基于多元多水平模型的阿尔茨海默病认知相关功能影响因素研究

发布时间：2018-07-25 07:20

【摘要】：目的通过随访研究了解太原市阿尔茨海默病患者的认知、抑郁、日常行为能力及生命质量现状、随时间的变化趋势以及其影响因素。探讨AD患者认知与抑郁,日常行为能力与生命质量之间的相关关系,为制订科学合理疾病防治策略提供依据。方法基于对AD患者首次随访资料,对患者的认知功能、抑郁状态、日常行为能力及生命质量进行单因素分析并以它们为反应变量进行多重线性回归分析,初步探讨各个反应变量的影响因素,进一步采用多元多水平模型探讨患者认知功能与抑郁状态的相关关系、随时间的变化趋势及影响因素,探讨患者日常行为能力及生命质量的相关关系、随时间的变化趋势及影响因索,同时探讨认知功能与抑郁状态对日常行为能力及生命质量的影响。结果 1、多无多水平模型拟合效果较好。 2、AD患者认知功能、抑郁状态、日常行为能力及生命质量影响因素的多元多水平结果显示,以AD患者认知功能及抑郁状态同为反应变量时,影响AD患者认知功能的因素为受教育程度、性格、、业余爱好、体育活动、读书看报、铝制炊具、限制饮食和高血压8个因素,影响AD患者抑郁状态的因素有婚姻状况、退休前职业、经常做家务、读书看报、铝制炊具、限制饮食及高血压7个因素,其中读书看报、铝制炊具、限制饮食和高血压为AD患者认知功能及抑郁状态的共同影响因素。教育水平高、性格外向者、具有业余爱好、经常参加体育活动经常读书看报、不常用铝制炊具、小限制饮食及不患有高血压的患者认知功能得分较高,具有较好的认知功能,独身、退休前从事体力劳动、不经常做家务、不读书看报、经常使用铝制炊具、限制饮食及患有高血压的患者抑郁状态得分较高，抑郁程度更强。并且有个体和测量时点水平上,AD患者认知功能及抑郁状态具有相关性且为负相关，相关系数分别为-0.685和-0.354。 3、以AD患者的日常行为能力及生命质量得分同为反应变量时,影响AD患者日常行为能力的因素有受教育程度、经常做家务、患者认知功能及抑郁状态4个因素，影响AD患者生命质量的因素有婚姻状况、体育活动、读书看报、饮酒及患者的认知功能和抑郁状态6个因素，其中AD患者认知功能及抑郁状态对患者的日常行为能力和生命质量都有影响,受教育程度低、不经常做家务、认知功能得分低及抑郁状态得分高的患者日常行为能力得分高，日常行为能力差，独身、不经常参加体育活动、不经常读书看报、不饮酒、认知功能得分低及抑郁状态得分高的患者生命质量得分低,生命质准差。在个体和测量时点水平上,AD患者日常行为能力及生命质量具有相关性,且为负相关，相关系数分别为-0.379和-0.238。结论AD患者的认知功能、抑郁状态、日常行为能力及生命质量与多种因素有关，需要注重AD患者对阿尔茨海默病的预防及治疗。此外，，相比于传统的纵向数据的分析方法多元多水平模型具有其优势，不仅能够分析其影响因素还能分析各反应变量随时间的变化趋势及两个反应变量之间的相关关系。
[Abstract]:Objective to investigate the cognition, depression, daily behavior ability and quality of life in patients with Alzheimer's disease in Taiyuan, and to explore the relationship between cognition and depression, daily behavior and quality of life in the patients with Alzheimer's disease in Taiyuan, and to provide a basis for the formulation of a scientific and rational disease control strategy. According to it.
Methods based on the first follow-up data of AD patients, the patients' cognitive function, depressive state, daily behavior ability and quality of life were analyzed by single factor analysis and multiple linear regression analysis was carried out with them as response variables. The factors affecting the response variables were preliminarily discussed, and the cognitive function of patients was studied by multiple multilevel models. The relationship with depression, the change trend and the influencing factors of time, the relationship between the daily behavior ability and the quality of life, the change trend and the influence of time, and the influence of cognitive function and depression on the daily behavior and quality of life.
Result
1, the multiple no multi level model has better fitting effect.
2, the multiple levels of cognitive function, depression, daily behavior and quality of life in AD patients showed that the factors affecting the cognitive function of AD patients were education, personality, hobbies, sports, reading, reading, cooking utensils, restricted diet when the cognitive function and depressive state of the AD patients were the reacting variables. And hypertension 8 factors, the factors affecting the depression of AD patients are marital status, pre retirement occupation, regular housework, reading and reading, aluminum cookers, diet and hypertension 7 factors, including reading and reading, aluminum cooking utensils, restriction diet and hypertension as the common influence factors of recognition and depression of AD patients. Education level is high, Extroverts, with hobbies, often participate in sports activities, often read and read newspapers, do not often use aluminum cooking utensils, small restricted diet and hypertension patients have higher cognitive function score, have better cognitive function, single, before retiring to engage in manual labor, do not do housework often, do not read newspapers, often use aluminum cookers, restrict the use of aluminum cookers, LIMITED Patients with diet and hypertension had a higher score of depression and a greater degree of depression. There was a correlation and negative correlation between the cognitive function and depression status of AD patients, and the correlation coefficient was -0.685 and -0.354., respectively.
3, when the daily behavior ability and quality of life score of AD patients were the reacting variables, the factors affecting the daily behavior of AD patients were education, housework, cognitive function and depression. The factors affecting the quality of life of AD patients were marital status, physical activity, reading and reading, drinking and cognition of patients. There are 6 factors of function and depression, of which the cognitive function and depression of AD patients have an impact on the patient's daily behavior and quality of life, low education, not often doing housework, low score of cognitive function and high score of depression, the higher scores of daily behavior ability, poor daily behavior, single, and unfrequent participation in the patients. At the level of individual and measuring time, the daily behavior ability and quality of life of AD patients were correlated and negatively correlated, and the correlation coefficient was -0.379 and -0.238., respectively.
Conclusion the cognitive function, depressive state, daily behavior ability and quality of life of AD patients are related to a variety of factors. It is necessary to pay attention to the prevention and treatment of Alzheimer's disease in AD patients. In addition, the multivariate and multilevel model of the traditional longitudinal data analysis method has its advantages, not only can analyze its influencing factors but also analyze the various kinds of anti Alzheimer's disease. The variation trend of strain with time and the correlation between the two reaction variables.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.16

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