北京市顺义区老年居民主观认知水平下降的影响因素分析

Analysis of the influencing factors of the subjective cognitive decline of the elderly residents in Shunyi District of Beijing

目的探讨老年人群主观认知下降问卷9(subjective cognitive decline questionnaire 9,SCD-Q9)得分的影响因素,为阿尔茨海默病(Alzheimer’s disease,AD)早期筛查提供科学依据。方法选取2016年9—11月北京市顺义区60~80岁的常住汉族居民,通过面对面询问的方式进行问卷调查。调查内容包括一般情况、社会支持、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)及SCD-Q9。结果2674名居民参与问卷调查,其中男1163人,女1511人;年龄中位数为66岁;受教育年限中位数为8年;94.3%的被访者和家人一起居住;近90.0%的被访者有健在的兄弟姐妹,有3个以上关系密切朋友的被访者占比最高,为66.4%;60.0%以上的被访者和邻居之间的关系为“很关心”;HAMD与HAMA评分中位数均为1.0分。SCD-Q9总得分中位数为5.0分,其中整体记忆功能及与时间对比维度得分中位数为4.0分,日常活动能力维度得分中位数为1.0分。影响SCD-Q9得分的多因素回归分析显示,性别、年龄、受教育年限、关系密切朋友的个数、与邻居的关系、HAMA评分、HAMD评分,以及合并脑血管病、高血压、高脂血症、癫痫是SCD-Q9得分的影响因素(P<0.05);其中HAMA评分对SCD-Q9得分影响最大,其次是HAMD评分和合并高脂血症史,年龄和合并高血压史对SCD-Q9得分影响最小。结论北京市顺义地区SCD-Q9总得分处于中等水平,人口学因素、社区支持、精神状态及合并疾病是SCD-Q9的影响因素,不同影响因素的权重不同。可在老年人群中应用该问卷,以早期发现认知受损的高危人群,并及时干预,改善患者预后。

Objective To explore the influencing factors of subjective cognitive decline questionnaire 9(SCD-Q9)score of the elderly population,and provide scientific basis for screening early Alzheimer’s disease(AD).Methods Permanent Han residents aged 60 to 80 in Shunyi District of Beijing from September to November,2016 were selected,and a questionnaire survey was conducted by face-to-face interview.The contents of the questionnaire included general situation,social support,Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)and SCD-Q9.Results A total of 2674 subjects participated in the survey,including 1163 males and 1511 females.The median age was 66 years old,and the median length of education was 8 years.Most participants lived with their families(94.3%),nearly 90.0%of the participants had living brothers and sisters.The proportion of participants who had more than three close friends was the highest,accounting for 66.4%,and more than 60.0%of participants’relationship with their neighbors was“very concerned”.The median score of HAMD and HAMA were both 1 score.The median score of SCD-Q9 was 5.0 score,of which the median score of overall memory and comparison with time was 4.0 score,and the median score of daily activities was 1.0 score.Multivariate analysis of influencing factors of SCD-Q9 showed that gender,age,years of education,number of close friends,relationship with neighbors,HAMA score,HAMD score,and history of cerebrovascular disease,hypertension,hyperlipidemia and epilepsy were the influencing factors of SCD-Q9(P<0.05).HAMA score had the greatest influence on SCD-Q9 score,followed by HAMD score and history of hyperlipidemia.Age and history of hypertension had the least influence on SCD-Q9 score.Conclusions The total score of SCD-Q9 in Shunyi District of Beijing is in the middle level.Demographic factors,social support,mental status and combined diseases are the influencing factors of SCD-Q9,and different influencing factors have different weights.The questionnaire can be used in the elderly to find out the high-risk population with cognitive impairment at an early stage,and intervene in time to improve the prognosis of patients.