上海市社区老年高血压患者认知功能障碍的影响因素分析

Influencing factors of cognitive impairment among the community elderly patients with hypertension in Shanghai

目的 了解上海市社区老年高血压患者认知功能障碍的流行病学现状并分析其影响因素.方法 采用随机整群抽样方法抽取上海市徐汇区华泾镇6个社区居委会中共计1192名65岁以上的老年人进行问卷调查.采用8条目痴呆筛查问卷(AD-8)评估老年人认知功能障碍的患病情况,以面对面交谈填写问卷的方式获取老年人高血压患病情况,通过多因素回归分析对不同生活方式与老年高血压患者认知功能障碍的相关性进行分析.结果 调查共检出高血压患者565例,认知功能障碍患者185例.高血压合并认知功能障碍患者为103例,占高血压人群的18.2%,显著高于非高血压人群[13.1%(82/527)],差异有统计学意义(χ^(2)=6.016,P=0.014).喜欢运动(OR=0.56,95%CI:0.34~0.93,P=0.025)、经常参加社区老年活动(OR=0.48,95%CI:0.24~0.93,P=0.045)是老年高血压患者患认知功能障碍的保护因素,而每日睡眠时长<7 h(OR=2.13,95%CI:1.30~3.48,P=0.003)则是老年高血压患者罹患认知功能障碍的危险因素.结论 喜欢运动、参加社区老年活动、睡眠时长不足等生活方式是老年高血压患者认知功能障碍的影响因素,采取健康的生活方式是预防老年高血压患者罹患认知功能障碍的重要措施.

Objective To investigate the epidemiological status of cognitive impairment in elderly patients with hypertension in Shanghai community,and analyze the influencing factors.Methods A total of 1192 elderly people over 65 years old were selected from 6 community neighborhood committees of Huajing Town,Xuhui District,Shanghai by random cluster sampling.The prevalence of cognitive impairment in the elderly was assessed by 8-item Ascertain Dementia(AD-8)screening questionnaire.The prevalence of hypertension in the elderly was obtained by face-to-face interview.The correlation between different lifestyles and cognitive impairment in elderly patients with hypertension was analyzed by multivariate regression analysis.Results A total of 565 patients with hypertension and 185 patients with cognitive impairment were detected.Among the 565 elderly patients with hypertension,103 had cognitive impairment.The prevalence of cognitive impairment in elderly patients with hypertension was 18.2%,which was significantly higher than that in nonhypertensive patients[13.1%(82/527),χ^(2)=6.016,P=0.014].The protective factors of cognitive impairment in elderly patients with hypertension were enjoying exercise(OR=0.56,95%CI=0.34-0.93,P=0.025)and often participating in community activities for the elderly(OR=0.48,95%CI=0.24-0.93,P=0.045).Less than 7 hours of sleep per day(OR=2.13,95%CI=1.30-3.48,P=0.003)was a risk factor for cognitive impairment in elderly patients with hypertension.Conclusions Regular exercise,participating in community activities and sleep time deficiency were the influential factors of cognitive impairment in elderly patients with hypertension.Promoting healthy lifestyle in the elderly patients with hypertension is an important measure to prevent development of cognitive impairment.