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韩国老年人认知障碍的性别特异性发病率及预测因素:一项为期6年的前瞻性队列研究结果

Gender-Specific Incidence and Predictors of Cognitive Impairment among Older Koreans: Findings from a 6-Year Prospective Cohort Study.

作者信息

Lyu Jiyoung, Kim Hae-Young

机构信息

National Institute of Dementia, Seongnam, Republic of Korea.

Department of Health Policy and Management, College of Health Sciences & Department of Public Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea.

出版信息

Psychiatry Investig. 2016 Sep;13(5):473-479. doi: 10.4306/pi.2016.13.5.473. Epub 2016 Sep 30.

Abstract

OBJECTIVE

This study investigated gender-specific incidence and predictors of cognitive impairment among community-dwelling older adults in South Korea.

METHODS

Using data from the 2006 and 2012 Korean Longitudinal Study of Ageing (KLoSA), 925 females and 834 males aged 65 and over without cognitive impairment at 2006 were analyzed separately. Cognitive impairment was measured based on the Korean version of the Mini-Mental State Exam (K-MMSE) normative score. Generalized Estimating Equations (GEE) was conducted to examine the predictors of cognitive impairment at 6-year follow up.

RESULTS

Incidence of cognitive impairment at 2012 was significantly higher for women (30.5%) than men (26.1%). GEE result showed that depression was significantly associated with cognitive impairment for both genders (female: OR=2.26, 95% CI=1.63-3.12; male: OR=3.26, 95% CI=2.19-4.83). Having IADL limitations (OR=1.15, 95% CI=1.03-1.28), high blood pressure (OR=1.72, 95% CI=1.27-2.34), poor hearing (OR=1.94, 95% CI=1.29-2.92), regular exercise (OR=0.67, 95% CI=0.45-0.99), and normal weight (OR=1.39, 95% CI=1.03-1.86) were significant predictors of cognitive impairment only among women. In contrast, age (OR=1.04, 95% CI=1.01-1.07) and ADL limitations (OR=1.48, 95% CI=1.21-1.82) were significant predictors of cognitive impairment at follow-up only among men.

CONCLUSION

Findings of this study show gender-specific predictors of cognitive impairment among older Koreans. This study can provide information for clinicians and policy makers to develop different intervention strategies considering gender differences in the progress of cognitive impairment.

摘要

目的

本研究调查了韩国社区居住的老年人中认知障碍的性别特异性发病率及其预测因素。

方法

利用2006年和2012年韩国老龄化纵向研究(KLoSA)的数据,对2006年时年龄在65岁及以上且无认知障碍的925名女性和834名男性进行了单独分析。认知障碍根据韩国版简易精神状态检查表(K-MMSE)的标准评分进行测量。采用广义估计方程(GEE)来检验6年随访时认知障碍的预测因素。

结果

2012年女性认知障碍的发病率(30.5%)显著高于男性(26.1%)。GEE结果显示,抑郁与两性的认知障碍均显著相关(女性:OR=2.26,95%CI=1.63-3.12;男性:OR=3.26,95%CI=2.19-4.83)。仅在女性中,日常生活活动受限(IADL)(OR=1.15,95%CI=1.03-1.28)、高血压(OR=1.72,95%CI=1.27-2.34)、听力差(OR=1.94,95%CI=1.29-2.92)、经常锻炼(OR=0.67,95%CI=0.45-0.99)和体重正常(OR=1.39,95%CI=1.03-1.86)是认知障碍的显著预测因素。相比之下,年龄(OR=1.04,95%CI=1.01-1.07)和日常生活活动受限(ADL)(OR=1.48,95%CI=1.21-1.82)仅在男性中是随访时认知障碍的显著预测因素。

结论

本研究结果显示了韩国老年人认知障碍的性别特异性预测因素。本研究可为临床医生和政策制定者提供信息,以便在考虑认知障碍进展中的性别差异的情况下制定不同的干预策略。

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