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老年脑梗死患者认知衰弱变化轨迹及影响因素

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目的 分析老年脑梗死患者认知衰弱的变化轨迹,并探讨其认知衰弱变化轨迹的影响因素.方法 选取2023年1月-9月在安徽医科大学附属宿州医院接受治疗的100例老年脑梗死患者作为研究对象.收集患者的临床资料,采用衰弱筛查量表和蒙特利尔认知评估问卷(MoCA)评估患者入院时、治疗后1个月、治疗后3个月、治疗后6个月的认知衰弱情况,将衰弱评分≥3分且MoCA<26分定义为认知衰弱.通过潜类别增长模型识别认知衰弱变化轨迹的潜在类别,多因素logistic回归分析影响患者认知衰弱变化轨迹的因素.结果 通过模型拟合识别出老年脑梗死患者认知衰弱变化轨迹可分为衰弱持续低水平组(30例)、衰弱缓慢上升组(52例)和衰弱持续高水平组(18例).多因素logistic回归分析显示:年龄较大、睡眠质量差、合并慢性病种数>4种均是老年脑梗死患者认知衰弱持续低水平发展成认知衰弱缓慢上升的危险因素(P<0.05);体质量指数较高、自理能力高均是老年脑梗死患者认知衰弱持续低水平发展成认知衰弱缓慢上升的保护因素(P<0.05);年龄较大、睡眠质量差、合并慢性病种数>4种均是老年脑梗死患者认知衰弱持续低水平进展成认知衰弱持续高水平的危险因素(P<0.05),自理能力高是老年脑梗死患者认知衰弱持续低水平进展成认知衰弱持续高水平的保护因素(P<0.05).结论 老年脑梗死患者认知衰弱变化可分为3种轨迹类型,且存在着群体异质性.
The trajectory of changes in cognitive frailty and factors influencing it in elderly patients with cerebral infarction
Objective The trajectory of cognitive frailty in elderly patients with cerebral infarction was analyzed,and the influencing factors were discussed.Methods A total of 100 elderly patients with cerebral infarction hospitalized in Suzhou Hospital of Anhui Medical University from January to September in 2023 were selected for the study.Clinical data were collected on the patients,and cognitive frailty was assessed using the Frailty Screening Scale and the Montreal Cognitive Assessment Questionnaire(MoCA)at the time of admission and 1,3,6 months after treatment.Failty score ≥ 3 scores and MoCA<26 scores were defined as cognitive frai-ly.Potential categories of cognitive frailty change trajectories were identified by latent category growth modeling,and multifactorial lo-gistic regression analyzed the factors influencing patients'cognitive frailty change trajectories.Results The trajectory of cognitive frail-ty change in elderly patients with cerebral infarction identified by model fitting can be categorized into a group with a persistently low level of frailty(30 cases),a group with a slow rise in frailty(52 cases),and a group with a persistently high level of frailty(18 ca-ses).Multifactorial logistic regression analysis showed that older age,poor sleep quality,and the number of comorbid chronic diseases>4 were all risk factors for the development of persistent low levels of cognitive frailty into a slow rise in cognitive decline in elderly patients with cerebral infarction(P<0.05),Higher body mass index and high self-care ability were both protective factors for the development of persistent low levels of cognitive decline into a slow rise in cognitive decline in elderly patients with cerebral infarction(P<0.05).Older age,poor sleep quality and the number of comorbid chronic diseases>4 were risk factors for the progression of persistent low levels of cognitive decline to persistent high levels of cognitive decline in elderly patients with cerebral infarction(P<0.05),and higher self-care ability were protective factors for the progression of persistent low levels of cognitive decline to persistent high levels of cognitive decline in elderly patients with cerebral infarction(P<0.05).Conclusion Elderly patients with cerebral infarction can be divided into three trajectory types of cognitive decline changes,and there is group heterogeneity.

Cerebral infarctionCognitive frailtyTrajectory of changeInfluencing factors

徐胜楠、梁钦、张莉、刘时华

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安徽医科大学附属宿州医院神经内科,宿州 234000

脑梗死 认知衰弱 变化轨迹 影响因素

2025

国际老年医学杂志
吉林大学

国际老年医学杂志

影响因子:0.435
ISSN:1674-7593
年,卷(期):2025.46(1)