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| 上海市浦东新区周康航地区老年人轻度认知功能障碍患病情况及危险因素分析 |
| 刘源1,赵桂年2,黄晶2,范佳红2,唐燕平2,李云霞3,赵玫1,2* |
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(1. 上海健康医学院附属周浦医院神经内科, 上海 201318;
2. 上海市浦东新区光明中医医院脑病科, 上海 201399;
3. 同济大学附属同济医院神经内科, 上海 200065
*通信作者) |
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| 摘要: |
| 目的 分析上海市浦东新区周康航地区老年人轻度认知功能障碍（MCI）的患病率及相关危险因素。方法 对2019年8月至2022年9月上海市浦东新区周康航地区1 537名老年人（年龄≥60岁）进行调查和评估，收集一般资料、心血管危险因素（血压、血糖、血脂等）、痴呆家族史、脑血管病史、海马MRI影像学资料，采用简易精神状态量表（MMSE）、蒙特利尔认知量表（MoCA）进行测试。根据MCI临床诊断标准将调查对象分为MCI组和非MCI组，比较两组调查对象临床资料的差异，采用多因素logistic回归分析筛选MCI发生的独立危险因素。对MCI患者进行随访观察。结果 1 537名调查对象中，MCI患者226例（14.70%），非MCI者1 311例（85.30%）。226例MCI患者中，单认知域遗忘型138例，多认知域遗忘型33例，单认知域非遗忘型11例，多认知域非遗忘型7例。MCI组中男性、糖尿病、高脂血症、痴呆家族史、脑血管病史患者占比高于非MCI组（均P＜0.05），海马萎缩程度高于非MCI组（P＜0.01）。多因素logistic回归分析显示，痴呆家族史、脑血管病史和海马萎缩程度是老年人发生MCI的独立危险因素（均P＜0.05）。214例MCI患者随访至2023年2月，其中20例（9.35%）诊断为阿尔茨海默病，4例（1.87%）诊断为路易体痴呆。结论 上海市浦东新区周康航地区老年人MCI患病率为14.70%，有痴呆家族史、有脑血管病史和海马萎缩是老年人发生MCI的独立危险因素。 |
| 关键词: 老年人 轻度认知功能障碍 患病率 危险因素 |
| DOI：10.16781/j.CN31-2187/R.20230092 |
| 投稿时间：2023-03-05修订日期：2023-08-24 |
| 基金项目:上海市浦东新区卫生健康委员会面上项目（PW2020A-21），上海市浦东新区科技发展基金资助项目（PKJ2023-Y24），上海健康医学院附属周浦医院教学课题（ZPJXKT-21-05）. |
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| Prevalence and risk factors of mild cognitive impairment among the elderly in Zhoukanghang region of Shanghai Pudong New Area |
| LIU Yuan1,ZHAO Guinian2,HUANG Jing2,FAN Jiahong2,TANG Yanping2,LI Yunxia3,ZHAO Mei1,2* |
(1. Department of Neurology, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai 201318, China;
2. Department of Encephalopathy, Guangming Hospital of Traditional Chinese Medicine of Shanghai Pudong New Area, Shanghai 201399, China;
3. Department of Neurology, Tongji Hospital, Tongji University, Shanghai 200065, China
* Corresponding author) |
| Abstract: |
| Objective To analyze the prevalence and related risk factors of mild cognitive impairment (MCI) in the elderly in Zhoukanghang region of Pudong New Area, Shanghai. Methods Clinical data of 1 537 elderly people (aged≥60 years old) in Zhoukanghang region of Pudong New Area, Shanghai from Aug. 2019 to Sep. 2022 were collected. Demographic data, cardiovascular risk factors (blood pressure, blood glucose, blood lipids, etc.), family history of dementia, cerebrovascular history, and hippocampal magnetic resonance imaging data were collected, and the MCI was tested by the simple mental state scale (MMSE) and Montreal cognitive assessment (MoCA). According to the clinical diagnostic criteria of MCI, the subjects were divided into MCI group and non-MCI group. The clinical data were compared between the 2 groups, and the independent risk factors of MCI were analyzed by multivariate logistic regression analysis. Results Among the 1 537 subjects, 226 cases (14.70%) were MCI patients and 1 311 cases (85.30%) were non-MCI individuals. Among the 226 patients with MCI, 138 had single domain amnestic MCI, 33 had multiple domain amnestic MCI, 11 had single domain non-amnestic MCI, and 7 had multiple domain non-amnestic MCI. The proportions of male, diabetes mellitus, hyperlipidemia, family history of dementia and cerebrovascular disease in the MCI group were significantly higher than those in the non-MCI group (all P＜0.05), and the hippocampal atrophy was significantly higher than that in the non-MCI group (P＜0.01). Multivariate logistic regression analysis showed that family history of dementia, cerebrovascular history and hippocampal atrophy were independent risk factors for MCI in the elderly (all P＜0.05). Totally 214 patients with MCI were followed up to Feb. 2023, of which 20 cases (9.35%) were diagnosed as Alzheimer’s disease and 4 cases (1.87%) as Lewy bodies dementia. Conclusion The prevalence of MCI in the elderly in Zhoukanghang region of Pudong New Area, Shanghai is 14.70%. Family history of dementia, cerebrovascular disease and hippocampal atrophy are independent factors for MCI in the elderly. |
| Key words: the elderly mild cognitive impairment prevalence risk factors |
