认知脆弱及其与社区居住老年人营养和抑郁的关系。
Cognitive Frailty and Its Association with Nutrition and Depression in Community-Dwelling Older People.
机构信息
David L.K. Dai, Hong Kong Alzheimer's Disease Association, G/F, Wang Yip House, Wang Tau Hom Estate, Hong Kong Email:
出版信息
J Nutr Health Aging. 2019;23(10):943-948. doi: 10.1007/s12603-019-1258-y.
BACKGROUND
Cognitive frailty is a condition where physical frailty and mild cognitive impairment (MCI) co-exist. It is associated with increased risk of dementia and dependency. Previous studies reported that malnutrition and depression are associated with physical frailty and MCI; however, their relationships with cognitive frailty remained to be explored. The aims of this study were to examine the association of nutrition and depression with cognitive frailty, in comparison to having physical frailty or MCI alone.
METHODS
This study employed a cross-sectional design. Data collection was conducted in the community settings on the older people without dementia. Dependent variables were cognitive frailty, physical frailty, and MCI. The independent variables were depression and nutrition. Multi-nominal regression was employed to examine the relationships between the dependent and independent variables. The associations were adjusted by four known co-variates, including age, gender, education and APOE ε4 carrier status.
RESULTS
A total of 185 participants were recruited from four community centres and one elderly hostel and completed the data collection. Approximately 44.9% of the older people with physical frailty and 82.5% of elderly with MCI belonged to cognitive frailty. Multi-nominal regression models showed that depression is positively associated with cognitive frailty and with physical frailty, but not associated with solely MCI. Nutrition is negatively associated with cognitive frailty, but not associated with physical frailty or MCI alone.
CONCLUSION
Cognitive frailty is associated with malnutrition and depression. Therapeutic interventions managing depression and malnutrition may focus the older people with cognitive frailty to improve efficacy and cost-effectiveness.
背景
认知脆弱是一种身体脆弱和轻度认知障碍(MCI)同时存在的情况。它与痴呆和依赖的风险增加有关。先前的研究报告称,营养不良和抑郁与身体脆弱和 MCI 有关;然而,它们与认知脆弱的关系仍有待探讨。本研究的目的是检查营养和抑郁与认知脆弱的关系,与仅存在身体脆弱或 MCI 进行比较。
方法
本研究采用横断面设计。数据收集在社区环境中进行,针对无痴呆的老年人。因变量是认知脆弱、身体脆弱和 MCI。自变量是抑郁和营养。多变量回归用于检查因变量和自变量之间的关系。关联通过四个已知协变量进行调整,包括年龄、性别、教育和 APOE ε4 携带状态。
结果
共从四个社区中心和一个老年人宿舍招募了 185 名参与者完成了数据收集。大约 44.9%的身体脆弱的老年人和 82.5%的患有 MCI 的老年人属于认知脆弱。多变量回归模型显示,抑郁与认知脆弱和身体脆弱呈正相关,但与仅 MCI 无关。营养与认知脆弱呈负相关,但与身体脆弱或 MCI 无关。
结论
认知脆弱与营养不良和抑郁有关。管理抑郁和营养不良的治疗干预可能会针对认知脆弱的老年人,以提高疗效和成本效益。