关键词: 社区护理, 老年人, 慢性病, 认知功能, 影响因素分析

Abstract:

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.

Key words: Community Nursing Care, Aged, Chronic Disease, Cognitive Function, Root Cause Analysis