Yan Zhixiong, Zou Xia, Hou Xiaohui
Psychology Department, Nanning Normal University, Nanning, China.
Guangxi College for Preschool Education, Nanning, China.
Front Psychol. 2020 Sep 10;11:2217. doi: 10.3389/fpsyg.2020.02217. eCollection 2020.
To unravel the combined effect of risk and protective factors that may contribute to preserve or impair cognitive status, this prospective cohort study systematically investigated a cluster of factors in elders aged 75 years and older from Guangxi Longitudinal Cohort (GLC) dataset. GLC has tracked 630 oldest-elders for two times within 2 years and will continue to follow two times in the next 4 years. At baseline geriatric assessment, sociodemographic information (e.g., education, Mandarin, marriage, and income), physical status [body mass index (BMI), chronic disease/medicine], lifestyle factors (smoking, alcohol, and exercise), and self-rated mental health (self-care, well-being, anxiety) were recorded by online interview. With 2 years' follow-up, Mini-Mental State Examination (MMSE) and memory test were performed through person-to-person interview. The performance of MMSE was applied to represent the responder's cognitive status which classified into cognitive impairment and normal group based on a cutoff point of 20. An age-related cognitive declining trend of 15 stratified factors was observed, though with a small effect size (R-square: 0.001-0.15). The odds of exposure or non-exposure on factors (memory, self-care, exercise, income, education, and literacy) had a significantly different effect on cognitive impairment through multivariate analysis after adjusting other confounding variables. Through stepwise multiple logistic regression analysis, the following 12 factors/index would be integrated to predict cognitive impairment: gender, physical health factors (BMI, chronic disease), socioeconomic and lifestyle factors (education, literacy, Mandarin, marriage, income, and exercise), and psychological health factors (memory, self-care cognition, and anxiety). Related clinical and nursing applications were also discussed.
为了阐明可能有助于维持或损害认知状态的风险因素和保护因素的综合作用，这项前瞻性队列研究系统地调查了广西纵向队列（GLC）数据集中75岁及以上老年人的一系列因素。GLC在2年内对630名高龄老年人进行了两次跟踪，并将在未来4年内继续跟踪两次。在基线老年评估中，通过在线访谈记录社会人口学信息（如教育程度、普通话水平、婚姻状况和收入）、身体状况[体重指数（BMI）、慢性病/药物治疗情况]、生活方式因素（吸烟、饮酒和运动）以及自评心理健康状况（自我护理、幸福感、焦虑）。在2年的随访中，通过面对面访谈进行简易精神状态检查表（MMSE）和记忆测试。MMSE的表现用于代表应答者的认知状态，根据20分的临界值分为认知障碍组和正常组。观察到15个分层因素存在与年龄相关的认知下降趋势，尽管效应量较小（决定系数：0.001 - 0.15）。在调整其他混杂变量后，通过多变量分析发现，因素（记忆、自我护理、运动、收入、教育程度和读写能力）的暴露或未暴露几率对认知障碍有显著不同的影响。通过逐步多元逻辑回归分析，将以下12个因素/指标整合起来以预测认知障碍：性别、身体健康因素（BMI、慢性病）、社会经济和生活方式因素（教育程度、读写能力、普通话水平、婚姻状况、收入和运动）以及心理健康因素（记忆、自我护理认知和焦虑）。还讨论了相关的临床和护理应用。
