社区老人轻度认知功能障碍现状及其影响因素间交互作用分析

Analysis of the current situation of mild cognitive impairment and the interaction between its influencing factors in the elderly in the community

目的 明确上海市闵行区社区老人轻度认知功能障碍(MCI)发生现状,分析MCI发生的影响因素间的交互作用关系。方法 采用横断面研究方法,应用AD-8与CSI-D对该区2021年65岁以上老人MCI发生现状进行双量表评估。应用SPSS 26.0软件,先后采用χ^(2)检验分析受检老人吸烟、饮酒、慢性病等因素在不同检出情况的构成、二分类非条件Logistic回归分析MCI发生的影响因素,再将各因素依次纳入双因素交互作用分析模型,分析各变量对MCI发生的交互作用。结果 应用AD8与CSI-D双量表评估法具有较高的灵敏度,评估闵行区社区老人MCI阳性率为26.6%,高于其他研究,低年龄(OR=1.09,95%CI:1.04~1.14)、良好的健康心态(OR=1.67,95%CI:1.15~2.42)是减少老人MCI的保护因素,职业类型(OR=1.19,95%CI:1.04~1.38)、照料者类型(OR=1.56,95%CI:1.09~2.22)与老人MCI的发生存在相关关系。家庭月总收入与照料者类型之间、是否饮酒与照料者类型之间对老人MCI的发生存在交互作用(P均<0.05)。结论 保持良好的心态可以降低老人MCI发生风险,不同职业类型、照料者类型与老人MCI的发生具有相关关系,照料者选择保姆可能会增加老人MCI风险。

Objective To clarify the current situation of mild cognitive impairment(MCI)in the community elderly in Minhang District,Shanghai,and analyze the interaction relationship between the influencing factors of MCI.Methods A crosssectional study method was used,and AD8 and CSI-D were used to evaluate the current situation of MCI in the elderly over 65 years old in this district in 2021.SPSS 26.0 software,chi-square test and binary unconditional Logistic regression model were used to analyze the composition of smoking,drinking,chronic diseases and other factors in different detected conditions and the influencing factors of MCI occurrence in the elderly.A factor interaction analysis model was used to analyze the interaction of each variable on the occurrence of MCI.Results The AD8 and CSI-D double-scale evaluation method had high sensitivity.The positive rate of MCI in the community elderly in Minhang District was 26.6%,which was higher than other studies.Younger age(OR=1.09,95%CI:1.04~1.14),good health mentality(OR=1.67,95%CI:1.15~2.42)were protective factors for reducing MCI in the elderly,occupation type(OR=1.19,95%CI:1.04~1.38),caregiver type(OR=1.56,95%CI:1.09~2.22)were correlated with the occurrence of MCI in the elderly.There were interaction effects between the total monthly household income and the type of caregivers,whether drinking or not and the type of caregivers on the occurrence of MCI in the elderly(all P<0.05).Conclusions Maintaining a good attitude can reduce the risk of MCI in the elderly.Different occupational types and types of caregivers are related to the occurrence of MCI in the elderly.Caregivers choosing nanny may increase the risk of MCI in the elderly.