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慢性阻塞性肺疾病老年患者认知脆弱的流行情况及相关因素:一项横断面研究。

Prevalence of and factors associated with cognitive frailty in elderly patients with chronic obstructive pulmonary disease: A cross-sectional study.

机构信息

School of Nursing and Health, Zhengzhou University, Zhengzhou, China.

出版信息

Medicine (Baltimore). 2024 Sep 13;103(37):e39561. doi: 10.1097/MD.0000000000039561.

Abstract

The status of cognitive frailty in elderly patients with chronic obstructive pulmonary disease (COPD) and its influencing factors in China remains unclear. This study aimed to investigate the prevalence of and factors associated with cognitive frailty in elderly patients with COPD. This cross-sectional study enrolled elderly patients with stable COPD between May and November 2022 from the Respiratory Department of the First Affiliated Hospital of Zhengzhou University and the Fifth Affiliated Hospital of Zhengzhou University. Convenience sampling method was adopted. Frailty Phenotype scale, Montreal Cognitive Assessment scale, Geriatric Depression Scale, and Clinical Dementia Rating scale were used to assess the prevalence of cognitive frailty in elderly patients with COPD. Multivariable logistic regression analysis was used to explore the associated factors. A total of 406 valid questionnaires were collected, and 173 patients (35.6%) had cognitive frailty. Binary logistic regression analysis showed that sex (odds ratio [OR] = 0.009; 95%CI: 0.001-0.770; P = .038), depression (OR = 17.780; 95%CI: 1.092-289.478; P = .043), modified Medical Research Council grade 1-3 (OR = 28.394-4095.683; 95%CI: 1.086-4,592,652.211; P < .05), global initiative for chronic obstructive lung disease grade 2 and 3 (OR = 32.508-282.072; 95%CI: 1.101-12,516.874; P < .05), and frequencies of acute exacerbations of COPD and hospitalizations within 1 year of 2 times (OR = 21.907; 95%CI: 4.587-104.622; P < .001) were independently associated with cognitive frailty. The prevalence of cognitive frailty in elderly patients with stable COPD was high. Female, depression, modified Medical Research Council grade, global initiative for chronic obstructive lung disease grade, and frequencies of acute exacerbations of COPD and hospitalizations within 1 year might be the factors independently associated with cognitive frailty, educational level might be a protective associated factor for cognitive frailty.

摘要

在中国,慢性阻塞性肺疾病(COPD)老年患者的认知脆弱状态及其影响因素尚不清楚。本研究旨在探讨老年 COPD 患者认知脆弱的患病率及其相关因素。

这项横断面研究于 2022 年 5 月至 11 月期间,采用便利抽样法,从郑州大学第一附属医院和郑州大学第五附属医院的呼吸科招募了稳定期 COPD 的老年患者。使用脆弱表型量表、蒙特利尔认知评估量表、老年抑郁量表和临床痴呆评定量表评估老年 COPD 患者认知脆弱的患病率。采用多变量逻辑回归分析探讨相关因素。共收集了 406 份有效问卷,其中 173 名患者(35.6%)存在认知脆弱。二项逻辑回归分析显示,性别(比值比[OR] = 0.009;95%CI:0.001-0.770;P = .038)、抑郁(OR = 17.780;95%CI:1.092-289.478;P = .043)、改良医学研究理事会分级 1-3 级(OR = 28.394-4095.683;95%CI:1.086-4,592,652.211;P < .05)、全球慢性阻塞性肺疾病倡议 2 级和 3 级(OR = 32.508-282.072;95%CI:1.101-12,516.874;P < .05)和 COPD 急性加重次数及 1 年内住院次数 2 次(OR = 21.907;95%CI:4.587-104.622;P < .001)与认知脆弱独立相关。稳定期 COPD 老年患者认知脆弱的患病率较高。女性、抑郁、改良医学研究理事会分级、全球慢性阻塞性肺疾病倡议分级、COPD 急性加重次数和 1 年内住院次数可能是认知脆弱的独立相关因素,教育水平可能是认知脆弱的保护性相关因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fda/11404930/4dfae7c889e3/medi-103-e39561-g001.jpg

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