住院老年痴呆患者衰弱现状及路径分析

Analysis of Frailty Degree and Influence Path of Inpatients with Dementia

目的调查住院老年痴呆患者衰弱现状及影响因素,并分析其影响路径。方法采用横断面调查的方法,选取2022年1月-10月沈阳市2所精神卫生医院的233例住院老年痴呆患者为研究对象,采用一般资料调查问卷、基于照护者的老年患者综合评估衰弱指数问卷(CP-FI-CGA)、改良巴氏指数量表(MBI)、简易智力精神状态量表(MMSE)进行调查。结果回收有效问卷233份(97.08%),233例住院老年痴呆患者中,轻度衰弱63例,中度衰弱96例,重度衰弱74例;MBI得分为(47.65±15.77)分,MMSE得分为(10.25±4.04)分;住院老年痴呆患者衰弱程度的影响因素为年龄、患病时间、文化程度和睡眠质量(P<0.05);Pearson相关性分析结果显示,住院老年痴呆患者衰弱程度与年龄、患病时间呈正相关,与文化程度,MBI总分、进食、上下楼、行走,MMSE总分、定向力、注意力和计算力、即刻记忆呈负相关;路径分析结果显示,认知功能对日常生活活动能力有正效应,日常生活活动能力对衰弱程度有负效应。结论住院老年痴呆患者处于中重度衰弱水平,其中认知功能对衰弱程度有间接负向效应,日常生活活动能力可作为间接变量影响衰弱程度。

Objective To investigate the current status and influencing factors of frailty in inpatients with dementia,and to analyze its influencing pathways.Methods Using a cross-sectional survey method,233 hospitalized elderly dementia patients from 2 mental health hospitals in Shenyang from January 2022 to October 2022 were selected for the study,and were investigated using a general information questionnaire,care partner frailty index-comprehensive geriatric assessment(CP-FI-CGA),Modified Barthel Index Scale(MBI),and Mini-Mental State Examination(MMSE).Results Among the 233 hospitalized dementia patients,63 were mildly frail,96 were moderately frail,and 74 were severely frail,with a score of(47.65±15.77)for activities of daily living(ADL)and(10.25±4.04)for cognitive function;Factors that influencing frailty were age,duration of illness,literacy and the quality of sleep(P<0.05).Pearson correlation analysis showed that the degree of frailty of hospitalized dementia patients was positively related to age and duration of illness,and inversely related to literacy level,eating,going up and down stairs,walking in ADL ability,and orienting,attention and calculation,and language ability in cognitive function;the results of the path analysis showed that the cognitive function had a positive effect on ADL ability,and ADL ability had a negative effect on the degree of frailty.Conclusion Most of the hospitalized Alzheimer's patients were at a moderate and severe level of frailty,in which cognitive function had an indirect negative effect on the degree of frailty,and the ability to perform ADL could be used as an indirect variable to influence the degree of frailty.