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心血管疾病患者认知衰弱的患病率及危险因素:一项基于医院的横断面研究。

Prevalence and risk factors of cognitive frailty in patients with cardiovascular disease: A hospital-based cross-sectional study.

作者信息

Guo Jinhua, Zhang Yi, Yang Yi, Lin Lixia, Shen Tiemei

机构信息

Department of Cardiovascular Disease Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences) Southern Medical University, Guangzhou, China.

出版信息

Medicine (Baltimore). 2024 Dec 6;103(49):e40761. doi: 10.1097/MD.0000000000040761.

Abstract

The prevalence of the cognitive frailty is increasing in China. Screening for this condition is crucial for its early detection, prevention, and treatment. This study was designed to explore the incidence of cognitive frailty among hospitalized elderly patients suffering from cardiovascular disease. It also aimed to analyze the factors influencing its occurrence, thereby providing substantial evidence for the development of early prevention and intervention strategies. From March 2022 to October 2023, under cardiovascular care program, the cardiovascular patients (n = 1190) were subjected to standardized questionnaires to collect demographical characteristics. Also, nutritional and psychosocial assessments tests were performed for the enrolled patients. Multivariate logistic regression analysis was used to evaluate factors associated with cognitive frailty. A total of 1190 (755 males and 435 females) were included. The mean age was 73.36 ± 7.37 years. The prevalence of cognitive frailty in the study population was 33.9% (404/1190). The prevalence of cognitive frailty was 40.7% in men, 22.3% in women. In terms of specific cardiovascular diseases, the prevalence of cognitive frailty was 28.5% in coronary heart disease, 20.5% in arrhythmia, 36.8% in valvular disease, 53% in heart failure, and 13.7% in hypertension. The multivariable analysis showed that age (OR = 1.13, 95% CI: 1.10-1.15, P < .001), anxiety (OR = 1.01, 95% CI: 1.03-1.11, P = .001), female sex (OR = 1.83, 95% CI: 1.10-1.16, P < .001), education level (college and above, OR = 0.27, OR = 0.12-0.64, P = .003), polypharmacy (OR = 2.29, 95% CI: 1.62-3.23, P < .001), comorbidity (OR = 1.93 95% CI: 1.37-2.71, P < .010), region (rural, OR = 1.77, 95% CI: 1.36-2.30, P < .001), sarcopenia (OR = 1.60, 95% CI: 1.16-2.19, P = .004), and nutritional status (risk of malnutrition, OR = 1.66, 95% CI: 1.17-2.35, P = .004; malnutrition exists, OR = 3.24, 95% CI: 1.85-5.83, P < .001) were independently associated with cognitive frailty. The prevalence of cognitive frailty was 33.9% in hospitalized elderly cardiovascular patients in Guangzhou. heart failure, hypertension, age, anxiety, female sex, education level, polypharmacy, comorbidity, region, sarcopenia, and nutritional status were independent risk factors for cognitive frailty.

摘要

认知衰弱在中国的患病率正在上升。筛查这种情况对于其早期发现、预防和治疗至关重要。本研究旨在探讨住院心血管疾病老年患者中认知衰弱的发生率。它还旨在分析影响其发生的因素,从而为制定早期预防和干预策略提供有力证据。2022年3月至2023年10月,在心血管护理项目下,对心血管疾病患者(n = 1190)进行标准化问卷调查以收集人口统计学特征。此外,对纳入的患者进行营养和心理社会评估测试。采用多因素逻辑回归分析来评估与认知衰弱相关的因素。共纳入1190例(755例男性和435例女性)。平均年龄为73.36±7.37岁。研究人群中认知衰弱的患病率为33.9%(404/1190)。男性认知衰弱的患病率为40.7%,女性为22.3%。就特定心血管疾病而言,冠心病中认知衰弱的患病率为28.5%,心律失常为20.5%,瓣膜病为36.8%,心力衰竭为53%,高血压为13.7%。多变量分析显示,年龄(OR = 1.13,95%CI:1.10 - 1.15,P <.001)、焦虑(OR = 1.01,95%CI:1.03 - 1.11,P =.001)、女性性别(OR = 1.83,95%CI:1.10 - 1.16,P <.001)、教育水平(大专及以上,OR = 0.27,OR = 0.12 - 0.64,P =.003)、多重用药(OR = 2.29,95%CI:1.62 - 3.23,P <.001)、合并症(OR = 1.93,95%CI:1.37 - 2.71,P <.010)、地区(农村,OR = 1.77,95%CI:1.36 - 2.30,P <.001)、肌肉减少症(OR = 1.60,95%CI:1.16 - 2.19,P =.004)和营养状况(营养不良风险,OR = 1.66,95%CI:1.17 - 2.35,P =.004;存在营养不良,OR = 3.24,95%CI:1.85 - 5.83,P <.001)与认知衰弱独立相关。广州住院老年心血管疾病患者中认知衰弱的患病率为33.9%。心力衰竭、高血压、年龄、焦虑、女性性别、教育水平、多重用药、合并症、地区、肌肉减少症和营养状况是认知衰弱的独立危险因素。

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