重庆市社会福利院老年人群认知功能及影响因素调查

发布时间：2018-03-02 00:32

本文关键词： 老年人群 AD 检出率影响因素　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 1.了解重庆市社会福利院老年人群认知功能状况及生活质量； 2.研究AD与各种相关影响因素的关系,为进一步制定有效的防治策略提供科学依据。方法 1.调查对象采用随机整群抽样方法,从重庆市主城区抽取12家社会福利院共711名签署知情同意书的老年人作为本次调查对象。 2.认知功能筛查用简易智力状态检查量表(MMSE)评定认知功能缺损情况,汉密尔顿抑郁量表(HRSD)评定抑郁状态,Hachinski缺血评分量表区分痴呆类型,日常生活能力量表(ADL)评定日常生活能力,临床痴呆程度评定量表(CDR)评定痴呆程度,采用美国精神障碍诊断统计手册第4版的标准(DSM-IV),美国神经病学、语言障碍和脑卒中、阿尔兹海默症(Alzheimer disease, AD)和相关疾病学会(NINCDS—ADRDA)标准诊断AD。 3.生活质量调查对受试对象的性别、婚姻、文化程度、经济状况等一般特征及慢性病的患病情况和营养素补充情况进行调查。 4.统计方法用统计软件SPSS17.0建立数据库,对资料进行统计描述,计数资料用率或构成比表示,用卡方检验做比较；AD的影响因素用单因素和多因素非条件Logistic回归分析。结果 1.60岁以上的受试者中,慢性病总检出率为76.8%,检出率较高,检出率居于第一至第五位的疾病分别是：高血压(43.5%)、冠心病(20.8%)、脑血管疾病(17.0%)、糖尿病(16.3%)、慢阻肺(6.9%) 2.60岁以上受试者老年痴呆患者共274人,检出率为64.8%,其中AD患者在受试者中构成比最高,为56.5%；AD患者在受试老年痴呆患者中所占比例最大,为87.3%,血管性痴呆(VD)检出率次之(5.9%),混合型痴呆(MY)检出率最低(2.4%)。其中,AD患者又以轻度AD最多,轻度AD、中度AD、重度AD所占比例分别为：82.0%、15.1%、2.9%； 3.不同性别比较,女性AD检出率(56.1%)与男性AD检出率(57.8)无显著差异(P0.05)；AD检出率随年龄增长而增高,90～岁组检出率最高,为64.7%。 4.单因素非条件Logistic回归分析有6个因素与AD检出率呈显著相关性(P0.05)：年龄、婚姻状况、学历、经济状况、护理入学历、是否长期补充微量营养素；多因素非条件Logistic回归显示高龄、低学历、低收入、护理人学历低为AD患病的危险因素,长期补充微量营养素为AD患病的保护因素。结论 1.影响重庆市社会福利院老年人群健康的疾病主要为高血压、冠心病、脑血管疾病、糖尿病、慢阻肺,AD检出率也较高,慢性病检出率与AD检出率均有随年龄增长而增高的趋势,整体健康水平不容乐观； 2.高龄、低学历、低收入、护理人学历低为AD患病的危险因素,应该从以上方面采取干预措施延缓AD的进程；长期补充微量营养素可能为AD患病的保护因素,在AD的预防措施中应该引起重视。
[Abstract]:Purpose. 1. To understand the cognitive function and quality of life of the elderly in Chongqing Social Welfare Institute; 2. To study the relationship between AD and various influencing factors, to provide scientific basis for the further formulation of effective prevention and treatment strategies. Method. 1. Respondents. A total of 711 elderly people who signed informed consent form 12 social welfare institutions in the main urban area of Chongqing were selected by random cluster sampling. 2. Cognitive screening. Cognitive impairment was assessed with MMSE, Hachinski Ischemia scale with Hamilton Depression scale (HRSD) and ADL with ability of Daily living (ADL). Clinical dementia rating scale (CDR) was used to assess the degree of dementia. The standard of DSM-IVD, American Neurology, speech Disorder and Stroke, Alzheimer's Disease (ADD) and NINCDS-ADRDAwere used in the diagnosis of dementia by the fourth edition of the American Statistical Manual for the diagnosis of Mental Disorders (AD4), American Neurology, language Disorder and Stroke, Alzheimer's Disease (ADD) and the NINCDS-ADRDAs. 3. Quality of life surveys. The general characteristics, such as sex, marriage, education, economic status, the prevalence of chronic diseases and nutrient supplementation were investigated. 4. Statistical methods. The database was set up by SPSS17.0, the data was described, the rate or composition ratio of the data was counted, and the influencing factors of AD were compared by chi-square test. Univariate and multivariate Logistic regression analysis was used to analyze the influencing factors of AD. Results. 1. Among the subjects over 60 years old, the total detection rate of chronic diseases was 76.80.The detection rate of chronic diseases was higher. The first to 5th diseases were: hypertension 43.5%, coronary heart disease 20.8%, cerebrovascular diseases 17.0%, diabetes 16.3g, slow obstructive lung 6.9cm). 2.There were 274 senile dementia patients over 60 years old, and the detection rate was 64.8. The proportion of AD patients was the highest among the subjects, and the proportion of AD patients was the largest among the subjects with Alzheimer's disease. The detectable rate of vascular dementia was 5.9m, and that of mixed dementia was 2.40.The proportion of mild AD, mild AD, moderate AD and severe AD were respectively 82.00.15.1% and 2.9cm, respectively. 3. There was no significant difference in the detection rate of AD between female (56.1%) and male (57.8). There was no significant difference between female and male (P 0.05). The detection rate of AD in the group of 90 years old was the highest (64.7%) with the increase of age. 4. Univariate conditional Logistic regression analysis showed significant correlation with AD detection rate (P 0.05): age, marital status, educational background, financial status, nursing education, long-term supplementation of micronutrients, multivariate non-conditional Logistic regression showed advanced age. Low education, low income and low degree of nursing were risk factors for AD, and long term micronutrient supplementation was the protective factor of AD. Conclusion. 1. Hypertension, coronary heart disease, cerebrovascular disease, diabetes mellitus and chronic obstructive pulmonary disease (COPD) were the main diseases affecting the health of the elderly population in Chongqing Social Welfare Institute. The detection rate of chronic diseases and AD increased with the increase of age. The overall health level is not optimistic; 2. Advanced age, low education, low income and low nursing education are the risk factors of AD disease. Intervention measures should be taken to delay the progression of AD. Long-term micronutrient supplementation may be the protective factor of AD. Attention should be paid to the prevention 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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