摘要
目的 了解青岛市老年居民认知功能现状及其影响因素.方法 采用简单随机抽样和分层抽样的方法从青岛市选取65岁以上居民5 311人.研究对象均采用AD8痴呆早期筛查问卷、简版社区痴呆筛查表(community screening instrument dementia,CSI-D)评估认知功能.AD8痴呆早期筛查问卷得分≥2分或CSI-D得分≤7分认定为认知功能减退.使用SPSS 26.0统计软件进行Mann-Whitney U检验、x2检验、Fisher确切概率法、单因素和多因素Logistic回归分析和Bootstrap验证.结果 所有5 311例研究对象中认知功能正常1 899人(35.76％),认知功能减退3 412人(64.24％).认知功能减退组的年龄显著高于正常组(P＜0.01).两组在性别、文化程度、农村居民、婚姻状况、慢性病史、高血压、类风湿关节炎、脑血管疾病、椎间盘疾病、缺血性心脏病、家庭月收入和饮酒情况等方面均差异有统计学意义(均P＜0.05).单因素Logistic回归分析结果显示,女性(β=0.313,OR=1.367,95％CI=1.221～1.530)、年龄(β=0.052,OR=1.053,95％CI=1.043～1.063)、农村居民(β=0.850,OR=2.340,95％CI=2.042～2.682)、丧偶(β=0.557,OR=1.745,95％CI=1.500～2.029)、有慢性病史(β=0.290,OR=1.336,95％CI=1.191～1.498)、高血压(β=0.134,OR=1.143,95％CI=1.020～1.281)、类风湿性关节炎(β=0.458,OR=1.581,95％CI=1.222～2.046)、脑血管疾病(β=0.584,OR=1.794,95％CI=1.352～2.380)、椎间盘疾病(β=0.578,OR=1.782,95％CI=1.370～2.319)、缺血性心脏病(β=0.501,OR=1.651,95％C/=1.272～2.143)是认知功能减退的危险因素;较高的文化程度、较高的家庭月收入以及戒酒(β=-0.244,OR=0.783,95％CI=0.619～0.992)是认知功能减退的保护因素.多因素Logistic回归分析结果显示,年龄(β=0.035,OR=1.036,95％CI=1.025～1.047)、农村居民(β=0.215,OR=1.239,95％CI=1.047～1.468)、慢性病史(β=0.191,OR=1.210,95％CI=1.067～1.372)、脑血管疾病(β=0.480,OR=1.616,95％CI=1.195～2.187)、椎间盘疾病者(β=0.456,OR=1.578,95％CI=1.190～2.094)是认知功能减退的危险因素;较高的文化程度和较高的家庭月收入是认知功能减退的保护因素.结论 认知功能减退的高危人群可能为患慢性疾病以及低收入、低文化程度老人,在早期筛查与干预中需要重点关注该类人群.
Abstract
Objective To investigate the cognitive function and its influencing factors among resi-dents in Qingdao city.Methods The 5 311 research subjects over 65 years old were selected from Qingdao by simple random sampling and stratified sampling.All subjects were investigated by AD8 dementia early screening questionnaire and community screening instrument dementia(CSI-D)to evaluate the prevalence of cognitive decline in this study.The score of AD8 dementia early screening questionnaire ≥ 2 points or the score of CSI-D ≤ 7 points was considered to be cognitive decline.Mann-Whitney U test,Chi-square test,Fisher exact probability method,univariate and multivariate Logistic regression analysis and Bootstrap verifi-cation were performed using SPSS 26.0 software.Results Among 5 311 subjects,1 899 subjects had nor-mal cognitive function(35.76％)and 3 412 subjects had cognitive decline(64.24％).The age of the cog-nitive decline group was significantly higher than that of the normal group(P＜0.01).There were significant differences in gender,educational level,rural residents,marital status,chronic medical history,hypertension,rheumatoid arthritis,cerebrovascular disease,intervertebral disc disease,ischemic heart disease,monthly household income and alcohol consumption between the two groups(all P＜0.05).Univariate Logistic re-gression analysis showed that female(β=0.313,OR=1.367,95％CI=1.221-1.530),age(β=0.052,OR=1.053,95％CI=1.043-1.063),rural residents(β=0.850,OR=2.340,95％CI=2.042-2.682),widowed(β=0.557,OR=1.745,95％CI=1.500-2.029),chronic medical history(β=0.290,OR=1.336,95％CI=1.191-1.498),hypertension(β=0.134,OR=1.143,95％CI=1.020-1.281),rheumatoid arthritis(β=0.458,OR=1.581,95％CI=1.222-2.046),cerebrovascular disease(β=0.584,OR=1.794,95％CI=1.352-2.380),intervertebral disc disease(β=0.578,OR=1.782,95％CI=1.370-2.319),ischemic heart disease(β=0.501,OR=1.651,95％CI=1.272-2.143)were the risk factors for cognitive decline.Higher education level,higher monthly household income and abstinence(β=-0.244,OR=0.783,95％CI=0.619-0.992)were protective factors for cognitive decline.Multivariate logistic regression analysis showed that age(β=0.035,OR=1.036,95％CI=1.025-1.047),rural residents(β=0.215,OR=1.239,95％CI=1.047-1.468),chronic medical history(β=0.191,OR=1.210,95％CI=1.067-1.372),cerebrovascular disease(β=0.480,OR=1.616,95％CI=1.195-2.187),intervertebral disc disease(β=0.456,OR=1.578,95％CI=1.190-2.094)were risk factors for Alzheimer's disease.Higher education level and higher monthly house-hold income were protective factors for Alzheimer's disease.Conclusion The elderly with chronic diseases,low income and low education level may be at the high risk of cognitive function decline,which should be paid attention to in early screening and intervention.
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