社区老年2型糖尿病患者久坐行为水平与认知障碍的相关性研究

A study of the correlation between sedentary behavior and cognitive dysfunction among community-dwelling older adults with type 2 diabetes mellitus

目的探讨社区老年2型糖尿病患者久坐行为水平与认知障碍现状及其相关性,为社区2型糖尿病管理提供参考。方法于2020年6—12月,选取郑州市航海东路社区和高新区社区参与免费体检的434例60岁及以上2型糖尿病患者为研究对象,对其进行体格检查及实验室检查,并采用一般资料调查表、简易智力状态量表(MMSE)、国际体力活动短问卷(IPAQ-SF)进行问卷调查。采用SPSS 23.0软件进行独立样本t检验、Mann-Whitney U检验和χ^(2)检验。采用Spearman相关性分析和多因素logistic回归分析社区老年2型糖尿病患者久坐行为水平与认知障碍的关系。结果共回收426份有效问卷,有效率为98.2%。社区老年2型糖尿病患者日均久坐行为时间为(7.01±2.15)h,其中139例(32.6%)患者每日久坐行为时间≥8 h。研究对象MMSE得分中位数为25分(P_(25),P_(75):21,26分),认知障碍患者161例,检出率为37.8%。Spearman相关性分析结果显示,控制混杂因素后,久坐行为与认知障碍呈正相关(偏相关系数为0.331,P<0.01)。多因素logistic回归分析结果显示,未校正混杂因素,久坐(OR=6.511,95%CI:4.169~10.170)与认知障碍患病高风险相关(P<0.01);校正混杂因素后,久坐(OR=7.442,95%CI:3.954~14.010)仍与认知障碍患病高风险相关(P<0.01)。结论社区老年2型糖尿病患者久坐行为与认知障碍患病风险密切相关,应积极采取健康教育等相关干预措施来减少老年2型糖尿病患者久坐行为。

Objective To explore the current status and correlation of sedentary behavior level and cognitive dysfunction among community-dwelling older adults with type 2 diabetes mellitus(T2DM),and provide the reference for the management of T2DM.Methods From June to December 2020,434 T2DM patients(≥60 years old)in free medical checkups were selected from two communities(Hanghai and Gaoxin)of Zhengzhou as the subjects,the investigation was conducted with the questionnaires,including the General Information Questionnaire,the Mini Mental State Examination(MMSE)and the International Physical Activity Questionnaire-Short Form(IPAQ-SF),the physical examination and laboratory tests.The t test,Mann-Whitney U test andχ^(2) test were used to analyze the data,the Spearman correlation analysis and multi-factor logistic regression model were used to analyze the correlation between sedentary behavior level and cognitive dysfunction in community-dwelling older adults with T2DM.The used software was SPSS 23.0.Results Finally,426 valid questionnaires were used in the analysis,the effective rate was 98.2%.The average daily duration of sedentary behavior in elderly patients with T2DM was(7.01±2.15)h.Among them,the proportion of subjects with daily duration of sedentary behavior≥8 h was 32.6%(139 cases).The median of MMSE score in the subjects was25 scores(P_(25),P_(75):21,26 scores),the detected rate of subjects with cognitive dysfunction was 37.8%(161 cases).Spearman correlation analysis showed that after controlling confounding factors,the sedentary behavior was positively correlated with cognitive dysfunction(partial correlation coefficient was 0.331,P<0.01).Multi-factor logistic regression analysis demonstrated that without adjusting the confounders,sedentary time(OR=6.511,95%CI:4.169-10.170)was related with the high risk of cognitive dysfunction(P<0.01).After adjusting the confounders,sedentary behavior level(OR=7.442,95%CI:3.954-14.010)was still related with the high risk of cognitive dysfunction(P<0.01).Conclusion Sedentary behavior is strongly related with the risk of cognitive dysfunction among community-dwelling elderly patients with T2DM.The health education and other relevant intervention measures should be actively implemented to reduce sedentary behavior of elderly patients with T2DM.