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老年人认知评估:感觉功能和脆弱性重要吗?

Cognitive Assessment of Older People: Do Sensory Function and Frailty Matter?

机构信息

Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China.

Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.

出版信息

Int J Environ Res Public Health. 2019 Feb 24;16(4):662. doi: 10.3390/ijerph16040662.

Abstract

: To examine the associations of visual and hearing functions, and frailty with subjective memory complaints (SMCs) in a community primary care pilot project of older people aged 60 years and over. : The study was conducted in 24 community centers. A total of 1949 community-dwelling older people aged between 60⁻97 years were evaluated for which detailed information regarding socio-demographics, lifestyle, and clinical factors were documented at baseline and an average of 12 months later. SMCs were assessed using the 5-item Abbreviated Memory Inventory for the Chinese (AMIC). Visual and hearing functions were measured with two separate single questions. Frailty was assessed using a simple frailty question (FRAIL). : At baseline, 1685 (74.6%) participants had reported at least 3 SMCs (AMIC score ≥ 3). Of the 573 participants without / with 1⁻2 SMCs (AMIC score = 0⁻2) at baseline, 75 had incomplete data regarding SMCs and 190 developed at least 3 SMCs after 12 months. After adjustments for age, sex, marital status, educational level, hypertension, and diabetes at baseline, poor vision (OR 2.2 95% CI 1.8⁻2.7), poor hearing (OR 2.2 95% CI 1.8⁻2.8), and frailty (OR 4.6 95% CI 3.1⁻6.7) at baseline were each significantly associated with an increased risk of at least 3 SMCs at follow-up. After a further adjustment for baseline SMCs, the associations remained significant. Similar results were obtained when incident SMCs and improvement in subjective memory were used as the outcome variables; and : In the care of older people, detection of sensory impairment and frailty through screening may allow formulation of strategies to prevent or delay the onset of cognitive decline.

摘要

: 目的:在一项针对 60 岁及以上老年人的社区初级保健试点项目中,研究视觉和听觉功能以及虚弱与主观记忆主诉 (SMC) 的相关性。 : 本研究在 24 个社区中心进行。共评估了 1949 名居住在社区的 60-97 岁老年人,基线时详细记录了他们的社会人口统计学、生活方式和临床因素信息,平均 12 个月后再次进行评估。SMC 使用 5 项简化的中文记忆量表 (AMIC) 进行评估。视觉和听觉功能分别通过两个单独的单项问题进行测量。虚弱使用简单的虚弱问题 (FRAIL) 进行评估。 : 在基线时,1685 名 (74.6%) 参与者报告至少有 3 项 SMC (AMIC 评分≥3)。在基线时没有 / 有 1-2 项 SMC (AMIC 评分=0-2) 的 573 名参与者中,有 75 名参与者的 SMC 数据不完整,有 190 名参与者在 12 个月后至少出现 3 项 SMC。在调整基线时的年龄、性别、婚姻状况、教育水平、高血压和糖尿病后,视力差 (OR 2.2,95%CI 1.8-2.7)、听力差 (OR 2.2,95%CI 1.8-2.8) 和虚弱 (OR 4.6,95%CI 3.1-6.7) 与随访时至少出现 3 项 SMC 的风险增加显著相关。进一步调整基线 SMC 后,相关性仍然显著。当将新发 SMC 和主观记忆改善作为结局变量时,也得到了相似的结果;并且 : 在老年人的护理中,通过筛查发现感觉障碍和虚弱,可能有助于制定预防或延缓认知能力下降的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c64/6406914/a8cdaa0ce69e/ijerph-16-00662-g001.jpg

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