Objective To investigate the current status of grip strength level in elderly patients with mechanical ventilation in ICU,and to explore its influencing factors. Methods The convenient sampling method was adopted to select 218 elderly mechanical ventilation patients in ICU of a tertiary hospital in Zhejiang Province as the research subjects from January 2020 to December,and researchers completed the cross-sectional study by using a general information questionnaire,an electronic grip strength device,and the Nutrition Risk Scaling 2002. Multivariate linear regression was used to analyse the factors influencing the grip strength level of elderly patients with mechanical ventilation. Results The average grip strength level of elderly patients with mechanical ventilation in ICU was（13.8±4.7） kg. Multivariate linear regression analysis showed that gender,age,exercise mode,time of sedative drugs,and score of Nutrition Risk Scaling 2002 were the main factors influencing their grip strength level（P<0.05）. Conclusion Grip strength levels were relatively low in elderly patients with mechanical ventilation in ICU. Grip strength levels were lower in patients with mechanical ventilation who were female,elderly,previously unexercised,the time of using sedation medication for >5 d,and the score of Nutrition Risk Scaling 2002≥3. Nursing staff should strengthen the dynamic evaluation of grip strength in patients with mechanical ventilation and control the related influencing factors.

Objective To investigate the current states of cognitive impairment and to identify the influencing factors associated with cognitive impairment in community-dwelling older adults with chronic diseases. Methods A total of 734 patients aged 60 years or older with chronic diseases were recruited from a community health service center in Shanghai by convenient sampling method. Data on demographics,clinical information and lifestyle were collected. Montreal cognitive assessment basic scale（MoCA-B） was used to measure cognitive function. Results In the sample of 734 elderly patients with chronic diseases,373（50.8%） had cognitive impairment,including 326（44.4%） with mild cognitive impairment and 47（6.4%） with Alzheimer disease. The results of multivariate Logistic regression analysis showed that age,light physical household chores,physical exercise,frequency of playing wechat or computer,hobbies,hearing loss,and history of diabetes are all common influencing factors for mild cognitive impairment patients and Alzheimer disease patients. Low education and family history of dementia（P<0.05） are factors specially associated with mild cognitive impairment. The Kruskal-Wallis analysis showed that the types of chronic diseases had statistically significant differences in the average score of MoCA-B rank（P<0.05）. Conclusion Elderly adults with 4 chronic diseases in the community have a higher prevalence of cognitive impairment than those with single one chronic disease. Health clinicians should screen cognitive function for older adults to identify these vulnerable population as early as possible.