Xiu Shuangling, Liao Qiuju, Sun Lina, Chan Piu
Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.
Department of Rheumatology, Beijing Institute of Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing, China.
Ther Adv Endocrinol Metab. 2019 Apr 2;10:2042018819836640. doi: 10.1177/2042018819836640. eCollection 2019.
The aim of this study was to investigate the risk factors for cognitive impairment in older people with diabetes.
This cross-sectional study included 2626 community-dwelling participants with diabetes aged ⩾55 years, living in Beijing, China. The participants were screened for risk factors, including smoking, obesity, hypertension, stroke, coronary heart disease, dyslipidemia, depression, apolipoprotein E (APOE) genotype, and low physical activity. Cognitive function was assessed with the scholarship-adjusted Mini-Mental State Examination (MMSE): MMSE ⩽17 for iliterate participants; MMSE ⩽20 for primary school graduates (⩾6 years of education); and MMSE ⩽24 for junior school graduates or above (⩾9 years of education).
The prevalence of cognitive impairment in older people with diabetes was 9.90%. Multiple logistic regression analysis demonstrated that stroke [odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.20-2.43], less than 0.5 h exercise per day (OR = 1.89, 95% CI = 1.37-2.61), and depression (OR = 1.64, 95% CI = 1.06-2.54), but not smoking, obesity, hypertension, dyslipidemia, and coronary heart disease, were independent risks for cognitive impairment in older people with diabetes. In addition, being married (OR = 0.66, 95% CI = 0.47-0.93) and urban living (OR = 0.33, 95% CI = 0.22-0.48) could decrease the risk of cognitive impairment.
Stroke, depression, and less than 0.5 h exercise per day were independent risks for cognitive impairment in older people with diabetes, whereas being married and urban living were protective.
本研究旨在调查老年糖尿病患者认知功能障碍的危险因素。
这项横断面研究纳入了2626名年龄≥55岁、居住在中国北京社区的糖尿病患者。对参与者进行危险因素筛查，包括吸烟、肥胖、高血压、中风、冠心病、血脂异常、抑郁、载脂蛋白E（APOE）基因型和低体力活动。认知功能采用经学历调整的简易精神状态检查表（MMSE）进行评估：文盲参与者MMSE≤17分；小学毕业（受教育年限≥6年）参与者MMSE≤20分；初中毕业及以上（受教育年限≥9年）参与者MMSE≤24分。
老年糖尿病患者认知功能障碍的患病率为9.90%。多因素logistic回归分析表明，中风（比值比[OR]=1.71，95%置信区间[CI]=1.20 - 2.43）、每天运动少于0.5小时（OR = 1.89，95% CI = 1.37 - 2.61）和抑郁（OR = 1.64，95% CI = 1.06 - 2.54）是老年糖尿病患者认知功能障碍的独立危险因素，而吸烟、肥胖、高血压、血脂异常和冠心病不是。此外，已婚（OR = 0.66，95% CI = 0.47 - 0.93）和居住在城市（OR = 0.33，95% CI = 0.22 - 0.48）可降低认知功能障碍的风险。
中风、抑郁和每天运动少于0.5小时是老年糖尿病患者认知功能障碍的独立危险因素，而已婚和居住在城市具有保护作用。
