty in the elderly patients with hypertension is higher.Age,malnutrition or the risk of malnutrition and chronic kidney disease are the independent related factors of cognitive frailty in the elderly patients with hypertension.