认知老化与城市老年人群住院率。
Cognitive aging and rate of hospitalization in an urban population of older people.
机构信息
Rush Alzheimer's Disease Center, Rush University Medical Center, 600 South Paulina Street, Suite 1038, Chicago, IL 60612.
出版信息
J Gerontol A Biol Sci Med Sci. 2014 Apr;69(4):447-54. doi: 10.1093/gerona/glt145. Epub 2013 Oct 10.
BACKGROUND
The association of age-related cognitive change with hospitalization is not well understood.
METHODS
At 3-year intervals for a mean of 8.7 years, 2,273 older residents of a geographically defined urban community underwent cognitive testing from which a global measure was derived. Hospitalization data were obtained from Part A Medicare beneficiary records. The association of level of cognitive function and rate of cognitive decline in each 3-year interval with subsequent rate of hospitalization was assessed using mixed-effects count regression models.
RESULTS
There were 9,091 hospitalizations involving 1,810 of the 2,273 individuals in the cohort (79.6%). Rate of hospitalization increased by 9.7% (95% confidence interval [CI]: 7.2, 12.3) with each additional study year; by 32.7% (95% CI: 26.8, 38.0) for each 1 point lower on the global cognitive measure at the beginning of an observation interval; and by 24.3% (95% CI: 16.6, 32.6) for each 1-point decrease in the global cognitive measure during the previous observation period. These associations persisted after adjustment for comorbidities and exclusion of those with a Mini-Mental State Examination score less than 26.
CONCLUSION
Individual differences in trajectories of cognitive aging are associated with subsequent risk of hospitalization.
背景
与年龄相关的认知变化与住院之间的关联尚不清楚。
方法
在 8.7 年的平均时间内，以 3 年为一个间隔，对一个地理位置明确的城市社区的 2273 名老年居民进行了认知测试，从中得出了一个总体衡量标准。住院数据来自 Medicare 受益人的 Part A 记录。使用混合效应计数回归模型评估每个 3 年间隔的认知功能水平和认知下降率与随后的住院率之间的关联。
结果
在该队列的 2273 人中，有 9091 人住院（79.6%），涉及 1810 人。每次研究增加一年，住院率增加 9.7%（95%置信区间：7.2，12.3）；在观察间隔开始时，全球认知量表的得分每降低 1 分，住院率增加 32.7%（95%置信区间：26.8，38.0）；在之前的观察期内，全球认知量表的得分每降低 1 分，住院率增加 24.3%（95%置信区间：16.6，32.6）。这些关联在调整合并症和排除 Mini-Mental State Examination 得分低于 26 的患者后仍然存在。
结论
认知衰老轨迹的个体差异与随后的住院风险相关。
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