社区老年人群主观认知下降与握力的相关性研究

董雅勤; 王为强

doi:10.16766/j.cnki.issn.1674-4152.002598

社区老年人群主观认知下降与握力的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.002598

董雅勤,
王为强^,

安徽医科大学附属宿州医院(安徽省宿州市立医院)全科医学科，安徽宿州 234000

基金项目:

安徽省科技创新战略与软科学研究专项计划项目 202106f01050042

详细信息

通讯作者:
王为强, E-mail: wwq007@126.com

中图分类号: R749.13 R746
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出版历程
- 收稿日期: 2021-12-28
- 网络出版日期: 2022-09-26

Correlation study between subjective cognitive decline and grip strength in elderly community population

DONG Ya-qin,
WANG Wei-qiang^,

Department of General Practice, Suzhou Hospital of Anhui Medical University (Suzhou Municipal Hospital of Anhui Province), Suzhou, Anhui 234000, China

摘要

摘要: 目的探讨社区老年人群主观认知下降(SCD)与握力的关系及相关危险因素。方法于2021年1-3月采用方便抽样法选取安徽省宿州市东关社区264名常住居民作为研究对象, 根据主观认知下降问卷9(SCD-Q9)评估的结果分为SCD组(153例)和非SCD组(111例)。2组研究对象均进行一般信息问卷调查、体格检查、生化指标等相关检查, 采用握力器测量双手握力。收集2组人群的检测结果进行比较, 采用logistic回归分析, 逐步选择法将性别、年龄等混杂因素纳入回归模型中, 分析主观认知下降与握力的相关性。结果 (1) 264名研究对象中主观认知下降153例, 占57.95%。(2) SCD组的握力[(23.08±3.09) kg]明显低于非SCD组[(27.99±4.79) kg], 差异有统计学意义(t=8.475, P < 0.001)。(3)2组年龄、性别、睡眠情况比较差异均有统计学意义(均P < 0.05)。(4) Logistic回归分析显示, 未调整混杂因素, 握力与主观认知下降之间有相关性(OR=0.723, 95%CI: 0.664~0.788, P < 0.001);调整相应混杂因素后, 握力与主观认知下降仍有相关性(OR=0.716, 95%CI: 0.653~0.786, P < 0.001)。结论低握力、女性、高龄、失眠是SCD的危险因素, 握力测量具有简易、低成本、操作性强等优点, 可作为社区评估认知功能下降的一项指标。
- 主观认知下降 /
- 握力 /
- 认知 /
- 危险因素
Abstract: Objective To explore the relationship between subjective cognitive decline (SCD) and grip strength and identify related risk factors in the elderly population in a certain community. Methods A total of 264 permanent residents in a community in Suzhou, Anhui Province, were selected as research objects by convenient sampling method from January to March of 2021.According to the evaluation results of subjective cognitive decline questionnaire 9(SCD-Q9), they were divided into two groups: the SCD group (153 cases) and the healthy control group (111 cases).General information questionnaire survey, physical examination, biochemical indexes and other related examinations were conducted.The test results of the two groups were collected for comparison.The relationship between grip strength and subjective cognitive decline was analysed by logistic regression analysis and step-to-step selection method, which included confounding factors such as gender and age into the regression model. Results (1) There were 153 cases of subjective cognitive decline in 264 subjects, accounting for 57.95%.(2) The grip strength of the SCD group (23.08±3.09) kg was significantly lower than that of the control group (27.99±4.79) kg, and the difference was statistically significant (t=8.475, P < 0.001).(3) Statistically significant differences in age, sex and sleep status were noted between the two groups (P < 0.05).(4) Logistic regression analysis showed a correlation between grip strength and subjective cognitive decline without adjusting for confounding factors (OR=0.723, 95%CI: 0.664-0.788, P < 0.001), as well as a correlation between grip strength and subjective cognitive decline after adjusting for corresponding confounding factors (OR=0.716, 95%CI: 0.653-0.786, P < 0.001). Conclusion Low grip strength, female, advanced age and insomnia are the risk factors for SCD.The measurement of grip strength has the advantages of simplicity, low cost and strong operability, and it can be used as an index for community assessment of cognitive decline within a population.
- Subjective cognitive decline /
- Grip strength /
- Cognition /
- Risk factors

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表 1 2组社区老年人群一般资料比较

Table 1. Comparison of general data between two groups of community elderly population

