中国神经免疫学和神经病学杂志2024，Vol.31Issue(1) ：25-33.DOI:10.3969/j.issn.1006-2963.2024.01.005

青海高原地区中老年人多维度认知功能及影响因素的性别差异分析

Analysis of gender differences in multidimensional cognitive function and its related factors in a middle-aged and elderly population in the Qinghai plateau region

刘文增 赵婷婷 侯永兰 张桂娟 钟欣 李国峰 李鹤 张占军 朱爱琴
中国神经免疫学和神经病学杂志2024，Vol.31Issue(1) ：25-33.DOI:10.3969/j.issn.1006-2963.2024.01.005
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青海高原地区中老年人多维度认知功能及影响因素的性别差异分析

Analysis of gender differences in multidimensional cognitive function and its related factors in a middle-aged and elderly population in the Qinghai plateau region

刘文增 1赵婷婷 2侯永兰 1张桂娟 3钟欣 3李国峰 3李鹤 4张占军 5朱爱琴3
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作者信息

  • 1. 810007 青海省人民医院老年医学科;810000 青海大学研究生院
  • 2. 462300 河南省漯河市中心医院;810000 青海大学研究生院
  • 3. 810007 青海省人民医院老年医学科
  • 4. 100700 中国中医科学院中医临床基础医学研究所
  • 5. 100875 北京师范大学老年脑健康研究中心
  • 折叠

摘要

目的 探讨高原地区中老年人多维度认知功能的性别差异,以及不同性别中老年人发生轻度认知功能障碍(mild cognitive impairment,MCI)的影响因素.方法 采用横断面随机抽样调查方法,选取青海地区(平均海拔3 000 m)中老年人500名(男性299名、女性201名).收集被调查者人口学信息、慢性病史、运动、经济和婚姻状况以及外周血指标,并进行多维度认知功能和心理评估,包括简易智能状态量表(mini mental state examination,MMSE)筛查、Rey-Osterrieth 复杂图形测验-延迟回忆(complex figure test delay recall,CFT-DR)、连线测验 A 和 B(trail making test,TMT-A&B)和数字符号转换测验(symbol-digit modalities test,SDMT)等,采用协方差分析不同性别人群年龄和教育程度对认知功能的影响.应用Logistic回归分析MCI发生的影响因素.结果 与女性比较,男性总体认知、情景记忆、工作记忆评分均增高(P＜0.05和P＜0.01),但注意力和执行力以及睡眠质量和抑郁状态评分明显降低(P＜0.01).校正受教育程度和年龄后,男性在不同年龄组和受教育程度组中总体认知、情景记忆、注意力和执行力均优于女性(P＜0.05,P＜0.01).进一步对比发现女性MCI患病率高于男性(25.9％比19.4％;x2=4.461,P＜0.05).Logistic 回归分析显示,高龄(OR男80岁～=3.636,OR女70岁～=2.578,OR男70岁～=2.914,OR女80岁～=1.500)是中老年人群发生MCI的危险因素(P＜0.05,P＜0.01),受教育程度高(OR男初中=0.146,OR女初中=0.166,OR女高中=0.151)是中老年人群发生MCI的保护因素(P＜0.01).而未婚是男性发生MCI的危险因素(OR=1.855,P＜0.05),睡眠质量差(OR=1.083,P＜0.05)和高同型半胱氨酸血症(OR=1.081,P＜0.05)是女性发生MCI的危险因素,教师职业是女性MCI的保护因素(OR=0.206,P＜0.05).结论 高原地区不同性别中老年人群存在多维度认知域的减退,其影响因素不同,随着增龄和教育水平低的影响,女性认知功能下降趋势比男性明显.女性是MCI发生的高危人群,针对性别差异应采取不同的预防和延缓认知损伤的措施.

Abstract

Objective T o explore the gender differences in multidimensional cognitive function among middle-aged and elderly people in plateau areas,and the risk factors for mild cognitive impairment(MCI)in men and women respectively.Methods Using a cross-sectional random sampling survey method,a total of 500 middle-aged and elderly people(299 men and 201 women)from Qinghai region(mean altitude 3 000 m)were selected.Demography information,chronic medical history,exercise,economic and marital status,and peripheral blood indicators were collected.Multi-dimensional cognitive function and psychological assessments were conducted,including Mini Mental State Examination(MMSE)screening,Delayed Recall N5 score of Rey-Osterrieth Complex Figure(CFT-DR),Trail Making Test A and B(TMT-A&B),and Symbol Digit Modifications Test(SDMT).Covariance analysis was used to compared the differences in cognitive function between different age and education level group.Multivariate logistic regression was used to determine gender-specific influencing factors of MCI occurrence.Results Compared with women,the scores of men's overall cognition,situational memory and working memory were higher(P＜0.05 and P＜0.01,respectively),but the scores of attention and executive ability,sleep quality and depression were significantly lower(all P＜0.01).Covariance analysis showed that men had better overall cognitive,situational memory,attention,and executive abilities than women in different age and education groups(P＜0.05,P＜0.01,respectively).Further comparison revealed that the incidence of MCI in women was higher than that in men(25.9％vs.19.4％,P＜0.05).Increasing age(OR men 80 years-=3.636,OR women 70 years-=2.578,OR men 70 years-=2.914,OR women 80 years-=1.500;P＜0.05,P＜0.01)was a risk factor for MCI,and the higher education level(OR middle school for men=0.146,OR middle school for women=0.166,ORhigh school for female=0.151;P＜0.01)was a protective factor for MCI.Being unmarried(OR=1.855,P＜0.05)was a risk factor for men MCI.Poor sleep quality(OR=1.083,P＜0.05)and hyperhomocysteinemia(OR=1.081,P＜0.05)were risk factors for women MCI,while teaching occupation was a protective factor for women MCI(OR=0.206,P＜0.05).Conclusions There is a decline in multidimensional cognitive domains in middle-aged and elderly people of different genders in plateau areas,and its influencing factors are different.As age increases and education levels decrease,the cognitive function of women tends to decline more significantly than that of men.Women are a high-risk group for MCI.We should take different measures to prevent and treat cognitive impairment based on gender differences.

关键词

高原地区/中老年人群/多维度认知域/轻度认知障碍/性别差异

Key words

plateau/middle-aged and elderly people/multi-dimensional cognitive function/mild cognitive impairment/gender differences

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基金项目

青海省科技厅应用基础研究项目(2021-ZJ-756)

国家重点研发计划(2018YFC1315200)

科技部科技创新2030"脑科学与类脑研究"重大项目(2022ZD0211602)

出版年

2024
中国神经免疫学和神经病学杂志
卫生部北京医院 中国免疫学会神经免疫学分会

中国神经免疫学和神经病学杂志

CSTPCD
影响因子：0.87
ISSN：1006-2963
参考文献量5
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