Liu Shou, Wang Fei, Zhang Cheng, Zhang Qinge, Dang Zhan-Cui, Ng Chee H, Xiang Yu-Tao
Department of Public Health, Medical College, Qinghai University, Xining, China.
Guangdong Provincial People's Hospital, Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangzhou, China.
Front Psychiatry. 2022 Jun 23;13:871414. doi: 10.3389/fpsyt.2022.871414. eCollection 2022.
Cognitive impairment is a major health concern in older adults. Few studies have examined the association between environmental factors and cognitive impairment, especially in high altitude areas. In this study, the prevalence of cognitive impairment in older adults living in high altitude was compared with those living in low altitude areas.
This was a comparative study conducted at Qinghai (high altitude group), and Guangzhou (low altitude group), China. Cognition, depressive symptoms and quality of life (QOL) were assessed using the Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ-9) and WHO Quality of Life brief version-WHOQOL-BREF, respectively.
Altogether, 644 older adults (207 in Qinghai and 437 in Guangzhou) completed the assessment. The prevalence rate of cognitive impairment was 94.7% (95% CI: 91.6-97.7%) in older adults living in the high altitude area, while the corresponding figure was 89.2% (95% CI: 86.3-92.1%) in the low altitude area. After controlling for covariates, the high altitude group appeared more likely to have cognitive impairment (OR = 2.92, 95% CI: 1.23-6.91, = 0.015) compared with the low altitude group. Within the high altitude group sample, multinomial logistic regression analysis revealed that older age (aged 74 and above) was significantly associated with higher risk of severe cognitive impairment (OR = 3.58, 95%CI: 1.44-8.93, = 0.006), while higher education level (secondary school and above) was associated with decreased risk of moderate cognitive impairment (OR = 0.43, 95%CI: 0.22-0.85, = 0.006). Within the high altitude group, QOL did not differ significantly between normal/mild, moderate and severe cognitive impairment subgroups across physical [ = 1.83, = 0.163], psychological [ = 1.50, = 0.225], social [ = 2.22, = 0.111] and environmental domains [ = 0.49, = 0.614].
This study found that cognitive impairment was more common among older adults living in the high altitude area. Regular screening and appropriate interventions should be provided to older adults in need.
认知障碍是老年人主要的健康问题。很少有研究探讨环境因素与认知障碍之间的关联，尤其是在高海拔地区。在本研究中，比较了生活在高海拔地区的老年人与生活在低海拔地区的老年人认知障碍的患病率。
这是一项在中国青海（高海拔组）和广州（低海拔组）进行的对比研究。分别使用蒙特利尔认知评估量表（MoCA）、患者健康问卷（PHQ-9）和世界卫生组织生活质量简表（WHOQOL-BREF）对认知、抑郁症状和生活质量（QOL）进行评估。
共有644名老年人（青海207名，广州437名）完成了评估。生活在高海拔地区的老年人认知障碍患病率为94.7%（95%CI：91.6-97.7%），而低海拔地区相应的患病率为89.2%（95%CI：86.3-92.1%）。在控制协变量后，与低海拔组相比，高海拔组出现认知障碍的可能性更大（OR=2.92，95%CI：1.23-6.91，P=0.015）。在高海拔组样本中，多项逻辑回归分析显示，高龄（74岁及以上）与严重认知障碍风险较高显著相关（OR=3.58，95%CI：1.44-8.93，P=0.006），而较高教育水平（中学及以上）与中度认知障碍风险降低相关（OR=0.43，95%CI：0.22-0.85，P=0.006）。在高海拔组中，正常/轻度、中度和重度认知障碍亚组在生理领域（F=1.83，P=0.163）、心理领域（F=1.50，P=0.225）社交领域（F=2.22，P=0.111）和环境领域（F=0.49，P=0.614）的生活质量差异均无统计学意义。
本研究发现认知障碍在生活在高海拔地区的老年人中更为常见。应向有需要的老年人提供定期筛查和适当干预。
