住院老年慢性病共病患者认知功能现状及其与衰弱的关系

The correlations between cognitive function and frailty in elderly inpatients with MCC

目的探讨住院老年慢性病共病(multiple chronic conditions,MCC)患者认知功能障碍情况,分析其与衰弱的关系。方法本研究为多中心横断面研究设计,2021年12月至2022年10月采用便利抽样方法选择肇庆市三家医院老年病房的MCC患者为研究对象,应用自制的调查问卷收集患者年龄、性别、疾病诊断、经济、文化水平等人口学资料,应用画钟试验和衰弱筛查量表分别进行认知功能和衰弱的评估。结果最终招募了264例患者,其中,认知功能障碍147例(占55.68%),衰弱97例(占36.7%);认知功能与衰弱及其表型中的体质量下降、疲乏、耐力减退、自由活动下降等维度(P<0.05)有关。二元logistic回归分析的结果显示:高龄(β=-0.707,95%CI=0.265~0.919)、糖尿病(β=-1.224,95%CI=0.141~0.616)、慢性肺病(β=-0.759,95%CI=0.251~0.873)、耐力减退(β=-0.850,95%CI=0.224~0.813)和自由活动下降(β=-1.601,95%CI=0.086~0.473)均是认知功能的独立危险因素,文化程度(β=1.521,95%CI=1.269~16.502)则是认知功能的保护因素。结论住院老年MCC患者认知功能障碍和衰弱的发生率较高,与高龄、文化程度低、糖尿病、慢性肺病有关,可导致衰弱的发生,主要以耐力减退、自由活动下降为主。

Objective To investigate the correlation between cognitive function and frailty of elderly MCC inpatients.Methods This was a multi-centre cross-sectional study.From December 2021 to October 2022,multiple chronic conditions(MCC)patients were selected by convenient sampling method in the geriatric wards from three hospitals in Zhaoqing City.We used a self-made questionnaire to collect their demographic data(age,gender,diseases diagnosis,monthly income and educational level),the clock drawing test(CDT)was used to assess the cognitive function and the FRAIL Scale was used to assess the prevalence of frailty.Results Altogether,264 MCC cases were enrolled,including 147 cases(55.68%)with cognitive dysfunction and 97 cases(36.7%)with frailty.Cognitive function was significantly correlated to frailty,mainly reflected in the decline of body mass,fatigue,endurance and free activity decline(P<0.05).Advanced age(β=-0.707,95%CI=0.265-0.919),diabetes(β=-1.224,95%CI=0.141-0.616),chronic lung disease(β=-0.759,95%CI:0.251-0.873),endurance loss(β=-0.850,95%CI:0.224-0.813)and free activity decline(β=-1.601,95%CI=0.086-0.473)were independent risk factors of cognitive dysfunction,and education level(β=1.521,95%CI=1.269-16.502)was the independent protection factor.Conclusion The incidence of cognitive dysfunction and frailty in hospitalized elderly patients with chronic comorbidity is high,which is correlated to age,education,diabetes,and chronic lung disease,and can lead to the occurrence of frailty,mainly with decreased endurance and free activity.