煤矿社区老年人认知功能及其与日常生活能力的相关性分析

Correlation between cognitive function and living ability of older adult patients living in a mining community

目的研究煤矿社区老年人的认知功能状况及与其日常生活能力的相关性。方法于2019年7-10月招募符合纳入标准的大同市煤矿社区老年人180例,按年龄分为低年龄组(<68岁)(n=94)和高年龄组(≥68岁)(n=86)。采用简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)和日常生活能力量表(ADL)对老年人进行认知功能和生活能力评估,并通过分层分析和Pearson相关分析探讨认知功能与生活能力的关系。结果低年龄组MMSE、MoCA筛查认知功能异常率分别为39.4%、66.0%,高年龄组分别为32.6%、61.6%,低、高年龄组MoCA筛查异常率均明显高于MMSE(χ^(2)=26.69、10.18,均P<0.001),但两组MMSE、MoCA筛查异常率差异无统计学意义(χ^(2)=0.90、0.36,均P>0.05)。低、高年龄组老年人日常生活能力异常率分别为4.3%、10.5%,两组差异无统计学意义(χ^(2)=2.58,P>0.05)。与MMSE、MoCA筛查阴性者相比,低年龄组中MMSE筛查阳性者ADL和使用工具生活能力(IADL)显著增加了7.0%和9.4%(均P<0.05),MoCA筛查阳性者ADL显著增加了3.5%(P<0.05)。相关分析结果显示,MMSE、MoCA总分与ADL评分(r=-0.26、-0.27,均P<0.001)、IADL评分(r=-0.27、-0.27,均P<0.001)均呈显著负相关。结论煤矿社区老年人认知功能和生活能力具有较好的相关性,应重视老年人认知障碍筛查结果,通过改善老年人认知功能以提高其生活能力。

Objective To investigate the correlation between cognitive function and living ability of older adult patients living in a mining community.Methods A total of 180 older adult patients living in a mining community who received treatment during July-October 2019 were included in this study.They were randomly divided into the low-age group(<68 years old,n=94)and the high-age group(≥68 years old,n=86).Cognitive function and living ability were evaluated using the Mini-Mental State Examination(MMSE),The Montreal Cognitive Assessment(MoCA),and the Activity of Daily Living Scale(ADL).The relationship between cognitive function and living ability was investigated using hierarchical analysis and Pearson correlation analysis.Results The proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA were 39.4%and 66.0%,respectively in the low-age group,and they were 32.6%and 61.6%,respectively in the high-age group.The MoCA had a greater performance in identifying abnormal cognitive function in each group than the MMSE(χ^(2)=26.69,10.18,both P<0.001).There were no significant differences in proportions of older adult patients with abnormal cognitive function identified by the MMSE and MoCA between low-age and high-age groups(χ^(2)=0.90,0.36,both P>0.05).The proportion of older adult patients with abnormal living ability was not significantly different between low-age and high-age groups(4.3%vs.10.5%,χ^(2)=2.58,P>0.05).Compared with patients negative for MMSE items,living ability and instrumental activity of daily living increased by 7.0%and 9.4%in low-age patients positive for MMSE items(both P<0.05).Compared with patients negative for MoCA items,living ability increased by 3.5%in low-age patients positive for MoCA items(P<0.05).Correlation analysis revealed that total scores of MMSE and MoCA were significantly negatively correlated with ADL score(r=-0.26,-0.27,both P<0.001)and instrumental activity of daily living score(r=-0.27,-0.27,P<0.001).Conclusion Cognitive function and living ability are correlated in older adult patients living in a mining community.We should pay attention to the screening results of cognitive disorder in older adult patients and improve their living ability by improving their cognitive function.