基础医学与临床 ›› 2022, Vol. 42 ›› Issue (2): 201-207.doi: 10.16352/j.issn.1001-6325.2022.02.001

• 研究论文 •    下一篇

认知衰弱增加老年人群5年后的跌倒风险

袁景林1, 马雅军2, 李晓东2, 蒋晓燕3, 王笑峰4, 李淑娟2, 周晓梅1*   

  1. 1.北京市大兴区人民医院 神经内科, 北京 102600;
    2.首都医科大学附属北京朝阳医院 神经内科, 北京 100020;
    3.同济大学医学院 病理学与病理生理学系 心律失常教育部重点实验室, 上海 200092;
    4.复旦大学 人类表型组研究院 现代人类学教育部重点实验室, 上海 200433
  • 收稿日期:2021-02-20 修回日期:2021-06-13 出版日期:2022-02-05 发布日期:2022-01-24
  • 通讯作者: * shujuanli@ccmu.edu.cn
  • 基金资助:
    国家重点研发计划(2018YFC2002000,2018YFC2000400);国家自然科学基金(81571372)

Cognitive frailty increases the risk of falls of elderly in five years

YUAN Jing-lin1, MA Ya-jun2, LI Xiao-dong2, JIANG Xiao-yan3, WANG Xiao-feng4, LI Shu-juan2, ZHOU Xiao-mei1*   

  1. 1. Department of Neurology, Beijing Daxing District People's Hospital, Beijing 102600;
    2. Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020;
    3. Key Laboratory of Arrhythmias, Ministry of Education, Department of Pathology and Pathophysiology, School of Medicine, Tongji University, Shanghai 200092;
    4. Ministry of Education Key Laboratory of Contemporary Anthropology, Human Phenome Institute, Fudan University, Shanghai 200433, China
  • Received:2021-02-20 Revised:2021-06-13 Online:2022-02-05 Published:2022-01-24
  • Contact: * shujuanli@ccmu.edu.cn

摘要: 目的 探索认知衰弱是否能增加中国老年人群5年后跌倒风险。方法 研究数据来源于如皋衰老队列。采用Fried衰弱表型评估衰弱,5项中符合≥3项者定义为衰弱,1~2项者为衰弱前期,均不符合者为强健。采用改良版长谷川痴呆量表(HDS-R)评估认知功能,排除严重认知功能障碍(HDS-R≤10分)后得分最低的四分位数为认知障碍。同时存在认知障碍和衰弱者定义为认知衰弱。应用二元Logistic回归分析衰弱及认知衰弱随访5年后的跌倒风险。结果 本研究纳入962例研究对象,基线时平均年龄为(74.7±3.7)岁,女性526人。经过5年随访,134人发生跌倒事件,女性、文盲、非在婚状态跌倒的发生率更高。Logistic回归分析结果显示,基线衰弱者更易发生跌倒(OR=4.360,95% CI=1.955~9.722),认知衰弱者相对强健且非认知障碍者跌倒风险更高(OR=6.000, 95% CI=1.935~18.603)。调整协变量后,认知衰弱较高者5年跌倒风险仍具有统计学意义(OR=6.736,95% CI=1.897~23.922, P<0.01)。结论 认知衰弱较衰弱具有更高的5年后跌倒风险,对于评估老年人跌倒风险具有重要意义。

关键词: 衰弱, 认知衰弱, 跌倒风险, 纵向研究

Abstract: Objective To explore whether cognitive frailty increases the risk of falls 5 years later in elderly Chinese population. Methods The data were collected from the Rugao Aging Cohort. Fried frailty phenotype was used to evaluate frailty. Those who met ≥3 of the five criteria were defined as frailty, those who met 1-2 criteria were defined as pre-frailty, and those who did not meet any criteria were considered to be robust. The revised Hasegawa Dementia Scale(HDS-R) was used to evaluate cognitive function. Excluding severe cognitive impairment (HDS-R≤10), the lowest quartile of scores was cognitive impairment. Those with both frailty and cognitive impairment were defined as cognitive frailty. Binary logistic regression was used to analyze frailty and falls risk at 5-year follow-up, and explore the effect of cognitive frailty (frailty plus cognitive function assessment) on falls risk. Results This study included 962 subjects with a mean age of 74.7±3.7 years at baseline, including 526 females. After 5 years of follow-up, 134 people experienced falls in the last year of following up . The incidence of falls was higher in female, illiterate and unmarried subgroups. Logistic regression analysis showed that the frail subjects at baseline were more likely to fall(OR=4.360,95% CI=1.955-9.722), and those with cognitive frailty had a higher risk of fall than those robust without cognitive impairment (OR=6.000,95% CI=1.935-18.603). After adjusting for covariates, the higher five-year falls risk for cognitive frailty remained statistically significant (OR=6.736,95% CI=1.897-23.922, P<0.05). Conclusions Cognitive frailty is significantly correlated with a higher risk of falls after 5 years. The assessment of cognitive frailty is important for assessing the risk of falls in older adults.

Key words: frailty, cognitive frailty, falls risk factors, longitudinal study

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