我国老年人口腔疾病与认知障碍的关系

The relationship between oral disease and cognitive impairment in the elderly in China

目的 通过队列研究分析我国老年人患口腔疾病与认知障碍之间的关系。方法 本研究为回顾性队列研究。选取2015年中国健康与养老追踪调查(CHARLS)的数据,采用简易智能精神状态检查量表得分情况筛选出2015年60岁以上无认知障碍的老年人1 433例作为观察对象,追踪观察2018年老年人的认知障碍发生情况。根据认知障碍的检出情况,将老年人分为四组:未患口腔疾病,有认知障碍;未患口腔疾病,无认知障碍;患口腔疾病,有认知障碍;患口腔疾病,无认知障碍。各组例数依次为343、598、249、243例。运用卡方检验和m Poisson回归模型分析口腔疾病与认知障碍之间的关系。结果 患口腔疾病的老年人中认知障碍的发生率为50.6%,未患口腔疾病的老年人认知障碍的发生率为36.5%,差异有统计学意义(P <0.001)。在控制混杂因素后,Cox比例风险模型发现患口腔疾病与认知障碍之间存在关联(风险比率HR=0.719,95%CI:0.611~0.847),老年男性患口腔疾病(HR=0.814,95%CI:0.663~0.999)较女性(HR=0.572,95%CI:0.431~0.785)更容易出现认知障碍(P <0.05)。结论 我国老年人患口腔疾病容易导致认知障碍的发生,认知障碍表现在语言表述能力方面最易受损,且男性高于女性,因此在口腔疾病治疗过程中,应积极采取预防措施,进而改善老年人的认知功能。

Objective To analyze the relationship between oral diseases and cognitive impairment in our older adults through a cohort study.Methods This study was a retrospective cohort study.Data from the 2015 China Health and Aged Care Tracking Survey(CHARLS)were selected,and 1433 elderly people over 60 years old without cognitive impairment in 2015 were selected as observation objects by using the scores of the simple intelligent mental state Examination Scale,and the incidence of cognitive impairment in the elderly in 2018 was followed up.According to the detection of cognitive impairment,the elderly were divided into four groups:No oral disease,cognitive impairment;no oral disease,no cognitive impairment;oral disease,cognitive impairment;oral disease,cognitive impairment;oral disease,no cognitive impairment.The number of cases in each group was 343,598,249,and 243 in that order.The relationship between oral diseases and cognitive impairment was analyzed using chi-square test and mPoisson regression model.Results The prevalence of cognitive impairment among older adults with oral disease was 50.6%,the prevalence of cognitive impairment in older adults without oral disease was 36.5%.The difference was statistically significant(P<0.001).After controlling for confounding factors,the Cox proportional risk model found an association between having oral disease and cognitive impairment(HR=0.719,95%CI:0.611~0.847).Older men with oral disease(HR=0.814,95%CI:0.663~0.999)were more likely to have cognitive inparment symptoms(P<0.05)than women(HR=0.572,95%CI:0.431~0.785).Conclusion Oral diseases of the elderly in our country tend to lead to the occurrence of cognitive disorders.The manifestation of cognitive disorders is most impaired in the aspect of linguistic expression ability.Therefore,during the treatment of oral diseases,preventive measures should be taken to improve cognitive functions of the elderly.