Kitamura Kaori, Nakamura Kazutoshi, Ueno Kimiko, Nishiwaki Tomoko
Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
Department of Nursing, Faculty of Medical Technology, Teikyo University, Tokyo, Japan.
Environ Health Prev Med. 2016 Nov;21(6):585-590. doi: 10.1007/s12199-016-0572-9. Epub 2016 Oct 3.
Health-related quality of life (HRQOL) has been reported to be associated with cognitive function; however, whether or not this relationship involves causality is uncertain. This study aimed to determine whether HRQOL levels are associated with subsequent changes in cognitive function in elderly people requiring care.
Participants were 74 community-dwelling elderly people utilizing the long-term care service (69 % women) who underwent physical and psychological examinations at baseline and follow-up. The outcome was 2-year changes in Mini-Mental State Examination (∆MMSE) score. The potential predictor was HRQOL level assessed by the EuroQol 5 dimension (EQ-5D) score (utility value) at baseline; other variables were body mass index (BMI), Barthel index, grip strength, Geriatric Depression Scale, serum albumin, and serum hemoglobin. Associations between EQ-5D and ∆MMSE scores were assessed using correlation analysis, regression analysis, and analysis of covariance (ANCOVA).
Mean age, BMI, and Barthel index at baseline were 81.6 years [standard deviation (SD) 8.2], 21.1 kg/m (SD 4.0), and 79 (SD 20), respectively; the mean ∆MMSE score was -2.2 (SD 5.1). EQ-5D was significantly correlated with ∆MMSE (partial r = 0.375, P = 0.0012). The mean ∆MMSE values of the 1st, 2nd, and 3rd EQ-5D quartiles were -4.2 (adjusted P = 0.0050), -2.6 (adjusted P = 0.0476), and -2.4 (adjusted P = 0.0298), respectively, which were lower than the -0.1 of the reference 4th quartile.
HRQOL as assessed by EQ-5D is associated with longitudinal cognitive decline in frail elderly people, and cognitive function may be maintained in individuals with high HRQOL levels.
据报道，健康相关生活质量（HRQOL）与认知功能有关；然而，这种关系是否涉及因果关系尚不确定。本研究旨在确定需要护理的老年人的HRQOL水平是否与认知功能的后续变化相关。
参与者为74名接受长期护理服务的社区老年人（69%为女性），他们在基线和随访时接受了身体和心理检查。结果是简易精神状态检查表（∆MMSE）评分的2年变化。潜在预测因素是基线时通过欧洲五维健康量表（EQ-5D）评分（效用值）评估的HRQOL水平；其他变量包括体重指数（BMI）、巴氏指数、握力、老年抑郁量表、血清白蛋白和血清血红蛋白。使用相关分析、回归分析和协方差分析（ANCOVA）评估EQ-5D与∆MMSE评分之间的关联。
基线时的平均年龄、BMI和巴氏指数分别为81.6岁[标准差（SD）8.2]、21.1kg/m（SD 4.0）和79（SD 20）；平均∆MMSE评分为-2.2（SD 5.1）。EQ-5D与∆MMSE显著相关（偏相关系数r = 0.375，P = 0.0012）。EQ-5D四分位数第1、第2和第3组的平均∆MMSE值分别为-4.2（校正P = 0.0050）、-2.6（校正P = 0.0476）和-2.4（校正P = 0.0298），均低于参考四分位数第4组的-0.1。
通过EQ-5D评估的HRQOL与体弱老年人的纵向认知衰退相关，HRQOL水平高的个体的认知功能可能得到维持。
