阿尔茨海默病早期相关保护性因素研究

殷淑琴; 王丽娜

doi:10.16766/j.cnki.issn.1674-4152.002931

阿尔茨海默病早期相关保护性因素研究

doi: 10.16766/j.cnki.issn.1674-4152.002931

殷淑琴^1, ,,
王丽娜²

1.
湖州师范学院医学院临床系，浙江湖州 313000
2.
湖州师范学院医学院护理系，浙江湖州 313000

基金项目:

国家自然科学基金项目 81373078

国家自然科学基金项目 72174061

详细信息

通讯作者:
殷淑琴，E-mail：ysq71718@163.com

中图分类号: R749.16
计量
- 文章访问数: 272
- HTML全文浏览量: 161
- PDF下载量: 20
- 被引次数: 0
出版历程
- 收稿日期: 2022-12-15
- 网络出版日期: 2023-05-31

A study on protective factors related to the early stages of Alzheimer' s disease

YIN Shuqin^{1
, ,},
WANG Lina²

1.
School of Medicine, Huzhou Normal University, Huzhou, Zhejiang 313000, China

摘要

摘要: 目的通过探讨阿尔茨海默病早期轻度认知功能损害的影响因素, 为阿尔茨海默病认知障碍预防提供指导。方法 2021年1月-2022年1月选取湖州市5个社区的老年人为研究对象, 其中300例轻度认知障碍(mild cognitive impairment, MCI)老年人作为研究组, 另选择300例正常老年人群作为对照组。评价患者的认知活动评分(CAS)、教育与社会经济地位(SES)、抑郁自评量表得分(SDS)、神经心理测试, 分析相关因素对认知功能缺陷的影响和保护作用。结果 MCI患者的MMSE评分(25.0±1.4)分显著低于对照组(28.9±1.1)分; SDS评分(35.5±4.5)分明显高于对照组(32.0±4.6)分, 差异均有统计学意义(均P < 0.05)。组间在平均受教育年限、CAS和SES方面比较, 差异均有统计学意义(均P < 0.05)。经logistic多元回归分析, 结果显示, 学历高、CAS分级高和SES分级高是影响阿尔茨海默病发生的保护因素(均P < 0.05)。结论社区老年患者中较高水平的认知活动与社会经济地位以及高水平的教育是阿尔茨海默病痴呆风险的保护性因素。
- 阿尔茨海默病 /
- 认知功能 /
- 保护因素 /
- 认知休闲活动
Abstract: Objective To explore the influencing factors of early mild cognitive impairment in Alzheimer's disease and provide guidance for the prevention of cognitive impairment in Alzheimer's disease. Methods From January 2021 to January 2022, the elderly in 5 communities in Huzhou City were selected as the research objects, of which a total of 300 elderly patients with mild cognitive impairment (MCI) were selected as the research group, and 300 normal elderly people were selected as the control group.The cognitive activity score, education and socio-economic status, self-rating depression scale (SDS), and neuropsychological tests of the patients were evaluated, and the influence and protective effect of related factors on cognitive deficits were analyzed. Results The MMSE score of MCI patients (25.0±1.4) was significantly lower than that of the control group (28.9±1.1).The SDS score (35.5±4.5) was significantly higher than that of the control group (32.0±4.6), and the differences were statistically significant (all P < 0.05).There were statistically significant differences in terms of mean years of education, CAS and SES between the groups (all P < 0.05).After logistic multiple regression analysis, the results showed that high educational background, high CAS grade and high SES grade were protective factors for the development of Alzheimer's disease (all P < 0.05). Conclusion Higher levels of cognitive activity and socio-economic status, as well as higher education in community-based elderly patients are significant protective factors against the risk of dementia in Alzheimer's disease.
- Alzheimer's disease /
- Cognitive function /
- Protective factors /
- Cognitive leisure activities

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表 1 2组人口学及临床信息统计

Table 1. Demographic and clinical statistics of 2 groups

项目	研究组 (n=300)	对照组 (n=300)	统计量	P值
年龄(x±s，岁)	75.22±3.26	74.85±3.59	1.321^a	0.187
性别(男/女，例)	134/166	135/165	0.007^b	0.935
MMSE评分(x±s, 分)	28.62±1.14	25.02±1.19	37.837^a	< 0.001
学历[例(%)]
初中及以下	85(28.33)	88(29.33)	0.294^c	0.863
高中及中专	125(41.67)	128(42.67)
大专及以上	90(30.00)	84(28.00)
SDS评分(x±s, 分)	32.02±3.26	35.52±3.10	13.475^a	< 0.001
CAS分级[例(%)]
低度	53(17.67)	80(26.67)	23.190^c	< 0.001
中度	202(67.33)	207(69.00)
高度	45(15.00)	13(4.33)
SES分级[例(%)]
低等	35(11.67)	79(26.33)	38.973^c	< 0.001
中等	180(60.00)	187(62.33)
高等	85(28.33)	34(11.33)
注：^a为t值，^b为χ²值，^c为U值。

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表 2 阿尔茨海默病保护因素的logistic回归分析

Table 2. Logistic regression analysis of protective factors for Alzheimer's disease

变量	B	SE	Wald χ²	P值	OR值	95% CI
学历(初中及以下为参照)
高中及中专	0.822	0.328	8.012	< 0.001	2.275	1.652~2.898
大专及以上	0.839	0.369	9.236	< 0.001	2.314	1.591~3.037
CAS分级(低度为参照)
中度	0.798	0.412	7.120	< 0.001	2.221	1.413~3.029
高度	0.896	0.569	8.526	< 0.001	2.450	1.335~3.565
SES分级(低等为参照)
中等	0.815	0.578	8.112	< 0.001	2.259	1.126~3.392
高等	0.891	0.598	10.256	< 0.001	2.438	1.266~3.610

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表 3 不同程度认知活动评分与神经心理学评估(x±s, 分)

Table 3. Scores of different degrees of cognitive activity and neuropsychological assessment(x±s, points)

变量	CAS分级			F值	P值
变量	低(n=133)	中(n=409)	高(n=58)	F值	P值
词汇即刻回忆	5.12±1.22	5.98±1.21	5.02±1.01	19.741	< 0.001
词汇延迟识别	6.23±2.41	6.93±2.21	7.82±2.22	6.094	0.002
空间定位	24.03±5.42	23.02±3.61	23.42±4.23	1.330	0.266
信息处理	17.52±4.41	17.32±3.81	16.22±2.52	1.818	0.164
注意力集中	394.28±66.62	410.25±60.82	428.61±55.42	3.839	0.023
抽象思维	25.82±3.62	27.88±2.72	29.82±2.53	23.799	< 0.001
模块设计	31.10±6.54	32.99±6.02	31.88±5.98	2.273	0.105
数字连接测试	24.54±4.52	22.05±5.82	18.85±3.82	13.762	< 0.001
注：CAS为认知活动度评分。

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