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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
住院共病老人认知衰弱现状及影响因素
Analysis of Cognitive frailty and associated factors in hospitalized geriatrics with comorbidity
投稿时间:2019-05-22  修订日期:2019-06-27
DOI:
中文关键词:  老年人;住院病人;共病;认知衰弱
英文关键词:aged; inpatients; comorbidity; cognitive frailty
基金项目:四川省卫生与计划生育委员会科研课题(150021)
作者单位E-mail
王凌霄 成都市第五人民医院老年科 lingxiao_w@126.com 
杨永学 成都市第五人民医院老年科 yyxwj@126.com 
管丽娟 成都市第五人民医院老年科 397629330@qq.com 
沈静 成都市第五人民医院老年科 drshenjing@163.com 
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中文摘要:
      目的 明确住院共病老人认知衰弱分布特点,进一步探讨其影响因素。 方法 回顾性分析2015年11月至2018年1月在我科住院年龄≥60岁的692例共病患者。根据老年综合评估构建衰弱指数评估衰弱状态;简易精神状态检查量表(MMSE)评估老年人认知情况;同时存在衰弱和认知障碍者定义为认知衰弱。采用趋势性x2 检验分析认知衰弱与年龄、共病及日常生活能力的关系;分析认知衰弱状态患者的临床特征;多因素logistic 回归分析认知衰弱的影响因素。 结果 25.4%(176例)共病患者存在认知衰弱。认知衰弱的患病率随着年龄(60-69岁为12.7%,70-79岁为19.1%,≥80岁为39.7%;P for trend<0.000)、CCI评分(低CCI组为11.1%,中CCI组23.2%,高CCI组31.5%;P for trend<0.000)的增高和Barthel日常生活能力(无障碍组为5.7%、轻度障碍35.3%、中度障碍42.4%、重度障碍 94.7%;P for trend=0.613)的下降而呈趋势性增加。认知衰弱患者合并慢性疾病(慢性心功能不全、冠心病、COPD、消化系统疾病、骨质疏松、脑血管疾病等)和老年综合征(营养不良、平衡功能障碍、抑郁、尿失禁、高跌倒风险等)的比例均偏高(P<0.05)。经校正混杂因素后,营养不良(OR=4.785, 95%CI: 2.424-9.446)、营养不良高风险(OR=2.210, 95%CI: 1.177-4.150)、平衡功能障碍(OR=5.300, 95%CI: 3.257-8.624)、骨质疏松(OR=1.751, 95%CI: 1.025-2.992)是认知衰弱的独立影响因素。 结论 住院共病老人中普遍存在认知衰弱,且认知衰弱的患病率与年龄、共病严重程度和日常生活能力下降呈线性趋势增加;营养不良/营养不良高风险、平衡功能障碍和骨质疏松与认知衰弱状态密切相关。
英文摘要:
      Objective To investigate the status of cognitive frailty among the multimorbid elderly and explore the associated factors. Methods General information,multimorbidity,cognitive impairment (MMSE), and frailty index of 692 elderly inpatients were collected in a retrospective study. The relationship between cognitive frailty and age、multimirbidity was explored by Pearson x2 test fore trend. Logistic regression analysis was used to explore the associated factors of cognitive frailty. Results Cognitive frailty were found in 25.4%(176 cases) of patients with comorbidity. The rates of cognitive frailty were increased by age (60-69y was 12.7%, 70-79y 19.1%, ≥80y 39.7%; P for trend<0.000),CCI index (low CCI 11.1%, medium CCI 23.2%, high CCI 23.2%; P for trend<0.000) and Barthel ADLs disability (normal 5.7%, mild 35.3%, moderate 42.4%, sever 94.7%;P for trend=0.613). Compared to the non-cognitive frail groups, the rate of chronic diseases (chronic cardiac dysfunction, coronary heart disease, COPD, digestive system disease, osteoporosis, cerebrovascular disease, etc) and Geriatric syndromes (malnutrition, balance dysfunction, depression, urinary incontinence, high risk of falls, etc) were statistically higher in frail patients (P<0.05). After adjusted confounding factors, malnutrition (OR=4.785, 95%CI: 2.424-9.446) ,high risks of malnutrition (OR=2.210, 95%CI: 1.177-4.150), balance dysfunction (OR=5.300, 95%CI: 3.257-8.624),and osteoporosis (OR=1.751, 95%CI: 1.025-2.992)were the associated factors for cognitive frailty. Conclusion The rates of cognitive frailty was increased with increasing age,severity of multimorbidity and decline of ADLs. And malnutrition/high risks of malnutrition, balance dysfunction and osteoporosis were significantly associated with cognitive frailty in hospitalized elderly patients.
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