泰安市农村老年人轻度认知障碍患病现况及影响因素的研究

发布时间：2018-06-09 00:41

本文选题：老年人 + 轻度认知功能障碍　；参考：《泰山医学院》2013年硕士论文

【摘要】：目的本研究旨在探讨泰安市农村老年人轻度认知功能障碍(MCI)患病现况,调查其患病率、检出率及其影响因素,为临床观察和治疗提供参考数据。同时分析蒙特利尔认知功能检查量表(MoCA)在本市农村老年人中进行MCI筛查的效果,评定其信度、效度、对MCI的敏感性和特异性,探讨最佳分界值,用以协助提早发现老年人MCI患者并进行早期干预。方法采用随机分层整群抽样的方法,运用MMSE和MoCA对泰安市农村老年人进行MCI筛查,计算调查人群MCI患病率、检出率；采用老年人身心健康一般状况调查表、老年抑郁量表(GDS)、焦虑自评量表(SAS)社会支持评定量表(SSRS)、5个条目的生活满意度量表进行调查,分析MCI的影响因素。其次,对MoCA进行探讨,计算其信度、效度、敏感性、特异性和Youden旨数,评价MoCA对泰安市农村老年人MCI筛查的应用价值,并计算适合我市农村老年人MCI患者的划界分。结果 1、参与此次社区调查人数2150人,完整有效问卷1971人次,有效率91.67%。615人可能存在抑郁情绪,267人可能存在焦虑情绪,675人患高血压,222人患高血脂,365人患冠心病,108人患脑血栓,273人有失眠史,315人吸烟,648饮酒。 2、其中,651人临床初步诊断为MCI,总体检出率为33.03%,患病率为17.78%,135人临床诊断为痴呆,总体检出率为6.85%,患病率3.56%。 3、年龄、文化程度、职业、不同居住情况、自认为身体状况、记忆力、听力、体重(BMI异常)、血脂、脑血栓、饮酒、是否做家务、睡眠情况、抑郁情绪、社会支持状况等对MCI患病有显著影响。 4、年龄、婚姻(离婚)、自认为身体状况差、参加活动少、高血脂、抑郁为MCI的危险因素；常做家务为保护因素。 5、MoCA量表的Cronbach's a为0.777,具有较好的信度；其总分与MMSE比较,相关系数为0.737,校标效度良好；除连线、复制立方体、动物命名、数字计算外,其余各项相关系数均与MoCA总分显著相关,内容效度良好。 6、MoCA以原版推荐26分为界,对MCI筛查的敏感性和特异性分别为98.85%和14.72%,Youden指数为0.1358。结论 1、泰安市农村人口以农民为主,平均受教育年限低,高龄老人所占比重大,患基础疾病者较多,抑郁、焦虑患病率高,身心健康状况不容乐观。 2、泰安市农村老人MCI患病率较高,应加强宣传教育及筛查力度。 3、年龄、婚姻(离婚)、自认为身体状况差、参加活动少、高血脂、抑郁为MCI的危险因素；常做家务为保护因素。 4、MoCA量表对农村老年人认知功能的筛查简便可行,具有良好的信度和效度敏感高,但以26分为分界其诊断价值较低,推荐以15分作为我市农村老年人的MCl分界值。 5、MoCA量表部分题目与我市农村文化传统存在一定差异,在农村老年人认知功能筛查中应做适当修改。
[Abstract]:Objective to explore the prevalence of mild cognitive impairment (MCI) in the elderly in rural areas of Taian City and to investigate its prevalence, detection rate and its influencing factors, so as to provide reference data for clinical observation and treatment. At the same time, we analyzed the effect of MCI screening by Montreal Cognitive function Checklist (MoCA) in the rural elderly in this city, evaluated its reliability, validity, sensitivity and specificity to MCI, and discussed the best demarcation value. Methods the method of random stratified cluster sampling and MMSE and MoCA were used to screen the MCI of the rural elderly in Taian city, and the prevalence rate and the detection rate of MCI were calculated. The general physical and mental health of the elderly was investigated with the Social support scale (SSRS), the elderly Depression scale (GDSs) and the Self-Rating anxiety scale (SAS). The influential factors of MCI were analyzed by the life satisfaction scale of 5 items. Secondly, the reliability, validity, sensitivity, specificity and Youden number of MoCA were calculated. Results 1. 2150 people participated in the community survey and 1971 valid questionnaires were completed. The effective rate is 91.67. 615 people may have depression. 267 people may have anxiety. 675 people may have high blood pressure, 222 people have high blood lipid, 365 people have coronary heart disease, 108 cases have cerebral thrombosis, 273 people have insomnia, 315 people smoke and drink alcohol. 22Of them, 651 cases are clinically diagnosed. The total detection rate of MCI was 33.03 and the prevalence rate was 17.780.135 people were clinically diagnosed with dementia. The overall detection rate was 6.85. The prevalence rate was 3.56.3, age, education, occupation, different living conditions, self-perceived physical condition, memory, hearing, body weight and BMI abnormality, blood lipid, cerebral thrombosis, alcohol consumption, household chores, sleep, depression, etc. Social support status had a significant impact on MCI prevalence. 4. Age, marriage (divorce, self-perceived poor physical condition, less participation in activities, hyperlipidemia, depression) were the risk factors of MCI. 5The Cronbachsa of the MoCA scale was 0.777, which had good reliability, the correlation coefficient was 0.737 and the calibration validity was good compared with MMSE, except for wired, duplicated cubes, animal nomenclature and numerical calculation, the total score of Cronbachsa was better than that of MMSE, and the correlation coefficient was 0.737, and the validity of calibration was good, except for connection, replication cubes, animal nomenclature and numerical calculation. The other correlation coefficients were significantly correlated with the total score of MoCA, and the content validity of MoCA was good. 6MoCA was classified by original recommendation 26, the sensitivity and specificity of MCI screening were 98.85% and 14.72% respectively, Youden index was 0.1358.Conclusion 1.The rural population of Tai'an is mainly peasant. The average number of years of education is low, the proportion of the elderly is large, the number of people suffering from basic diseases is more, the prevalence rate of depression, anxiety is high, the state of physical and mental health is not optimistic. 2, the prevalence rate of MCI of the rural elderly in Tai'an City is higher. We should strengthen propaganda, education and screening. 3, age, marriage (divorce, self-perceived poor physical condition, less participation in activities, hyperlipidemia, depression are the risk factors of MCI; 4MoCA scale was simple and feasible for the screening of cognitive function of the elderly in rural areas, and had good reliability and sensitivity, but its diagnostic value was low according to the dividing line of 26. It is recommended that 15 points be taken as the MCL boundary value of the rural elderly in our city. 5. Some items of the MoCA scale are different from those of the rural cultural tradition in our city, which should be properly modified in the screening of the cognitive function of the rural elderly.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.16

