基于广义估计方程的阿尔茨海默病健康相关生命质量影响因素研究

发布时间：2018-12-08 10:48

【摘要】：目的研究阿尔茨海默病(Alzheimer’s disease,AD)进程中不同认知转归结局健康相关生命质量(healthrelated quality of life,HRQOL)的主要影响因素。方法将阿尔茨海默病进程中的疾病状态和生命质量相结合,以认知正常老化为状态1、轻度认知障碍为状态2、中重度认知障碍为状态3、阿尔茨海默病为状态4,针对3次随访的纵向资料,引入广义估计方程,研究AD进程中HRQOL随疾病状态转移的影响因素。结果状态1至状态2 HRQOL有统计学意义的影响因素是婚姻、离休前职业、参加娱乐公益活动、吸烟、GDS;状态2至状态3 HRQOL影响因素是婚姻、夫妻关系、出生胎次、参加体育锻炼、一级亲属痴呆、ADL、GDS;状态3至状态4 HRQOL影响因素是教育水平、退休后第二职业、做家务情况、参加体育锻炼、喝茶、一级亲属痴呆、高血脂、GDS;状态3至状态2 HRQOL影响因素是教育水平、离休前职业、业余爱好、喝茶、吸烟、铝制炊具使用、控制食量、脑部疾患、ADL、GDS。结论 AD进程中HRQOL随状态转移的影响因素各有不同,应该根据不同认知转归结局生命质量各自的影响因素,制定疾病分阶段卫生政策,提高老年人生命质量。
[Abstract]:Objective to study the main influencing factors of health-related quality of life (healthrelated quality of life,HRQOL) in patients with Alzheimer's disease (Alzheimer's disease,AD) with different cognitive outcomes. Methods the state of disease and quality of life in the course of Alzheimer's disease were combined. Cognitive normal aging was considered as state 1, mild cognitive impairment as state 2, moderate and severe cognitive impairment as state 3, and Alzheimer's disease as state 4. Based on the longitudinal data of three follow-up visits, the generalized estimation equation was introduced to study the influencing factors of HRQOL metastasis with disease state in the process of AD. Results from state 1 to state 2, HRQOL were significantly affected by marriage, pre-retirement occupation, participation in recreational activities, smoking, and GDS;. The influencing factors of state 2 to state 3 HRQOL are marriage, marital relationship, birth order, physical exercise, dementia of first-degree relatives, ADL,GDS;. The influencing factors of state 3 to 4 HRQOL are educational level, second occupation after retirement, housework, physical exercise, tea drinking, dementia of first-degree relatives, hyperlipidemia, GDS;. The influencing factors of state 3 to state 2 HRQOL are educational level, pre-retirement occupation, hobbies, tea, smoking, aluminum cooking utensils, food control, brain disorders, ADL,GDS.. Conclusion the influencing factors of HRQOL in the process of AD are different with the change of state. According to the influencing factors of the quality of life of different cognitive outcomes, the health policy of disease stages should be formulated to improve the quality of life of the elderly.
【作者单位】：山西医科大学卫生统计学教研室;太原市中心医院;
【基金】：国家自然科学基金(30972545) 山西省国际科技合作计划项目(2012081047) 山西省留学回国人员科技活动择优项目山西医科大学科技创新项目
【分类号】：R749.16

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