项目	SCD组(153例)	非SCD组(111例)	统计量	P值
性别[例(%)]			4.608^a	0.032
男性	65(42.48)	62(55.86)
女性	88(57.52)	49(44.14)
年龄[例(%)]			2.776^b	0.006
60~69岁	42(27.45)	45(40.54)
70~79岁	70(45.75)	50(45.05)
≥80岁	41(26.80)	16(14.41)
文化程度[例(%)]			1.113^b	0.266
小学及以下	48(31.37)	38(34.23)
初中	58(37.91)	48(43.24)
高中	34(22.22)	18(16.22)
大专及以上	13(8.50)	7(6.31)
体育锻炼[例(%)]			0.558^b	0.577
从不	37(24.18)	24(21.62)
偶尔	65(42.48)	47(42.34)
经常	51(33.33)	40(36.04)
睡眠情况[例(%)]			3.888^a	0.049
正常	85(55.56)	75(67.57)
失眠	68(44.44)	36(32.43)
吸烟[例(%)]	58(37.91)	40(36.04)	0.097^a	0.756
饮酒[例(%)]	46(30.01)	37(33.33)	0.319^a	0.572
高血压病[例(%)]	75(49.02)	57(51.35)	0.140^a	0.708
冠心病[例(%)]	42(27.45)	28(25.24)	0.164^a	0.686
糖尿病[例(%)]	32(20.92)	23(20.72)	0.001^a	0.969
身高(x±s, m)	1.58±0.06	1.59±0.05	1.140^c	0.255
男性	1.65±0.06	1.66±0.05	1.839^c	0.068
女性	1.59±0.06	1.59±0.05	0.099^c	0.921
体重(x±s, kg)	66.47±5.48	67.74±5.46	1.860^c	0.064
BMI(x±s)	22.66±3.13	22.84±2.73	0.488^c	0.626
腰围(x±s, cm)	85.43±2.41	85.12±1.89	1.541^c	0.125
收缩压(x±s, mm Hg)	130.48±7.81	130.96±7.49	0.509^c	0.611
舒张压(x±s, mm Hg)	80.06±4.03	79.30±4.44	1.429^c	0.154
心率(x±s, 次/min)	76.95±6.73	77.99±6.14	1.301^c	0.195
握力(x±s, kg)	23.08±3.09	27.99±4.79	8.475^c	＜0.001
注：^a为χ²值，^b为Z值，^c为t值；1 mm Hg=0.133 kPa。

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表 2 2组社区老年人群生化指标比较(x ±s)

Table 2. Comparison of biochemical indexes between two groups of community elderly population(x ±s)

组别	例数	空腹血糖 (mmol/L)	糖化血红蛋白 (%)	总胆固醇 (mmol/L)	低密度脂蛋白 (mmol/L)	BDNF (ng/mL)	同型半胱氨酸 (μmol/L)
SCD组	153	5.32±1.22	5.44±0.57	4.81±0.96	2.41±0.41	3.68±0.75	11.51±1.98
非SCD组	111	5.46±0.90	5.42±0.82	4.83±1.03	2.31±0.38	3.86±0.78	11.23±2.19
t值		1.092	0.278	0.131	1.905	1.937	1.080
P值		0.276	0.780	0.563	0.058	0.054	0.281

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表 3 Logistic回归分析中各变量赋值方法

Table 3. Variable assignment method in logistic regression analysis

变量	赋值方法
自变量
性别	男性=1，女性=2
年龄	60~69岁=1，70~79岁=2，≥80岁=3
文化程度	小学及以下=1，初中=2，高中=3，大专及以上=4
BMI	以实际值赋值
握力	以实际值赋值
吸烟	是=1，否=0
饮酒	是=1，否=0
冠心病	是=1，否=0
高血压病	是=1，否=0
糖尿病	是=1，否=0
体育锻炼	从不=1，偶尔=2，经常=3
睡眠情况	正常=1，失眠=2
因变量	主观认知下降=1，非主观认知下降=0

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表 4 握力与SCD相关性的logistic回归分析

Table 4. Logistic regression analysis of the correlation between grip strength and SCD

模型	B	SE	Wald χ²	P值	OR值	95% CI
模型1	-0.324	0.044	54.679	＜0.001	0.723	0.664~0.788
模型2	-0.316	0.044	51.056	＜0.001	0.729	0.669~0.795
模型3	-0.333	0.047	50.216	＜0.001	0.716	0.653~0.786
注：模型1未进行调整；模型2对年龄、性别进行调整；模型3对年龄、性别、文化程度、BMI、吸烟、饮酒、冠心病、高血压病、糖尿病、体育锻炼、睡眠情况进行调整。

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