煤矿社区中老年人轻度认知功能障碍特点及相关危险因素分析

Characteristics and related risk factors of mild cognitive impairment in middle-aged and elderly adults in a coal mine community

目的研究煤矿社区≥48岁中老年人轻度认知功能障碍(MCI)特点,并分析其相关危险因素。方法2019年7月至10月对符合纳入标准的180例大同煤矿社区中老年人进行基本信息调查;应用简易智力状态检查(MMSE)和蒙特利尔认知评估(MoCA)量表评估认知功能;采用单因素分层和多重线性回归分析性别、年龄、受教育年限、睡眠、独居、体育锻炼、社会活动、吸烟和饮酒状态、体重指数、慢病等因素对认知功能的影响。结果48~<64岁、64~<72岁、72~90岁年龄组MMSE和MoCA筛查MCI阳性率差异无统计学意义(原始和校正P>0.05);各年龄组MoCA筛查MCI阳性率(64.4%、66.7%、60.9%)显著高于MMSE(35.6%、45.6%、28.1%)(均P<0.05);MMSE与MoCA得分呈正相关(r=0.762,P<0.001)。随着年龄增加,MoCA检出记忆、执行、视空间得分显著降低(均P<0.05),而注意、语言、定向得分未见显著变化(均P>0.05)。单因素分层显示MMSE或MoCA得分的显著影响因素有性别、年龄、受教育年限、睡眠情况(均P<0.05)。多元线性回归分析显示性别(β_(MMSE)=-0.192;β_(MoCA)=-0.140)、受教育年限(β_(MMSE)=0.209;β_(MoCA)=0.328)、睡眠情况(β_(MMSE)=-0.162;β_(MoCA)=-0.136)是影响MMSE和MoCA得分的危险因素(P<0.05)。结论煤矿社区中老年MCI者较多,以记忆、执行及视空间受损为主要特点。应对煤矿社区女性、低教育年限、睡眠差者及早开展MCI干预,防止和减少痴呆发生。

Objective To investigate the characteristic of mild cognitive impairment(MCI)in the adults aged 48 years and over in a coal mine community,and to analyze its associated risk factors.Methods From July to October 2019,a questionnaire survey for basic information was conducted among 180 middle-aged and elderly adults who met the inclusion criteria in the Datong coal mine community.The cognitive function was evaluated by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA).The effects of gender,age,years of education,sleep,living alone,physical exercise,social activities,smoking and drinking status,body mass index and chronic diseases on cognitive level were analyzed by single factor stratification and multiple linear regression.Results There was no significant difference in the positive rate of MCI screened by MMSE and MoCA in the age groups of 48-<64,64-<72 and 72-90(original and corrected P>0.05);The positive rate of MCI in MoCA screening(64.4%,66.7%,60.9%)was significantly higher than that in MMSE(35.6%,45.6%,28.1%)(all P<0.05);MMSE was positively correlated with MoCA score(r=0.762,P<0.001).With the increase of age,the scores of memory,execution and visual space detected by MoCA decreased significantly(all P<0.05),while the scores of attention,language and orientation did not change significantly(all P>0.05).Univariate stratification showed that the significant influencing factors of MMSE or MoCA scores were gender,age,years of education and sleep status(all P<0.05).Multiple linear regression analysis showed that gender(β_(MMSE)=-0.192;β_(MoCA)=-0.140),years of education(β_(MMSE)=0.209;β_(MoCA)=0.328)and sleep status(β_(MMSE)=-0.162;β_(MoCA)=-0.136)were risk factors affecting MMSE and MoCA scores(P<0.05).Conclusions More middle-aged and elderly adults with MCI might be observed in a coal mine community,and the main characteristics of MCI are impaired memory,executive function and visual space.To prevent and reduce the occurrence of dementia,early interventions of MCI should be carried out among the adults with female,old age,low years of education and poor sleep quality.