重庆市社会福利院老年人群阿尔兹海默症发病及与维生素A营养关系的调查研究

发布时间：2018-02-25 06:23

本文关键词： 维生素A 阿尔兹海默症流行病学　出处：《重庆医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的通过调查重庆市社会福利院老年人群认知功能现状、AD发病情况以及维生素A营养状况,分析两者之间的关系,从而探讨VA营养状况与AD发病可能存在的联系以及影响。对象与方法采用整群随机抽样的方法,在重庆市十二家公立及私立社会福利院抽取合格志愿受试者,并进行现场问卷调查及认知功能测试、体格检查和血清VA水平检测。认知功能测试采用HIS、HRSD、MMSE、 ADLIADL、ADAS、CDR量表,血清VA水平检测采用高效液相色谱法(HPLC)。共收集到有效样本322例。并按照AD和VA的评价标准,将有效样本分为认知功能正常、AD轻度痴呆、AD中度痴呆组和VAN、MVAD、VAD组,分析不同认知功能层面下血清VA水平的情况以及不同VA营养状况中认知功能损害及其程度的差异。结果 1.社会福利院老年人群女性年龄(79.59±7.52)比男性(75.08±8.82)偏大约5岁(P0.01),认知功能损害人群所占比例较大(55.9%)；认知功能量表评分高年龄层(85～95岁)均低于低年龄层(65～75岁或57～85岁),其中ADL、IADL、ADAS和CDR统计学差异明显(P0.05)。 2.社会福利院老年人群VAD(10.9%)和MVAD (30.1%)检出率高,VAN的构成比在认知功能正常组明显高于认知功能损害组,MVAD和VAD的检出率随认知功能损害加重而明显上升(P0.05)；且轻度痴呆组(1.07±0.38μmol/L)和中度痴呆组(1.01±0.34μmol/L)的血清VA水平均显著低于认知正常组(1.33±0.37μmol/L)(P0.05)。 MMSE、IADL、ADL、ADAS、CDR五个认知功能量表的评分所反应的认知功能情况在VA正常组均要明显好于VA缺乏组(包括MVAD和VAD),且有统计学差异(P0.05)。血清VA水平和文化程度与MMSE、IADL评分存在正相关(P0.01),与ADL、ADAS、CDR评分存在负相关(P0.05)；年龄与ADL、ADAS和CDR呈正相关(P0.05)。结论重庆市社会福利院老年人群中AD认知功能损害以及VA缺乏的情况普遍存在,认知损害与文化程度和年龄存在相关性,年龄越大,文化程度越低,损害越容易发生。而老年人群VA营养与认知功能状况之间也存在一定的相关性,低血清VA水平可能导致认知功能的损害,以及认知功能损害程度的加重,从而增加AD发病的风险。
[Abstract]:Purpose. By investigating the prevalence of AD and vitamin A nutrition in the elderly population in Chongqing Social Welfare Institute, the relationship between VA nutritional status and AD was analyzed, and the possible relationship between VA nutritional status and AD was discussed. Objects and methods. By cluster random sampling, qualified volunteers were selected from 12 public and private social welfare institutions in Chongqing, and the questionnaire survey and cognitive function test were carried out. Physical examination and serum VA level. Cognitive function test was performed with HIS-HRSDMMSE, ADLIADLLUADAS-CDR scale, and serum VA level was measured by HPLC. 322 effective samples were collected and assessed according to AD and VA evaluation criteria. The effective samples were divided into two groups: mild dementia with normal cognitive function and moderate dementia with mild AD and VANG MVADVAD. The levels of serum VA in different cognitive function levels and the differences of cognitive impairment and their degrees in different VA nutritional status were analyzed. Results. 1. The age of elderly women (79.59 卤7.52) was higher than that of men (75.08 卤8.82), and the proportion of people with cognitive impairment was 55.9%, and the score of cognitive function scale was 85 ~ 95 years old, which was lower than 6575 or 5785 years of age in the lower age group (P < 0.05). ADAS and CDR were significantly different in ADAS and CDR (P 0.05). 2. The detection rate of VAD-10.9 and MVAD 30.1in the elderly in social welfare institutions was significantly higher in the normal cognitive group than in the cognitive impairment group, and the detection rate of MVAD and VAD in the mild dementia group was significantly higher than that in the mild dementia group. The serum VA levels of 1.07 卤0.38 渭 mol / L) and 1.01 卤0.34 渭 mol / L of moderate dementia group were significantly lower than those of normal cognitive control group (1.33 卤0.37 渭 mol / L, P 0.05). There was a positive correlation between serum VA level and MMSE IADL score (P 0.01), a negative correlation between serum VA level and CDR score (P 0.05), and a positive correlation between age and ADL ADAS and CDR (P 0.05). Conclusion. The AD cognitive impairment and VA deficiency were common in the elderly population of Chongqing Social Welfare Institute. The cognitive impairment was correlated with the education level and age. The older the age, the lower the education level. However, there is a certain correlation between VA nutrition and cognitive function in the elderly. Low serum VA level may lead to cognitive impairment and increase the degree of cognitive impairment. Thus increasing the risk of AD.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.16

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