青岛市老年人认知功能障碍与慢性病及其共病的关系研究

Study on the relationship between cognitive dysfunction and chronic disease and their comorbidities in the elderly in Qingdao City

目的了解青岛地区≥60岁老年人认知功能障碍发生率,探讨其与高血压、糖尿病、血脂异常及其共病的关系。方法于2021-06-10-2021-10-30采用分层整群随机抽样方法,在青岛市10个区(市)各随机抽取1个镇街,每个抽取的镇街随机抽取1个社区(村),抽取的社区(村)中≥60岁老年人全部纳入研究,最终获得有效研究对象3365名;对研究对象进行一般人口学资料调查、身体测量和免费体检;采用简易精神状态量表(MMSE)进行认知功能评定;按照年龄、文化程度、患不同慢性病等进行分组比较,采用χ^(2)检验差异性,认知功能障碍的影响因素使用二分类logistic回归分析。结果老年人认知功能障碍发生率为23.6%(795例);随年龄增长而增高(χ^(2)=75.40,P<0.001)、随文化程度的提高而降低(χ^(2)=86.70,P<0.001);独居、不经常运动、超重肥胖、腹型肥胖老年人的认知功能障碍发生率较高,均P<0.001;不同慢性病患者中,三病共患(高血压、糖尿病、血脂异常)患者认知功能障碍发生率(47.3%)最高,差异有统计学意义,χ^(2)=198.32,P<0.001;在各影响因素中,三病共患是最强影响因子,OR=5.09,95%CI:3.61~7.17。结论高龄、低文化程度、独居和超重肥胖的老年人认知功能障碍发生率较高;罹患高血压、糖尿病、血脂异常等慢性疾病提高了老年人认知功能障碍的发生率,三病共患影响更为明显;因此改善生活方式、加强高血压、糖尿病、血脂异常及其共病的控制,减少共患疾病,是降低老年认知功能障碍发生率的有效措施。

Objective To understand the incidence of cognitive dysfunction in the elderly ≥ 60 years old in Qingdao and explore its relationship with hypertension, diabetes, dyslipidemia and their comorbidities.Methods Stratified cluster random sampling method was used to select the subjects from June 10,2021 to Octorber 30,2021 in Qingdao.One town(street) was randomly selected from each of 10 districts(cities),one community(village) was randomly selected from each selected town(street),and the elderly ≥ 60 years old in the selected community(village) were all included in the study.Finally, 3 365 effective subjects were obtained.The subjects were investigated with general demographic data, physical measurement and free physical examination.The cognitive function of the subjects was assessed with the mini-mentalstateexamination(MMSE).The subjects were grouped and compared according to their age, education level and chronic diseases;Chi-square test was used for rate comparison.The influencing factors of cognitive impairment were analyzed by binary logistic regression.Results The incidence of cognitive dysfunction in these elderly was 23.6%(795) and it increased with age(χ^(2)=75.40,P<0.001),decreased with the improvement of education level(χ^(2)=86.70,P<0.001);The incidence of cognitive dysfunction in elderly people who lived alone, did not exercise regularly, were overweight and obese, and had abdominal obesity was higher(all P<0.001);Among patients with different chronic diseases, the incidence of cognitive dysfunction(47.3%) in patients with the comorbidity of three diseases(hypertension, diabetes, dyslipidemia) was the highest, and the difference was statistically significant(χ^(2)=198.32,P<0.001);Among all the influencing factors, the comorbidity of three diseases was the strongest influencing factors(OR=5.09,95%CI:3.61-7.17).Conclusions The incidence of cognitive dysfunction was higher in the elderly with old age, low education and those living alone or overweight;Chronic diseases such as hypertension,diabetes,and dyslipidemia increase the incidence of cognitive dysfunction in the elderly,and the effects of the comorbidity of three diseases are more obvious.Therefore,improving lifestyle,strengthening the control of hypertension,diabetes,dyslipidemia and their comorbidities,reducing comorbidities are effective measures to reduce the incidence of cognitive dysfunction in the elderly.