【摘要】 目的　通过对一个社区居住的老年人群的前瞻性研究 ,探讨对认知功能随增龄减退有重要影响的因素。　方法　在北京市 5 5岁以上的老年与老年前期人群抽取样本 ,分别于 1992年和1997年测查简易智能量表 (MMSE)。　结果　基线调查时在正常范围者 5年后 2 4.4% MMSE评分明显下降。多因素分析证实 ,基线调查时评分在临界水平者易出现进一步下降 ;对认知功能减退有预测作用的因子主要有年龄、受教育程度、地区等人口学因素 ,健康有关指标作用相对较弱 ,其中日常生活能力对认知功能的减退有预测作用 ,近 5年内新患脑卒中也是重要的预测因子 ;影响 75岁以下老年人与 75岁以上老年人认知功能减退的因素不尽相同。　结论　影响老年人认知功能减退的因素主要是年龄、受教育程度、居住地等 ,健康方面躯体功能下降和脑血管病史也有重要意义 ,但作用相对弱于人口学因素。更多还原

【Abstract】 Objective To analyze the relative important factors affecting cognitive change with aging by longitudinal observation. Methods 1 227 community lived elderly and presenile subjects aged 55 and over were tested with short mental test of Mini Mental State Examination (MMSE) both in 1992 and 1997.Other informations about demographic, living, and health condition of the subjects were collected in 1992 and analyzed as potential predictors. Results Among the cognitively intact subjects 24 4% decreased more than 2 points in the 5 year interval on their MMSE achievement. Multivariate analysis showed that those subjects who scored around cutoff points tended to decline further. Other factors which predict deterioration in MMSE included demographic characters as age, educational attainment, and residential area. The health related factors were less important; among these the level of activity of daily living (ADL) in baseline time was a significant predictor, together with the onset of stroke in recent five years. Further observation stratified by age verified that the factors impacting cognitive change among the young, old or very old subjects were somehow dissimilar. Conclusions Important determinants on cognitive decline are age, education and residential area. Failure in physical function and history of cerebrovascular diseases are also predictors of cognitive change, but their impact are weaker than the demographic factors mentioned above.更多还原