School of Health Sciences, Wuhan University, 115# Donghu Road, Wuhan 430071, China.
Global Health Institute, Wuhan University, 8# South Donghu Road, Wuhan 430072, China.
Int J Environ Res Public Health. 2018 Nov 30;15(12):2705. doi: 10.3390/ijerph15122705.
Mild cognitive impairment (MCI) is an early stage of Alzheimer's disease or other forms of dementia that occurs mainly in older adults. The MCI phase could be considered as an observational period for the secondary prevention of dementia. This study aims to assess potential differences in the risk of MCI among different elderly groups in Wuhan, China, and to further identify the most vulnerable populations using logistic regression models. A total of 622 older adults participated in this study, and the prevalence of MCI was 34.1%. We found that individuals aged 80⁻84 (odds ratio, OR = 1.908, 95% confidence interval, 95% CI 1.026 to 3.549) or above (OR = 2.529, 95% CI 1.249 to 5.122), and those with two chronic diseases (OR = 1.982, 95% CI 1.153 to 3.407) or more (OR = 2.466, 95% CI 1.419 to 4.286) were more likely to be diagnosed with MCI. Those with high school degrees (OR = 0.451, 95% CI 0.230 to 0.883) or above (OR = 0.318, 95% CI 0.129 to 0.783) and those with a family per-capita monthly income of 3001⁻4500 yuan (OR = 0.320, 95% CI 0.137 to 0.750) or above (OR = 0.335, 95% CI 0.135 to 0.830) were less likely to experience MCI. The results also showed that those aged 80 or above were more likely to present with cognitive decline and/or reduced activities of daily living (ADL) function, with the odds ratios being 1.874 and 3.782, respectively. Individuals with two, or three or more chronic diseases were more likely to experience cognitive decline and/or reduced ADL function, with odds ratios of 2.423 and 2.631, respectively. Increased risk of suffering from either MCI and/or decline in ADL functioning is strongly positively associated with older age, lower educational levels, poorer family economic status, and multiple chronic diseases. Our findings highlight that the local, regional, and even national specific MCI-related health promotion measures and interventions must target these vulnerable populations.
轻度认知障碍(MCI)是一种主要发生在老年人中的阿尔茨海默病或其他形式痴呆的早期阶段。MCI 阶段可以被视为痴呆二级预防的观察期。本研究旨在评估中国武汉不同老年人群体发生 MCI 的潜在差异,并进一步使用逻辑回归模型确定最脆弱的人群。共有 622 名老年人参与了这项研究,MCI 的患病率为 34.1%。我们发现,80-84 岁(比值比,OR=1.908,95%置信区间,95%CI 1.026 至 3.549)或以上(OR=2.529,95%CI 1.249 至 5.122),以及患有两种(OR=1.982,95%CI 1.153 至 3.407)或更多慢性疾病(OR=2.466,95%CI 1.419 至 4.286)的个体更有可能被诊断为 MCI。那些具有高中及以上学历(OR=0.451,95%CI 0.230 至 0.883)或以上(OR=0.318,95%CI 0.129 至 0.783)以及家庭人均月收入为 3001-4500 元(OR=0.320,95%CI 0.137 至 0.750)或以上(OR=0.335,95%CI 0.135 至 0.830)的个体不太可能出现 MCI。结果还表明,80 岁及以上的老年人更有可能出现认知能力下降和/或日常生活活动(ADL)功能下降,比值比分别为 1.874 和 3.782。患有两种或三种或更多慢性疾病的个体更有可能出现认知能力下降和/或 ADL 功能下降,比值比分别为 2.423 和 2.631。患有 MCI 和/或 ADL 功能下降的风险与年龄较大、教育水平较低、家庭经济状况较差以及患有多种慢性疾病呈正相关。我们的研究结果表明,地方、地区甚至国家特定的 MCI 相关健康促进措施和干预措施必须针对这些脆弱人群。