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维持性血液透析老年患者认知衰弱的患病率及影响因素:一项多中心横断面研究

Prevalence and Influence Factors of Cognitive Frailty in the Older Adult Patients Undergoing Maintenance Haemodialysis: A Multi-Centre Cross-Sectional Study.

作者信息

Li Siyu, Huang Li, Wang Wenmian, Zeng Jing

机构信息

School of Nursing, Chengdu Medical College, Chengdu, China.

出版信息

J Clin Nurs. 2025 Sep;34(9):3693-3703. doi: 10.1111/jocn.17527. Epub 2024 Nov 5.

Abstract

AIMS

To examine the prevalence of factors of cognitive frailty in patients undergoing maintenance haemodialysis (MHD).

DESIGN

A cross-sectional study.

METHODS

From September 2023 to January 2024, 1023 patients undergoing MHD were recruited from 11 hospitals in Chengdu, China, using convenience sampling. The participants' sociodemographic and lifestyle factors, health information and laboratory indicators were assessed using a general information questionnaire. Cognitive frailty was assessed using the Fried Frailty Phenotype and Montreal Cognitive Assessment Scales. Multivariate logistic regression was used to examine the associations between cognitive frailty and sociodemographic and clinical characteristics. Independent variables for the multivariate logistic regression model encompassing age, sex, educational level, marital status, visual impairment, hearing impairment, falls within a year, depression, weight, height, Malnutrition-inflammation score and serum albumin, sodium, phosphorus, total cholesterol and creatinine levels.

RESULTS

Among 1023 participants with a mean age of 69.52 years, 300 (29.3%) had cognitive frailty, with a predominance of older patients. Regression analysis showed that advanced age, low literacy and low serum creatinine, sodium and total cholesterol levels were positively correlated with cognitive frailty. Furthermore, 17.1% of the participants experienced depression, a risk factor for cognitive frailty, and malnutrition was an independent risk factor for cognitive frailty.

CONCLUSION

Older adult patients undergoing (MHD) are at an increased risk of developing cognitive frailty. The aetiology of cognitive frailty in this cohort was multifactorial. Targeted interventions should be designed and implemented based on these factors, prioritising nutritional guidance and mood management to prevent or reverse cognitive frailty.

REPORTING METHOD

The study adhered to the STROBE checklist.

IMPACT

Older adult patients undergoing MHD are at increased risk of developing cognitive frailty. Cognitive frailty screening must be incorporated into the routine assessment of older patients undergoing MHD.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

探讨维持性血液透析(MHD)患者认知衰弱因素的患病率。

设计

一项横断面研究。

方法

2023年9月至2024年1月,采用便利抽样法从中国成都11家医院招募了1023例接受MHD的患者。使用一般信息问卷评估参与者的社会人口学和生活方式因素、健康信息及实验室指标。采用Fried衰弱表型和蒙特利尔认知评估量表评估认知衰弱。多因素logistic回归用于检验认知衰弱与社会人口学及临床特征之间的关联。多因素logistic回归模型的自变量包括年龄、性别、教育程度、婚姻状况、视力障碍、听力障碍、一年内跌倒情况、抑郁、体重、身高、营养不良-炎症评分以及血清白蛋白、钠、磷、总胆固醇和肌酐水平。

结果

在1023名平均年龄为69.52岁的参与者中,300名(29.3%)存在认知衰弱,老年患者居多。回归分析显示,高龄、低文化程度以及低血清肌酐、钠和总胆固醇水平与认知衰弱呈正相关。此外,17.1%的参与者存在抑郁,这是认知衰弱的一个危险因素,且营养不良是认知衰弱的独立危险因素。

结论

接受MHD的老年患者发生认知衰弱的风险增加。该队列中认知衰弱的病因是多因素的。应基于这些因素设计并实施有针对性的干预措施,优先进行营养指导和情绪管理,以预防或逆转认知衰弱。

报告方法

本研究遵循STROBE清单。

影响

接受MHD的老年患者发生认知衰弱的风险增加。认知衰弱筛查必须纳入接受MHD老年患者的常规评估中。

患者或公众贡献

无患者或公众参与。

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