老年主观记忆障碍患者轻度认知障碍发生情况及影响因素分析

The incidence of mild cognitive impairment and influencing factors of elderly patients with subjective memory impairment

目的了解老年主观记忆障碍患者轻度认知障碍(MCI)发生情况,并分析其影响因素。方法采用便利抽样法,选择2020年10月—2021年3月解放军总医院老年衰弱认知管理门诊主观记忆障碍患者322例,根据《2018中国痴呆与认知障碍诊治指南的诊断标准》将研究对象分为MCI组、非MCI组。采用自设问卷收集患者人口学资料、生理因素、心理因素、生活方式及营养状况,采用Barthel指数评定量表评估日常生活能力、9项患者健康问卷(PHQ-9)评估抑郁状态、广泛焦虑自评量表(GAD-7)评估焦虑状态、匹兹堡睡眠质量指数评估睡眠障碍、微型营养评定简表(MNA-SF)评定营养状态。采用单因素分析、多因素二项Logistic回归分析对患者发生MCI的影响因素进行探讨。结果322例老年主观记忆障碍患者中发生MCI 173例(53.73%),非MCI患者149例(46.27%)。二项Logistic回归分析结果显示,阅读习惯、做家务情况、社会交往、焦虑、年龄、抑郁、有无睡眠障碍是老年主观记忆障碍患者发生MCI的影响因素(P<0.05)。结论老年主观记忆障碍患者MCI发生率较高,认知管理门诊应对此类患者全面评估并分析影响因素,根据个人情况协助患者建立健康的生活方式,从而改善患者认知情况。

Objective To understand the incidence of mild cognitive impairment(MCI)of elderly patients with subjective memory impairment and analyze its influencing factors.Methods A total of 322 patients with subjective memory impairment in elderly frail cognitive management clinic in General Hospital of Chinese PLA were selected by the convenient sampling method.According to the 2018 Diagnostic Criteria for Diagnosis and Treatment of Dementia and Cognitive Impairment in China,the subjects were divided into the MCI group and the non-MCI group.Demographic data,physiological factors,psychological factors,lifestyle and nutritional status of patients were collected using self-designed questionnaires.The Barthel Index Rating Scale was used to assess activity of daily living,9-item Patient Health Questionnaire(PHQ-9)was used to assess depression and Generalized Anxiety Disorder Questionnaire(GAD-7)was used to to assess anxiety.The Pittsburgh Sleep Quality Index was used to assess sleep disturbances and Mini Nutritional Assessment Short Form(MNA-SF)was used to assess nutritional status.Univariate analysis and multivariate binary logistic regression analysis were used to explore the influencing factors of MCI in patients.Results Among the 322 elderly patients with subjective memory impairment,173(53.73%)had MCI and 149(46.27%)were non-MCI patients.Binomial Logistic regression analysis showed that reading habits,housework,social interaction,anxiety,age,depression,and sleep disturbance were the influencing factors of MCI in the elderly with subjective memory impairment(P<0.05).Conclusions The incidence of MCI in elderly patients with subjective memory impairment is relatively high.The cognitive management clinic should comprehensively evaluate and analyze the influencing factors of such patients and assist patients to establish a healthy lifestyle according to their personal conditions,so as to improve their cognitive status.