影响养老院居民正常衰老认知能力下降发展为痴呆的因素。
Factors influencing the deterioration from cognitive decline of normal aging to dementia among nursing home residents.
机构信息
Adult health-nursing department, Faculty of Nursing, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan.
Department of Physiotherapy, School of Rehabilitation Sciences, University of Jordan, Amman, Jordan.
出版信息
BMC Geriatr. 2020 Nov 18;20(1):479. doi: 10.1186/s12877-020-01875-3.
BACKGROUND
A dearth of differential research exists regarding the determinants of mild cognitive impairment (MCI) and moderate cognitive impairment or dementia among nursing home residents. This study aimed to identify and examine the association between medical factors (number of comorbidities, hospitalization, disability, depression, frailty and quality of life) and moderate cognitive impairment or dementia in nursing homes residents.
METHODS
A cross-sectional design was used in this study. Convenience sampling of 182 participants was conducted in nursing homes located in the central part of Jordan. Montreal cognitive assessment (MoCA) was used to screen both MCI and moderate cognitive impairment or dementia. Bivariate analysis, including t-test and ANOVA test, and logistic and linear regression models were used to examine and identify the medical factors associated with moderate cognitive impairment or dementia compared to mild cognitive impairment.
RESULTS
Most nursing home residents had MCI (87.4%) compared to a few with moderate cognitive impairment or dementia. Age (t = - 2.773), number of comorbidities (t = - 4.045), depression (t = - 4.809), frailty (t = - 4.038), and quality of life physical (t = 3.282) and mental component summaries (t = 2.469) were significantly different between the stages of cognitive impairment. Marital status (t = - 4.050, p < 0.001), higher-income (t = 3.755, p < 0.001), recent hospitalization (t = 2.622,p = 0.01), depression (t = - 2.737, p = 0.007), and frailty (t = 2.852, p = 0.005) were significantly associated with mental ability scores among nursing home residents.
CONCLUSION
The coexistence of comorbidities and depression among nursing home residents with MCI necessitates prompt management by healthcare providers to combat depressive symptoms in order to delay the dementia trajectory among at-risk residents.
TRAIL REGISTRATION
ClinicalTrials.gov NCT04589637 , October 15,2020, Retrospectively registered.
背景
在养老院居民中，关于轻度认知障碍（MCI）和中度认知障碍或痴呆的决定因素，研究还很少。本研究旨在确定并检查医疗因素（共病数量、住院、残疾、抑郁、虚弱和生活质量）与养老院居民中度认知障碍或痴呆之间的关系。
方法
本研究采用横断面设计。在约旦中部的养老院进行了方便抽样，共纳入 182 名参与者。使用蒙特利尔认知评估（MoCA）筛查 MCI 和中度认知障碍或痴呆。采用 t 检验、方差分析、logistic 和线性回归模型进行单变量分析，以检查和确定与轻度认知障碍相比与中度认知障碍或痴呆相关的医疗因素。
结果
大多数养老院居民患有 MCI（87.4%），而只有少数患有中度认知障碍或痴呆。年龄（t=-2.773）、共病数量（t=-4.045）、抑郁（t=-4.809）、虚弱（t=-4.038）以及生活质量的身体（t=3.282）和精神成分综合评分（t=2.469）在认知障碍的不同阶段存在显著差异。婚姻状况（t=-4.050，p<0.001）、高收入（t=3.755，p<0.001）、近期住院（t=2.622，p=0.01）、抑郁（t=-2.737，p=0.007）和虚弱（t=2.852，p=0.005）与养老院居民的精神能力评分显著相关。
结论
MCI 养老院居民共病和抑郁的共存需要医疗保健提供者及时管理，以治疗抑郁症状，从而延缓高危居民的痴呆进程。
试验注册
ClinicalTrials.gov NCT04589637，2020 年 10 月 15 日，回顾性注册。
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