老年卒中幸存者认知障碍的患病率及其影响因素:一项横断面研究。

Prevalence and factors influencing cognitive impairment among the older adult stroke survivors: a cross-sectional study.

机构信息

School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan, China.

Nipissing University, Toronto, ON, Canada.

出版信息

Front Public Health. 2023 Sep 15;11:1254126. doi: 10.3389/fpubh.2023.1254126. eCollection 2023.

Abstract

BACKGROUND

Cognitive impairment as a complication in post-stroke patients has high prevalence throughout the world. However, few studies have focused on the older adult stroke survivors and explored their prevalence and factors of post-stroke cognitive impairment (PSCI). The study aims to evaluate the cognitive status of stroke patients in Hunan Province, China and to determine the potential risk factors associated with PSCI in order to identify the older adult population in advance and promote healthy aging.

METHODS

This cross-sectional study was carried out from August to December, 2021. A total of 520 stroke survivors from 6 tertiary hospitals were randomly selected. The information was collected using the general questionnaire, the Barthel Index Rating Scale and the Mini-mental State Examination (MMSE). Analysis was based on descriptive statistics, chi-square test and the significant variables were included in multivariate logistic regression. The reporting of this cross-sectional study followed the STROBE checklist.

RESULTS

A total of 195 older adults (40.37%) were screened for cognitive impairment based on the results of the MMSE score. Patients in the PSCI group had a higher proportion of individuals aged 70 or older (35.90% vs. 24.65%, <0.001). The potential risk factors for post-stroke cognitive impairment in older adults were being aged between 70 and 79 years old (OR = 3.973, 95% CI, 2.346-6.729, <0.001), being aged 80 years or older (OR = 3.590, 95% CI, 1.373-9.387,  = 0.009), having a low level of education (OR = 9.183, 95% CI, 5.341-15.789, <0.001), having hypertension (OR = 1.756, 95% CI, 1.121-2.753,  = 0.014), and having a dominant hemisphere lesion (OR = 1.880, 95% CI, 1.193-2.962, <0.001).

CONCLUSION

The prevalence of PSCI was high among Chinese older adults, particularly those aged 80 years or older. The factors identified in our study could assist in the early identification of older adults at risk, develop personalized management plans, and promote healthy aging.

摘要

背景

认知障碍作为脑卒中患者的一种并发症,在全球范围内的患病率很高。然而,很少有研究关注老年脑卒中幸存者,并探讨其脑卒中后认知障碍(PSCI)的患病率和相关因素。本研究旨在评估中国湖南省脑卒中患者的认知状况,并确定与 PSCI 相关的潜在危险因素,以便提前识别老年人群,并促进健康老龄化。

方法

本横断面研究于 2021 年 8 月至 12 月进行,从 6 家三级医院随机抽取 520 名脑卒中幸存者。使用一般问卷、Barthel 指数评定量表和简易精神状态检查(MMSE)收集信息。分析基于描述性统计、卡方检验,将有统计学意义的变量纳入多变量逻辑回归。本横断面研究的报告遵循 STROBE 清单。

结果

根据 MMSE 评分结果,共有 195 名老年人(40.37%)被筛查为认知障碍。PSCI 组中年龄在 70 岁及以上的患者比例更高(35.90%比 24.65%,<0.001)。老年人发生脑卒中后认知障碍的潜在危险因素为年龄在 70 岁至 79 岁之间(OR=3.973,95%CI,2.346-6.729,<0.001)、年龄在 80 岁或以上(OR=3.590,95%CI,1.373-9.387,<0.001)、文化程度低(OR=9.183,95%CI,5.341-15.789,<0.001)、高血压(OR=1.756,95%CI,1.121-2.753,<0.001)和优势半球病变(OR=1.880,95%CI,1.193-2.962,<0.001)。

结论

中国老年人 PSCI 的患病率较高,尤其是 80 岁及以上的老年人。本研究确定的因素有助于早期识别高危老年人,制定个性化的管理计划,并促进健康老龄化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa00/10542404/d0a9f4a480bf/fpubh-11-1254126-g001.jpg

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