人体测量学指标用于社区老年人轻度认知障碍筛查研究

Screening ability of anthropometric indicators for mild cognitive impairment in the elderly

目的评估人体测量学指标对老年人轻度认知障碍的筛查能力,确定最佳筛查指标。方法采用多阶段分层抽样的方法,对广西3个市6个社区/乡镇的60岁以上常住老年人502名进行蒙特利尔认知评估量表-北京版(MoCA-B)测评和人体指标测量,以认知评估结果为金标准,将老年人分为认知正常组和轻度认知障碍组,比较两组人体测量学指标的差异,绘制受试者工作特征曲线,评价人体测量学指标对轻度认知障碍的筛查能力。结果认知正常组244名,轻度认知障碍组258名。两组身高、腰围、小腿围、BMI、腰高比、腰小腿围比、身体圆度指数、腹部体积指数和体脂肪指数比较,差异有统计学意义(均P<0.05);腰小腿围比对总样本轻度认知障碍具有较高的筛查能力(AUC=0.681);联合指标腰小腿围比+腰高比在60~<65岁老年人中筛查能力最高(AUC=0.708);腰小腿围比+体脂肪指数在65~<75岁老年人中筛查能力最高(AUC=0.735)。结论腰小腿围比、体脂肪指数和腰高比对老年人轻度认知障碍具有一定筛查价值。腰小腿围比+腰高比是60~<65岁老年人的最佳联合筛查指标;腰小腿围比+体脂肪指数是65~<75岁老年人的最佳联合筛查指标。

Objective To evaluate the screening ability of anthropometric indicators for mild cognitive impairment(MCI)in the elderly and to determine the optimal cut-off value.Methods The multi-stage stratified random sampling method was used to select 502 permanent residents over 60 years old in 6 communities/towns in 3 cities in Guangxi,for cognitive assessment,and measurement of anthropometric indicators.The elderly were divided into cognitively normal group and MCI group,and the differences of anthropometric indexes between the two groups were compared.With cognitive assessment result as gold standard,receiver operating characteristic curve(ROC)was plotted and area under curve(AUC)was compared.Results There were significant differences in height,waist circumference,calf circumference,BMI,waist to height ratio,waist to calf circumference ratio(WCR),body roundness index,abdominal volume index and body adiposity index(BAI)between the two groups(all P<0.05).The ratio of waist to calf circumference showed higher screening ability for MCI(AUC=0.681).The screening ability of waist to calf circumference ratio+waist to height ratio was highest in patients aged 60-<65 years(AUC=0.708),while WCR+BAI was the hig-hest in the 65-<75 year old group(AUC=0.735).Conclusion WCR,BAI and WHtR have a certain value for screening MCI in the elderly.WCR+WHtR is the best combination for the aged 60-<65 years,while WCR+BAI is the best combination for 65-<75 years old.