住院老年慢性心力衰竭患者认知衰弱的影响因素分析

Cognitive frailty and its influencing factors in hospitalized elderly patients with chronic heart failure

目的了解老年慢性心力衰竭(chronic heart failure,CHF)患者的认知衰弱(cognitive frailty,CF)状况,探讨其影响因素,为老年CHF患者CF的早期识别和干预提供依据。方法收集124例老年病科住院的CHF患者病历资料,使用Freid衰弱表型量表评估患者衰弱状态,采用MMSE简易精神状态检查量表评估认知情况,比较认知衰弱和非认知衰弱患者的一般人口学资料、慢性病病史及实验室数据。采用多因素Logistic回归法分析老年CHF患者发生CF的独立影响因素。结果老年CHF患者合并CF的发生率为29.03%。与非CF组相比,CF组的患者年龄更大、BMI更小,文化程度更低,脑梗死、多重用药更多见,血红蛋白、左室射血分数值更低(均P<0.05)。多因素Logistic回归分析显示,BMI(OR=0.790,95%CI:0.662~0.943)、脑梗死(OR=3.391,95%CI:1.058~10.867)、年龄(OR=1.145,95%CI:1.034~1.268)是老年CHF患者合并CF的独立影响因素(均P<0.05)。结论老年CHF患者合并CF的发生率较高,临床应重点关注年龄较大、BMI较小、有脑梗死病史的患者,及早甄别CF的危险因素,进行预见性干预。

Objective To investigate the cognitive frailty(CF)status among elderly patients with chronic heart failure(CHF)and explore the factors influencing CF,so as to provide evidence for early identification and intervention of CF in elderly CHF patients.Methods A total of 124 elderly patients with CHF admitted to the department of geriatrics were included in this study.The clinical data of patients were collected.Freid Scale was used to assess patients'frailty status,and the mini-mental state examination(MMSE)Scale was used to assess their cognitive status.The general demographic characteristics,chronic disease history and laboratory data of the patients were compared between those with cognitive frailty(CF)and those without CF.Multivariate Logistic regression was used to identify independent factors associated with CF in elderly patients with CHF.Results The prevalence of cognitive frailty(CF)in elderly patients with CHF was 29.03%.Compared to the non-CF group,patients in the CF group were older,had a lower BMI,lower educational level,higher incidence of stroke,and were more likely to be taking multiple medications.They also had lower levels of hemoglobin and left ventricular ejection fraction(all P<0.05).Multivariate Logistic regression analysis showed that BMI(OR=0.790,95%CI:0.662~0.943),history of cerebral infarction(OR=3.391,95%CI:1.058~10.867)and age(OR=1.145,95%CI:1.034~1.268)were independent factors associated with CF in elderly CHF patients(all P<0.05).Conclusions Elderly patients with chronic heart failure have a high incidence of cognitive frailness.Clinical attention should be paid to patients who are older,have a lower BMI,and have a history of cerebral infarction.Early identification of risk factors for CF and proactive interventions should be implemented to prevent or mitigate the development of CF in this population.