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目的:调查农村老年人认知现状,探讨主观认知下降(subjective cognitive decline,SCD)的特征和影响因素。方法:于2018年3~9月对5 765名60岁以上的农村老年人进行基线调查,采用主观认知下降问卷(subjective cognitive decline questionnaire,SCD-Q9),简易精神状态量表(mini-mental state examination,MMSE)、言语流畅性测试(verbal fluency test,VFT)、中文版听觉词语学习测验(Chinese auditory verbal learning test,CAVLT)、数字广度测验(digital span test,DST)、日常生活能力量表(activities of daily living,ADL),筛查出SCD患者2 654人(SCD组),认知功能正常者1 008人(NC组)。采用社会支持评定量表(social support rating scale,SSRS)、简版老年抑郁量表(geriatric depression scale-15,GDS-15)评定其社会心理状况。采用SPSS 26.0软件进行描述性统计和Logistic回归分析。结果:(1)与NC组比较,SCD组延迟再认[(8.25±2.51)分,(12.38±2.53)分],逆向数字广度[(2.63±1.37)分,(3.69±1.45)分],社会支持得分[(69.81±8.71)分,(64.40±9.44)分],GDS-15得分[(2.27±2.63)分,(1.31±2.17)分]差异有统计学意义(均n P0.05)。(2)与NC组比较,SCD组饮食结构、血糖、血脂等生化指标,脑血管、糖尿病、癫痫、冠心病病史差异无统计学意义(n P>0.05)。(3)SCD主要受年龄(n β=0.06,n OR=2.29,95%n CI =1.09~4.85)、抑郁情绪(n β=-0.01,n OR=2.96,95%n CI =0.68~4.94)、高血压( n β=-0.17,n OR=1.89,95%n CI=1.11~2.15)、低水平社会支持(n β=2.07,n OR=1.49,95%n CI=1.32~2.12)的影响(均n P0.05). (3)SCD was mainly affected by age(n β=0.06, n OR=2.29, 95%n CI=1.09-4.85), depression(n β=-0.01, n OR=2.96, 95%n CI=0.68-4.94), hypertension(n β=-0.17, n OR=1.89, 95%n CI=1.11-2.15), and low level of social support(n β=2.07, n OR=1.49, 95%n CI=1.32-2.12) (all n P<0.05).n Conclusion:The scores of delayed recognition and reverse digit span in patients with SCD are lower than those with normal cognitive function.The other objective cognitive functions are basically normal.Old age, low social support level, depression, low education level and hypertension are the risk factors of SCD.