医养结合型养老机构老年人可逆性认知衰弱现状及影响因素分析

Current status of reversible cognitive frailty of elderly people in medical-nursing combined care institutions and its influencing factors

目的调查医养结合型养老机构老年人的可逆性认知衰弱现状,并分析其影响因素。方法采用方便抽样法,于2023年2—5月抽取合肥市5所医养结合型养老机构的438名老年人为调查对象,采用一般资料调查表、Fried衰弱表型、蒙特利尔认知评估量表、临床痴呆评定量表、单条目主观认知下降评定、微型营养评估量表及简版老年抑郁量表对其进行调查,采用二元Logistic回归分析老年人可逆性认知衰弱的影响因素。结果医养结合型养老机构老年人可逆性认知衰弱发生率为29.0%。二元Logistic回归结果显示,年龄(OR=3.243、9.832)、慢性病数量(OR=2.700、4.508)、抑郁情绪(OR=3.681)是医养结合型养老机构老年人可逆性认知衰弱的危险因素(均P<0.05);文化程度(OR=0.448、0.387、0.316)、自评睡眠质量(OR=0.475)、营养状况(OR=0.298、0.106)、运动锻炼情况(OR=0.496、0.483)是医养结合型养老机构老年人可逆性认知衰弱的保护性因素(均P<0.05)。结论医养结合型养老机构老年人可逆性认知衰弱发生率为29.0%,医务人员应重点关注高龄、文化程度低、慢性病数量多、自评睡眠质量差、运动锻炼少、营养不良及抑郁的老年人,并制定针对性干预策略以减少或避免可逆性认知衰弱的发生发展。

Objective To investigate the current status of reversible cognitive frailty among the elderly in medical-nursing combined care institutions and analyze its influencing factors.Methods From February to May 2023,convenience sampling was used to select 438 elderly people from 5 medical-nursing integrated care institutions in Hefei as the subjects.General information questionnaire,Fried Frailty Phenotype,Montreal Cognitive Assessment,Clinical Dementia Rating Scale,Single Item Subjective Cognitive Decline,Mini Nutritional Assessment(MNA)and the Geriatric Depression Scale(SDS)were used for the investigation.Binary Logistic regression was used to analyze the influencing factors of reversible cognitive frailty in the elderly.Results The incidence of reversible cognitive frailty was 29.0%in the elderly in medical-nursing integrated care institutions.Binary Logistic regression analysis showed that age(OR=3.243,9.832),number of chronic diseases(OR=2.700,4.508)and depression(OR=3.681)were the risk factors for reversible cognitive frailty in the elderly in medical-nursing integrated care institutions(all P<0.05).Education background(OR=0.448,0.387,0.316),self-rated sleep quality(OR=0.475),nutritional status(OR=0.298,0.106)and exercise(OR=0.496,0.483)were its protective factors(all P<0.05).Conclusion The incidence of reversible cognitive frailty was 29.0%in the elderly in medical-nursing integrated care institutions.It is crucial to pay closer attention to specific subgroups within this population,including those who are advanced in age,have lower levels of education,multiple chronic diseases,poor self-rated sleep quality,limited physical exercise,malnutrition,and depression.Targeted intervention strategies should be implemented to mitigate or prevent the occurrence and progression of reversible cognitive frailty.