【摘要】 目的探讨上海市静安社区老年人发生认知障碍的状况及其影响因素。方法 2014年11月—2015年10月随机选择上海市中心某社区服务中心215例老人,采用蒙特利尔认知评估量表进行评估,以26分为界将老人分为认知障碍组(n=52)和非认知障碍组(n=163)。自制一般情况调查表对两组老人进行问卷调查,分析认知障碍状况及相关影响因素。计量资料采用t检验,计数资料采用χ2检验,认知功能的影响因素采用多因素Logistic回归分析,P<0.05为差异有统计学意义。结果 215例老人中认知障碍发生率为24.1%。认知障碍组和非认知障碍组在受教育程度、生活自理能力、社会活动能力、抑郁情绪、既往有无脑卒中史、高血压病史方面比较差异均有统计学意义(均P<0.05)。在认知障碍相关因素的Logistic回归分析中,受教育程度(OR=0.078,95%CI为0.548~0.926)、Barthel指数(OR=1.107,95%CI为0.998~1.228)、社会活动能力(OR=0.672,95%CI为0.518~0.871)、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分(OR=0.490,95%CI为0.358~0.672)、既往卒中史(OR=0.080,95%CI为0.609~1.595)、高血压病史(OR=0.045,95%CI为0.002~1.151)是影响社区老人认知功能的重要因素。依次进入方程的是社会活动能力、HAMD评分、既往卒中史,其中HAMD评分与认知障碍相关性最强。结论静安社区老人认知障碍的发生率较高。受教育程度、生活自理能力、社会活动能力、精神状况、既往卒中史、高血压病史是影响社区老人认知功能的重要因素,其中社会活动能力和抑郁情绪、既往卒中史是主要相关因素。更多还原

【Abstract】 Objective To investigate the incidence of cognitive impairment and its related factors for elderly in some communities of Shanghai. Methods 215 elderly people( ≥ 60 years old) randomly selected in some communities of Shanghai from November 2014 to October 2015 were assessed with Montreal cognitive assessment, and indentified with two groups of cognitive impairment(n=52)and non-cognitive impairment(n=163). These elderly people in two groups were investigated with questionnaire survey. The related factors of cognitive impairment were analyzed with single factor analysis and the ordinal Logistic regression method to find out influence factors. Measurement data was processed by t test, count data was processed by chi square test, P<0.05 was considered statistically significant.Results The prevalence of cognitive impairment in 215 elderly people were 24.1%. There were significant statistical differences in education level, activity of daily living, the ability of social activities, depression, histories of stroke or hypertension(all P<0.05). In the Logistic regression analysis, the important factors in the influence of community elderly cognitive function are education degree(OR=0.078, 95% CI 0.548-0.926), Barthel index(OR=1.107, 95% CI 0.998-1.228), social activities(OR=0.672, 95% CI 0.518-0.871), Hamilton depression scale(HAMD) records(OR=0.490, 95% CI 0.358-0.672), history of stroke(OR=0.080, 95% CI 0.609-1.595) and history of hypertension(OR=0.045, 95% CI 0.002-1.151).The ability of social activities, depression, histories of stroke were the risk factors for cognition while depression was the most related factor. Conclusion The prevalence of cognitive impairment in eldly people in the communities of Jing’an district was high. Cognitive impairment was associated with education level, activity of daily living, the ability of social activities, depression, histories of stroke or hypertension. Ability of social activities, depression, histories of stroke were the more important related factors.更多还原