上海市金山区亭林镇老年人轻度认知功能障碍的流行病学特点及筛查工具研究

Epidemiological characteristics and screening tools of cognitive dysfunction in the elderly in Tinglin Town,Jinshan District,Shanghai

目的分析讨论蒙特利尔认知评估基础量表(MoCA)以及简易精神状态量表(MMSE)在老年人轻度认知功能障碍(MCI)患者筛查评估的效果,确定最佳评估阈值,并探讨量表对特定认知功能领域的评估准确度方法。方法进一步分析影响认知功能的危险因素、本地区的发病率。本研究共纳入上海市金山区亭林镇社区2800名老年人,包括健康老年人(HC)、MCI患者,所有纳入受试者均接受MMSE、MoCA及完整的三大认知领域神经心理学量表评估(包括记忆、语言、执行功能)。在影响因素方面利用了χ^(2)检验,方差分析,用二分类Logistic回归对认知功能水平多因素分析,利用受试者工作特征曲线(ROC)对MoCA和MMSE诊断MCI患者的灵敏度、特异度进行分析。结果MoCA和MMSE在认知功能障碍方面有较好的筛查评估效果,且MoCA更具有优势。人口社会学因素,生活方式因素,健康指标均为认知功能水平的影响因素。结论年龄,人群中社会关系性、抑郁、结婚状态、受教育文化程度,日常生活方式活动、教育水平、家庭经济状况产生显著影响的因素。其中抑郁是老年人群中最常见的精神疾病,直接危害老年人身心健康。会对老年人的认知水平和身心健康造成极大的损伤。

Objective To analyze and discuss the effectiveness of the Montreal cognitive assessment(MoCA)and the mini-mental state examination(MMSE)for screening older people with mild cognitive impairmen(MCT).Methods To determine optimal assessment thresholds,investigate the accuracy of the scale approach in specific areas of cognitive function and further analysis of risk factors and the prevalence of cognitive function in the region.2800 elderly people were involved in this study,including healthy older adults(HC)and(MCI mild cognitive impairment patients),living in the Jinshan District of Shanghai Tingling.All participants were tested on the MMSE,MoCA,and cognitive domains of all three major neuropsychological scales(including memory,language,and executive function).Factors affecting cognitive function were investigated using the square test,ANOVA,multivariate analysis of variance with dichotomous logistic regression.The sensitivity and specificity of the MoCA and MMSE in the diagnosis of patients with MCI were analyzed using receiver operating characteristic(ROC)analysis.Results MoCA and MMSE were the best screening assessments for cognitive dysfunction,with MoCA being more favorable.the demographic and sociological factors,lifestyle factors,and health factors,and all tests were the influencing factors of cogintive function.Conclusion Age,social relationships,depression,marital status,educational level,daily lifestyle activities,educational level,and family economic status among the population have a significant impact.Among them,depression is the most common mental illness among the elderly population,directly endangering their physical and mental health.It can cause significant damage to the cognitive level and physical and mental health of the elderly.