北京市农村社区老年高血压患者认知衰弱状况及影响因素分析

Analysis on prevalence and risk factors of cognitive frailty in Beijing rural elder hypertensive patients

目的 了解北京市农村社区老年高血压患者认知衰弱的患病特征并探讨其影响因素,为老年高血压患者认知衰弱的防治提供依据。方法 该研究数据源自北京城乡老年人群健康综合队列研究的农村横断面调查数据,该调查于2014年6—10月随机抽取北京市密云县30个行政村年龄≥60岁的2 397名老年人。该研究以其中895例高血压患者作为研究对象。采用中文版简易智力状态筛检量表(MMSE)和Fried衰弱表型评估工具(FP)进行认知衰弱评估。采用SPSS 25.0软件进行t检验、χ^(2)检验和多因素logistic回归分析。结果 北京市农村地区老年高血压患者的认知衰弱患病率为9.8%。多因素logistic回归分析显示,服用3种及以上药物(OR=2.353)和有抑郁症状(OR=13.078)与老年高血压患者认知衰弱患病高风险相关;小学及以上文化程度(与文盲相比OR=0.244)、体育锻炼时间≥0.5 h/d(OR=0.068)、高臀围(OR=0.960)与老年高血压患者认知衰弱患病低风险相关,均有统计学意义(P<0.05,P<0.01)。结论 北京市农村社区老年高血压人群认知衰弱患病率较高,应鼓励老年人积极参与身体锻炼,密切关注臀围的变化,同时促进社会对老年群体的支持与价值认同改善抑郁状况以预防认知衰弱。

Objective To understand the prevalence of cognitive frailty (CF) in elderly patients with hypertension in Beijing rural area and explore its risk factors,provide the basis for the prevention and treatment of CF in elder hypertensive patients.Methods The data were from the rural cross-sectional survey of the Beijing Comprehensive Elderly Health Cohort Study,which randomly selected 2 397 elderly residents (≥60 years old) from 30 administrative villages in Miyun county from June to October 2014.In the study,895 hypertension patients served as the subjects.The Mini-Mental Status Examination (MMSE) and frailty phenotype(FP) were used to assess the CF.The t test,χ^(2)test and multinomial logistic regression model were used to analyze the data.The used software was SPSS 25.0.Results The rate of cognitive frailty among elderly hypertensive patients in rural areas of Beijing was9.8%.Multivariate logistic regression analysis showed that the≥3 medications (OR=2.353) and depressive symptoms (OR=13.078)correlated with high risk of CF in elderly hypertensive patients;educational level with≥elementary school,(as compared with illiteracy,OR=0.244),physical exercise time≥0.5 h/d (OR=0.068),and high hip circumference (OR=0.960) were associated with low risk of CF in elderly hypertensive patients (P<0.05 or P<0.01).Conclusion The morbidity of CF in elderly hypertensive patients of Beijing rural communities is higher.The older adults should be encouraged to actively participate in physical exercise,changes of the hip circumference should be focused on.Social support and value recognition for the elderly should be promoted to reduce symptom of depression so as to prevent CF.