社区轻度认知障碍老年人短期内认知功能下降与生活行为的相关性研究及护理启示

doi:10.3761/j.issn.0254-1769.2024.21.002

摘要/Abstract

摘要：

目的分析不同社区轻度认知障碍老年人生活行为与认知功能下降的相关性。方法 2023年3月—2024年1月，采用便利抽样法，选取北京市2所社区卫生服务中心的轻度认知障碍老年人为调查对象，对其进行6个月的追踪随访，采用一般资料调查表、生活行为调查表、中文版蒙特利尔认知评估量表、简易智能精神状态检查、日常生活活动能力量表进行问卷调查，按照是否出现可靠的临床认知功能变化分为认知功能下降组和未下降组，采用Logistic回归方法分析社区轻度认知障碍老年人认知功能短期内下降的独立影响因素。结果该研究最终共随访385例社区轻度认知障碍老年人，有113例（29.4%）出现认知功能下降。Logistic回归分析显示，较多被动认知活动、抑郁症状、睡眠质量差是社区轻度认知降碍老年人短期内认知功能快速下降的独立危险因素（P<0.05），而较高的受教育程度和良好社交活动是保护因素（均P<0.05）。结论社区轻度认知障碍老年人短期内认知功能下降发生率较高，应积极引导轻度认知障碍老年人建立健康生活方式，如良好社交活动、较少被动认知活动、保持良好心理状态及较好睡眠质量等，以延缓甚至逆转其认知功能下降。

关键词: 老年人, 轻度认知障碍, 生活行为, 认知功能下降, 队列研究, 护理

Abstract:

Objective To analyze the impact of different lifestyle behaviors on the rapid decline in cognitive function within 6 months among the elderly with mild cognitive impairment（MCI） in the community. Methods From March 2023 to January 2024，a convenient sampling method was used to select elderly people with MCI from 2 community health service centers of Beijing as the research subjects. They were followed up for 6 months，and the data on general information，life behaviors，and changes in cognitive function were collected. They were divided into a cognitive decline group and a non-decline group based on whether there were reliable changes in clinical cognitive function. Logistic regression was used to analyze the independent influencing factors of short-term cognitive decline in MCI elderly. Results A total of 385 MCI elderly people were successfully followed up in this study，and 113（29.4%） showed cognitive decline. Logistic regression analysis revealed that life behaviors such as frequent passive cognitive activities，depressive symptoms，and poor sleep quality are independent risk factors for rapid cognitive decline in elderly individuals with MCI over a short period （P<0.05）. Conversely，higher educational levels and good social activities are protective factors（P<0.05）. Conclusion The incidence of rapid cognitive decline is relatively high among MCI elderly people in the community. We should actively guide MCI elderly people to establish healthy lifestyle behaviors，such as engaging in social activities，reducing passive cognitive activities，maintaining a good psychological state，and ensuring good sleep quality，so as to delay or even reverse their cognitive decline.

Key words: Aged, Mild Cognitive Impairment, Lifestyle Behaviors, Cognitive Decline, Cohort Study, Nursing Care

胡慧秀, 孙超, 赵雅洁, 李想, 李磊. 社区轻度认知障碍老年人短期内认知功能下降与生活行为的相关性研究及护理启示[J]. 中华护理杂志, 2024, 59(21): 2571-2578.

HU Huixiu, SUN Chao, ZHAO Yajie, LI Xiang, LI Lei. The impact of life behaviors on the rapid cognitive decline in the short term among community-dwelling elderly with mild cognitive impairment[J]. Chinese Journal of Nursing, 2024, 59(21): 2571-2578.

图/表 3

表1 调查对象一般资料情况及不同特征社区轻度认知障碍老年人认知功能下降的单因素分析结果[例（百分比，%）]

Table 1 The general information of survey subjects and univariate analysis of the elderly MCI with different characteristics[cases（percentage，%）]

表2 自变量赋值方式

Table 2 The assignment of independent variables

表3 社区轻度认知降碍老年人认知功能下降的Logistic回归分析（n=385）

Table 3 Logistic regression analysis of the impact of life behaviors on cognitive decline in the elderly with MCI（n=385）

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