【参考文献】

中国期刊全文数据库前10条

1 谈世东;庞洪波;李雪芹;陈观保;金炜;;轻度认知功能障碍患者抑郁状况的相关因素分析[J];中国实用神经疾病杂志;2012年06期

2 郑玲;徐格林;卢光明;刘新峰;樊小兵;张志强;;颈动脉狭窄对轻度认知功能损害患者转变为痴呆的影响[J];中国脑血管病杂志;2007年01期

3 朱文佳;高中宝;杨磊;王炜;陈彤;贾建军;;蒙特利尔认知评估量表筛查轻度认知功能障碍分界值的研究[J];中华老年心脑血管病杂志;2012年05期

4 高jK若生 ,刘芳;轻度认知功能障碍[J];日本医学介绍;2005年03期

5 田金洲;时晶;张新卿;毕齐;马辛;王志良;李晓斌;盛树力;李林;吴振云;房立岩;赵晓东;苗迎春;王蓬文;任映;尹军祥;王永炎;;《轻度认知损害临床研究指导原则(草案)》编制说明[J];中西医结合学报;2008年01期

6 张振馨,ZahnerGE,RomanGC,刘君,洪震,屈秋民,刘协和,张晓君,周玢,武成斌,唐牟尼,洪霞,李辉;中国北京、西安、上海和成都地区痴呆亚型患病率的研究[J];中国现代神经疾病杂志;2005年03期

7 于维东,范红杰;脑卒中后精神功能评定[J];中国临床康复;2002年09期

8 曹晓林;贲艳丽;陈仁花;王芳;;几种筛查量表应用于轻度认知功能障碍患者中的效果观察[J];现代临床护理;2011年03期

9 周东升;徐银儿;陈中鸣;胡珍玉;陈彦方;;老年人轻度认知功能障碍患病调查[J];中国公共卫生;2011年11期

10 于宝成,王玉敏,田京利,王成章,欧阳丽莎,齐丽娟,潘志刚,魏士贤,高义;军队离退休干部轻度认知功能损害的患病率调查[J];中国行为医学科学;2002年05期