老年住院患者认知衰弱与抑郁、日常生活能力的相关性分析

Correlation analysis between cognitive frailty with depression and daily life ability of elderly hospitalized patients

目的:调查老年住院患者认知衰弱现状及其与抑郁、日常生活能力的相关性。方法:纳入2021年7月至2023年2月在海南医学院第二附属医院老年医学科≥60岁住院病人,采用一般资料、Fried衰弱表型、日常生活活动能力量表(ADL)、简易智能精神状态检查量表(MMSE)、简版老年抑郁量表(GDS-15)等老年综合征评定量表对老年患者认知衰弱发生率及影响因素进行分析,明确认知衰弱与抑郁、日常生活能力的相关性。结果:老年住院患者共729例,其中男336例(46.1%),女393例(53.9%);平均年龄(74.29±7.96)岁。其中60~69岁225例(30.9%),70~79岁298例(40.9%),≥80岁206例(28.2%);已婚634例(87%),未婚/离异/丧偶95例(13%);认知衰弱199例(27.3%)。多因素回归分析显示,站立行走≥12 s(OR=1.706,95%CI:1.124~2.590)、抑郁(OR=3.173,95%CI:2.134~4.718)、失眠(OR=1.883,95%CI:1.288~2.754)、跌倒坠床高风险(OR=2.494,95%CI:1.354~4.592)、重度失能(OR=3.305,95%CI:1.611~6.780)、重度依赖(OR=3.005,95%CI:1.545~5.846)均为影响患者发生认知衰弱的危险因素(P<0.05);运动正常为影响患者发生认知衰弱的保护因素(OR=0.895,95%CI:0.838~0.957,P<0.05)。结论:老年住院病人认知衰弱的发生与抑郁、日常生活能力有明显的相关性,需要及时做出干预,以延缓认知衰弱的进展。

Objective:To investigate the current situation of cognitive frailty in elderly hospitalised patients and its correlation with depression and daily life ability.Methods:Inclusion of inpatient≥60 years of age in the geriatrics department of the Second Affiliated Hospital of Hainan Medical College from July 2021 to February 2023.The incidence of cognitive frailty and influencing factors were analyzed by using general information,Fried frailty phenotype,Daily Life Activity Ability Scale(ADL),Simple Intelligent Mental State Examination Scale(MMSE),Simplified Senile Depression Scale(GDS-15)and other geriatric syndromes assessment scales in the patients,and the correlation between cognitive frailty with depression and daily life ability was clarified.Results:There were a total of 729 elderly hospitalized patients,including 336 males(46.1%)and 393 females(53.9%);mean age(74.29±7.96)years,of which 225(30.9%)were 60-69 years old,298(40.9%)were 70-79 years,and 206(28.3%)were≥80 years old;634(87%)were married,95(13%)were unmarried/divorced/widowed;199(27.3%)were cognitive frailty.Multi-factor regression analysis showed that standing walking≥12 s(OR=1.706,95%CI:1.124-2.590),depression(OR=3.173,95%CI:2.134-4.718),insomnia(OR=1.883,95%CI:1.288-2.754),high risk of falling bed(OR=2.494,95%CI:1.354-4.592),severe incapacitation(OR=3.305,95%CI:1.611-6.780),severe dependence(OR=3.005,95%CI:1.545-5.846)were the risk factors affecting the occurrence of cognitive frailty in patients(P<0.05);concise exercise was a protective factor affecting the occurrence of cognitive frailty in patients(OR=0.895,95%CI:0.838-0.957,P<0.05).Conclusion:The occurrence of cognitive frailty in elderly hospitalized patients is clearly correlated with depression and daily life ability,and timely intervention is needed to delay the progress of cognitive frailty.