广州市某社区老年人可逆性认知衰弱现状及影响因素

Status Quo of Reversible Cognitive Frailty Among the Elderly in a Community of Guangzhou and Its Influencing Factors

目的 了解社区老年人可逆性认知衰弱(reversible cognitive frailty,RCF)现状并分析影响因素,为开展RCF的三级预防和健康管理提供依据。方法 2020年8月至2021年2月,便利选取广州某社区参与体检的老年人212名为研究对象,采用一般资料调查表、RCF筛查表(Fried衰弱表型、蒙特利尔认知评估量表、临床痴呆评定量表、主观认知下降评定条目)进行问卷调查。结果 42名老年人(19.81%)存在RCF。不同年龄、体育锻炼情况、自评睡眠质量、日间精神状态、慢性疼痛、慢性病数量、服药数量、健康自评情况、生活满意度自评情况、营养状况及工具性日常活动能力的老年人,其RCF患病率比较差异均有统计学意义(均P<0.05)。患多种慢性病、工具性日常活动能力受损、日间精神状态差和增龄,是社区老年人RCF的危险因素,体育锻炼是保护因素(均P<0.05)。结论 社区老年人RCF发生率较高,医护人员应重视老年人日常活动能力评估,加强慢性病管理并开展个性化运动指导,以逆转或延缓认知衰弱进程。

Objective To explore status quo of reversible cognitive frailty(RCF)among the elderly in community and its influencing factors,so as to provide reference for the 3-level RCF prevention and health management.Methods From August 2020 to February 2021,212 old people who participated the physical examination in a community of Guangzhou were selected by convenience sampling method.A questionnaire survey was conducted using general information questionnaire,RCF screen scales including Frailty Phenotype,Montreal Cognitive Assessment Scale,Clinical Dementia Rating Scale,and Subjective Cognitive Decline items.Results 19.81%of the subjects suffered from RCF(n=42).There were statistically significant differences in RCF prevalence among the elderly with different ages,physical exercise,self-rated quality of sleep,daytime mental state,chronic pain,number of chronic diseases,amount of medication,self-rated health condition,self-rated life satisfaction,nutritional status and instrumental daily activities(all P<0.05).Multiple chronic diseases,impaired instrumental daily activities,poor daytime mental state and aging are the risk factors for RCF among the elderly in the community and physical exercise was the protective factors(all P<0.05).Conclusions The prevalence of RCF is high among the old people in community.Medical staff should pay attention to the evaluation of health condition and daily activity abilities of the elderly in community,strengthen the chronic diseases management and individualized exercise instruction to reverse or delay the process of cognitive frailty.