老年骨质疏松症患者的认知功能特点及相关性

Characteristics and correlation of cognitive function in elderly patients with osteoporosis

目的:探讨老年骨质疏松症(osteoporosis,OP)患者的认知功能特点,并分析二者的相关性。方法:选取2018年10月至2020年6月海南省三亚市人民医院老年病科收治的120例老年OP患者,记为OP组。另选取同期来院例行体检的50例非OP老年志愿者,记为对照组。两组均接受简易智力状态检查量表(Mini Mental State Examination Scale,MMSE)筛查,OP组接受股骨颈(femoral neck,FN)、腰椎L1~4骨密度(bone mineral density,BMD)测量。依据MMSE评分,将OP组分成单纯OP组与认知障碍组。比较2组的MMSE评分和认知障碍发生率,比较单纯OP组和认知功能障碍组的BMD测量值,并分析OP与老年人群认知障碍的关系。结果:OP组MMSE量表各维度评分及总分低于对照组,认知障碍发生率为39.17%,高于对照组的20.00%(P<0.05)。认知障碍组FN-BMD、腰椎L1~4-BMD均低于单纯OP组(P<0.05)。OP组MMSE评分与FN-BMD、腰椎L1~4-BMD呈中度正相关(r=0.387、r=0.584,P<0.05)。多因素logistic回归显示OP是老年人群认知障碍发生的独立危险因素(OR=2.558,95%CI:1.123~5.812)。结论:与非OP老年人群相比,老年OP患者的认知功能明显较差,更易发生认知功能障碍,且OP与认知功能障碍存在一定相关性,临床抗OP治疗时应予以重视。

Objective:To explore the characteristics of cognitive function in elderly patients with osteoporosis(OP)and analyze the correlation between them.Methods:A total of 120 elderly OP patients treated in the geriatric department of Sanya People’s Hospital of Hainan Province from October 2018 to June 2020 were selected as the OP group.In addition,50 non-OP elderly volunteers who came to the hospital for routine physical examination in the same period were selected as the control group.Both groups were screened by mini mental state examination scale(MMSE),and OP group was measured by femoral neck(FN)and lumbar L_(1-4)-BMD.According to MMSE score,the OP group was divided into a simple OP group and a cognitive impairment group.The MMSE score and the incidence of cognitive impairment in the OP group and the control group were compared.The BMD measurements in the OP group and the cognitive impairment group were compared.The correlation between BMD measurements and MMSE score in the OP group was analyzed by Pearson correlation coefficient method.The relationship between OP and cognitive impairment in the elderly was analyzed.Results:The scores and total scores of MMSE in the OP group were lower than those in the control group,and the incidence of cognitive impairment was 39.17%,higher than that in the control group(22.00%,P<0.05).FN-BMD and lumbar L_(1-4)-BMD in the cognitive impairment group were lower than those in the simple OP group(P<0.05).MMSE score in the OP group was moderately positively correlated with FN-BMD and lumbar L_(1-4)-BMD(r=0.387,r=0.584,P<0.05).Multivariate logistic regression showed that OP was an independent risk factor for cognitive impairment in the elderly(OR=2.558,95%CI:1.123-5.812).Conclusion:Compared with the non-OP elderly people,the cognitive function of elderly OP patients is significantly worse,and they are more prone to cognitive impairment.There is a certain correlation between OP and cognitive impairment,which should be paid attention to in clinical anti-OP treatment.