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台湾退伍军人退休社区居民中痴呆症和认知障碍的预测因素:对认知健康促进活动的启示。

Predictive factors for dementia and cognitive impairment among residents living in the veterans' retirement communities in Taiwan: Implications for cognitive health promotion activities.

作者信息

Chen Liang-Yu, Wu Yi-Hui, Huang Chung-Yu, Liu Li-Kuo, Hwang An-Chun, Peng Li-Ning, Lin Ming-Hsieh, Chen Liang-Kung

机构信息

Aging and Health Research Center, National Yang-Ming University, Taipei, Taiwan.

Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.

出版信息

Geriatr Gerontol Int. 2017 Apr;17 Suppl 1:7-13. doi: 10.1111/ggi.13039.

Abstract

AIM

To identify potentially modifiable risk factors for cognitive decline among veterans' home residents in Taiwan METHODS: The present retrospective cohort study was part of the Veteran Affairs-Comprehensive Geriatric Assessment study that retrieved data of the comprehensive geriatric assessment for 946 residents living at four veterans' homes in Taiwan. The study participants were interviewed every 3-6 months from January 2012 and December 2014. Demographic characteristics,multimorbidity by Charlson's Comorbidities Index, physical function by the Barthel Index, cognition by the Mini-Mental State Examination (MMSE), depression by the five-item Geriatric Depression Scale and nutritional status by the Mini-Nutrition Assessment-Short Form were collected for analysis. A generalized estimating equation model was used after it was adjusted for age, educational level, five-item Geriatric Depression Scale, and problem of communication difficulty to identify potential modifiable risk factors for cognitive decline.

RESULTS

The mean age of the participants was 85.7 ± 5.2 years, with a mean follow-up period of 41 ± 21.6 weeks. The prevalence of cognitive impairment (defined by MMSE <24) was 65.6%, whereas 34% of the study participants were positive for depressive symptoms. Approximately one-fifth of the study participants were using psychotropic agents, which was higher among participants with cognitive impairment (23.6% vs 15.6%, P < 0.05) than those without. In the generalized estimating equation model, physical function, nutritional status, depressive symptoms, ex-drinker, multimorbidity and stool incontinence were positively correlated with MMSE score; whereas advanced age, low educational level (<6 years), presence of communication difficulty and use of psychotropic agents were inversely associated with the MMSE score.

CONCLUSIONS

Physical function and nutritional status were positively associated with the MMSE score, and use of psychotropic agents was negatively correlated with cognitive function. Further intervention study is required to improve the cognitive health of older adults living in the veterans' retirement communities. Geriatr Gerontol Int 2017: 17 (Suppl. 1): 7-13.

摘要

目的

确定台湾地区退伍军人之家居民认知功能衰退的潜在可改变风险因素。

方法

本回顾性队列研究是退伍军人事务综合老年评估研究的一部分,该研究收集了台湾四家退伍军人之家946名居民的综合老年评估数据。研究参与者于2012年1月至2014年12月期间每3 - 6个月接受一次访谈。收集人口统计学特征、采用查尔森合并症指数评估的多种疾病、采用巴氏指数评估的身体功能、采用简易精神状态检查表(MMSE)评估的认知功能、采用老年抑郁量表五项版评估的抑郁状况以及采用微型营养评定简表评估的营养状况进行分析。在对年龄、教育水平、老年抑郁量表五项版及沟通困难问题进行校正后,采用广义估计方程模型来确定认知功能衰退的潜在可改变风险因素。

结果

参与者的平均年龄为85.7±5.2岁,平均随访期为41±21.6周。认知障碍(定义为MMSE<24)的患病率为65.6%,而34%的研究参与者有抑郁症状阳性。约五分之一的研究参与者正在使用精神药物,认知障碍参与者的使用率(23.6%对15.6%,P<0.05)高于无认知障碍者。在广义估计方程模型中,身体功能、营养状况、抑郁症状、既往饮酒者、多种疾病和大便失禁与MMSE评分呈正相关;而高龄、低教育水平(<6年)、存在沟通困难和使用精神药物与MMSE评分呈负相关。

结论

身体功能和营养状况与MMSE评分呈正相关,使用精神药物与认知功能呈负相关。需要进一步开展干预研究以改善居住在退伍军人退休社区的老年人的认知健康状况。《老年医学与老年病学国际杂志》2017年;17(增刊1):7 - 13。

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