老年人婚姻状况与轻度认知障碍的相关性研究

Study on the correlation between marital status and mild cognitive impairment in older adults

目的探讨老年人婚姻状况与轻度认知障碍(MCI)的相关性。方法整群随机抽样。对2020年1—12月河北四省市60岁及以上的老年人进行问卷调查,最终筛选出调查问卷填写合格的MCI组与正常对照组2690名。把婚姻状况分为2组:已婚且与配偶一起居住(E1组)、离异或独身居住(E2组)。对两组简易精神状态量表(MMSE)评分情况进行比较,分析2组婚姻状态的认知差异以及婚姻状态、社交活动、生活事件的交互作用对认知的影响。结果有伴侣陪伴的已婚老年人认知保存较好(P<0.01);生活事件越多越容易引起认知障碍(P<0.01),婚姻状况、社交活动、生活事件交互作用对认知影响比较明显(P<0.01);已婚、与配偶住在一起的老年男性认知优于已婚、与配偶住在一起的老年女性(模型3中P<0.05);丧偶的老年女性认知优于丧偶的老年男性(模型1中P<0.1;模型2中P<0.1);在老年男性中,已婚、与配偶住在一起认知优于丧偶(模型1、2中P<0.01,模型3中P<0.1);在老年女性中,已婚、与配偶住在一起认知优于丧偶(模型1中P<0.01,模型2中P<0.01)。结论已婚同时有伴侣陪伴对老年人认知起保护因素,且婚姻状况对认知的影响存在性别差异。

Objective To explore the relationship between marital status and mild cognitive impairment in older adults.Methods This study is a cluster random sampling.From January to December 2020,a questionnaire survey was conducted among older adults aged 60 years and over in four cities of Hebei Province.Finally,2690 older adults with mild cognitive impairment and normal cognitive function were enrolled.The older adults were divided into 2 groups according to their marital status:married and living with their spouses(group E1),divorced or living alone(group E2).The mini-mental state examination(MMSE)scores of older adults in the two groups were compared.Moreover,the cognitive differences of older adults between the two groups and the interaction of marital status,social activities and life events on cognitive outcomes were analyzed.Results The married older adults with partners had better cognitive preservation(P<0.01).The more life events were more likely to cause cognitive impairment(P<0.01),and the interaction of marital status,social activities and life events had a significant impact on cognition(P<0.01).Older men who were married and lived with spouse had better cognition than older women who were married and lived with spouse(P<0.05 in Model 3).The cognition of widowed elderly women was better than those of widowed elderly men(P<0.1 in Model 1;P<0.1 in Model 2).Among elderly men,the cognition of those married and living with spouse was better than that those of widowed(P<0.01 in models 1 and 2,P<0.1 in model 3).Among elderly women,those married and living with spouse had better cognitive outcomes than those widowed(P<0.01 in Model 1,P<0.01 in Model 2).Conclusions Marital companionship is a protective factor for the cognition of older adults,and there are gender differences in the impact of marital status on cognition in late life.