上海市松江区老年人轻度认知障碍患病现状及影响因素
Prevalence and influencing factors of mild cognitive impairment in the elderly in Songjiang District, Shanghai
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摘要:
背景 随着我国人口老龄化程度不断加深，老年认知障碍越来越得到公众关注。筛查并干预轻度认知障碍（MCI）人群，对预防减少认知障碍发生意义重大。
目的 了解上海市松江区老年人MCI患病现状，探讨老年人MCI患病的影响因素，为推动松江区老年人认知障碍早期筛查和开展老年人MCI精准干预工作提供科学依据。
方法 本研究采用横断面研究设计。于2022年8—10月，采用多阶段随机抽样方法，对松江区6个街镇6个居委/村委1800位60岁及以上老年人开展认知障碍筛查。调查内容包括一般情况调查表、健康状况与健康行为调查表、《工具性日常生活活动能力（IADL）量表》《患者健康问卷（PHQ-9）》和《简易精神状态检查（MMSE）量表》。分析不同社会人口学特征、健康状况和行为的老年人MCI患病情况，使用多因素二分类logistic回归分析探讨MCI患病的影响因素。
结果 共筛查出MCI老年人209人，健康老年人1591人，松江区60岁及以上老年人MCI患病率为11.6%。身体活动活跃（OR=0.556，95%CI：0.399~0.774）降低MCI患病风险（
P <0.05），文化程度为文盲（OR=1.810，95%CI：1.239~2.644）、文化程度为小学（OR=3.454，95%CI：2.342~5.092）、不参与社会活动（OR=1.945，95%CI：1.360~2.781）、IADL受损（OR=3.173，95%CI：2.137~4.712）、抑郁（OR=1.957，95%CI：1.112~3.443）增加MCI患病风险（P <0.05）。结论 松江区老年人MCI患病情况低于全国平均水平，文化程度、身体活动、社会活动参与、IADL、抑郁可能是老年人MCI患病的影响因素。建议对老年人开展认知障碍早筛查、早发现、早干预；鼓励老年人加强运动锻炼，增加社会活动参与；关注老年人心理健康，加强老年人心理健康问题的筛查与干预工作；开展MCI社区干预活动时，应考虑低文化程度和失能老人等弱势群体的特殊需求。
Abstract:Background With the aging of China's population, cognitive impairment in the elderly is receiving increasing public attention. Screening and intervention of people with mild cognitive impairment (MCI) are of great significance to prevent and reduce the occurrence of cognitive impairment.
Objective To understand the prevalence and explore potential influencing factors of MCI in the elderly in Songjiang District, Shanghai, and to provide scientific basis for promoting early screening of cognitive impairment and precise intervention of MCI in the elderly in this area.
Methods A cross-sectional study design was adopted. From August to October 2022, using multi-stage random sampling, 1800 elderly residents aged 60 years and above were screened for cognitive impairment in 6 neighborhood/village committees in 6 towns in Songjiang District. The survey questionnaires included a sociodemographic questionnaire, a health status and lifestyle questionnaire, the Instrumental Activities of Daily Living (IADL), the Patient Health Questionnaire (PHQ-9), and the Mini-Mental State Examination (MMSE). Prevalence rates of MCI among the elderly by selected social demographic characteristics, health status, and lifestyle were estimated, and potential influencing factors of MCI were evaluated by binary logistic regression.
Results A total of 209 elderly residents with MCI and 1591 healthy elderly residents were detected, and the prevalence of MCI in the elderly aged 60 and above was 11.6% in Songjiang District. Being physically active (OR=0.556, 95%CI: 0.399, 0.774) reduced the risk of MCI. Illiteracy (OR=1.810, 95%CI: 1.239, 2.644), primary school education level (OR=3.454, 95%CI: 2.342, 5.092), non-participation in social activities (OR=1.945, 95%CI: 1.360, 2.781), IADL damaged (OR=3.173, 95%CI: 2.137, 4.712), and depression (OR=1.957, 95%CI: 1.112, 3.443) increased the risk of MCI (
P ＜0.05).Conclusion The prevalence of MCI among the elderly in Songjiang District is lower than the national average. Educational level, physical activity, participation in social activities, IADL, and depression may be the influencing factors of MCI in the elderly. It is recommended to carry out early screening, early detection, and early intervention for cognitive impairment in the elderly. Improving involvement in physical exercise and increasing participation in social activities are encouraged. Special attention should be paid to the needs of vulnerable groups such as low education level and disabled elderly during a community MCI intervention program.
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