基础医学与临床 ›› 2023, Vol. 43 ›› Issue (3): 468-475.doi: 10.16352/j.issn.1001-6325.2023.03.468

• 临床研究 • 上一篇    下一篇

云南省某医院老年医学科住院患者认知功能障碍的患病率及影响因素分析

戴靖榕1,2, 李婕1,2, 何旭1,2, 李杨2, 李燕1,2*   

  1. 1.昆明理工大学 医学院 云南 昆明 650500;
    2.云南省第一人民医院 老年医学科 国家老年疾病临床医学研究中心云南分中心,云南省老年疾病临床医学研究中心,董碧蓉专家工作站, 云南 昆明 650032
  • 收稿日期:2021-11-01 修回日期:2022-04-19 出版日期:2023-03-05 发布日期:2023-02-27
  • 通讯作者: * liyanken@126.com
  • 基金资助:
    国家重点研发计划(2018YFC2002103);国家自然科学基金(81760109);云南省老年疾病临床医学研究中心(202102AA310069);云南省董碧蓉专家工作站(202105AF150032);云南省临床医学开发项目(2019LCZXKF-NM08,2021LCZXXF-NM09);云南省医疗卫生单位内设研究机构科研项目(2017NS221,2017NS222,2018NS0241)

Prevalence and influencing factors of cognitive dysfunction among inpatients in Geriatrics Department of a hospital in Yunnan Province

DAI Jingrong1,2, LI Jie1,2, HE Xu1,2, LI Yang2, LI Yan1,2*   

  1. 1. School of Medicine, Kunming University of Science and Technology, Kunming 650500;
    2. Department of Geriatrics Medicine, the First People's Hospital of Yunnan Province, Yunnan Branch of National Clinical Research Center for Geriatric Diseases, Clinical Research Center for Geriatric Diseases of Yunnan Province, Dong Birong Expert Workstation, Kunming 650032, China
  • Received:2021-11-01 Revised:2022-04-19 Online:2023-03-05 Published:2023-02-27
  • Contact: * liyanken@126.com

摘要: 目的 调查云南省某医院老年医学科住院患者认知功能障碍的患病率,并分析老年人认知功能障碍的影响因素。方法 选取2018年9月至2021年8月云南省第一人民医院老年医学科住院患者(≥60岁)2 216例为研究对象,收集患者一般资料;采用云南省第一人民医院老年医学科自主研发的“老年综合评估系统”软件对患者进行老年综合评估,并利用其中的简易智能精神状态量表(MMSE)表型进行认知功能评估。结果 2 216例患者中,认知功能正常1 087例(49.1%),轻度认知障碍639例(28.8%),中度认知障碍285例(12.9%),重度认知障碍205例(9.3%)。多因素Logistic回归分析显示:年龄增大[OR=1.026,95% CI(1.015,1.037)(P<0.001]、视力下降[OR=1.290,95% CI(1.002,1.662),P<0.05]、空巢[OR=1.433,95% CI(1.009,2.034),P<0.05]、家庭支持障碍[OR=1.436,95% CI(1.120,1.842),P<0.05]、失眠[OR=1.380,95% CI(1.095,1.740),P<0.05]和患慢性阻塞性肺疾病[OR=1.234,95% CI(1.008,1.512),P<0.05]是老年人认知功能的危险因素,而以脑力活动为主[OR=0.678,95% CI(0.540,0.852),P<0.001]、小学[OR=0.613,95% CI(0.485,0.776),P<0.001]、中学[OR=0.670,95% CI(0.534,0.839),P<0.001]和大学以上文化程度[OR=0.555,95% CI(0.410,0.751,P<0.001]是老年人认知功能的保护因素。结论 在老年住院患者中,认知功能障碍的患病率高且与多种因素密切相关,及时干预相关影响因素对老年人认知障碍的早期预防具有重要意义。

关键词: 认知功能障碍, 老年综合征, 老年综合评估, 影响因素, 住院患者

Abstract: Objective To investigate the prevalence of cognitive dysfunction among inpatients in Geriatrics Depart- ment of a hospital in Yunnan Province, and to analyze the influencing factors of cognitive dysfunction of the elderly.Methods A total of 2 216 admitted patients(≥60 years old) in the Department of Geriatrics of a hospital in Yunnan Province from September 2018 to August 2021 were recruited as the subjects. General data of the patients were collected. Comprehensive geriatric assessment was conducted by an internet-based platform of the Comprehensive Geriatric Assessment developed by the Department of Geriatrics of Yunnan First People's Hospital, among which cognitive function was assessed by the Mini-Mental State Examination(MMSE)phenotype. Results Among 2 216 patients, 1 087(49.1%) had normal cognitive function, 639(28.8%) had mild cognitive impairment, 285 (12.9%) had moderate cognitive impairment and 205 (9.3%) had severe cognitive impairment. According to multivariate Logistic regression analysis, increased age [OR=1.026,95% CI(1.015, 1.037),P< 0.001], vision decline[OR=1.290,95% CI(1.002, 1.662),P< 0.05], empty nest[OR=1.433,95% CI(1.009, 2.034),P< 0.05], family support disorder[OR=1.436,95% CI(1.120, 1.842),P< 0.05], insomnia [OR=1.380,95% CI(1.095, 1.740),P< 0.05] and suffered chronic obstructive pulmonary disease [OR=1.234,95% CI(1.008, 1.512),P< 0.05) were the risk factors for cognitive function in the elderly, while the individuals mainly engaged in mental activities[OR=0.678,95% CI(0.540,P< 0.05).0.852, P< 0.001], education experience of primary school[OR=0.613,95% CI(0.485,0.776,P<0.001], secondary school[OR=0.670,95% CI(0.534, 0.839), P< 0.001) and university degree or above [OR=0.555,95% CI(0.410, 0.751),P< 0.001] were protective factors. Conclusions The prevalence of cognitive dysfunction in elderly hospitalized patients is high and closely related to a variety of factors. Specific intervention of related factors is of great significance for the early prevention of cognitive impairment in the elderly.

Key words: cognitive impairment, geriatric syndrome, Comprehensive Geriatric Assessment, influencing factor, inpatient

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