2型糖尿病老年患者认知衰弱的相关因素：一项横断面研究

Related factors of cognitive frailty among older adults with type 2 diabetes: a cross-sectional study.

作者信息

Cheng Min, Qiao Yan, Yang Bailin, He Mei

机构信息

School of Nursing, North Sichuan Medical University, Nanchong, China.

Nursing Department of Mianyang, Central Hospital/School of Medicine Affiliated to University of Electronic Science and Technology of China, Mianyang, China.

出版信息

Psychogeriatrics. 2025 Mar;25(2):e70004. doi: 10.1111/psyg.70004.

DOI:10.1111/psyg.70004

PMID:39935280

Abstract

BACKGROUND

The correlation between diabetes and cognitive frailty is still controversial. The purpose of this study was to explore the related factors of cognitive frailty in older adults with type 2 diabetes, and to provide new ideas for realising healthy ageing of diabetic patients.

METHODS

The survey was conducted at Mianyang Central Hospital affiliated to University of Electronic Science and Technology of China from January 15 to June 30, 2024. The subjects were older adults with type 2 diabetes aged 60 years or older. Cognitive frailty was assessed using Fried's phenotype and Mini-Mental State Examination. Statistical analysis and plotting were conducted using SPSS 25.0 and R 4.3.3. Least absolute shrinkage and selection operator (LASSO) regression was used to reduce the dimensionality of 30 clinical features collected, and the unimportant factors were initially screened out. The important factors with non-zero coefficients identified by LASSO regression were included in a multivariate logistic regression analysis to explore the factors influencing cognitive frailty in older diabetic patients.

RESULTS

This study included 301 older persons with type 2 diabetes. Among them, 91 (30.2%) cases of cognitive frailty occurred. Related factors for cognitive frailty in older adults with type 2 diabetes include: age (odds ratio (OR) = 6.417, 95% CI: 1.882-21.876, P = 0.003), hypomnesia (OR = 2,985, 95%CI: 1.143-7.797, P = 0.026), depression (OR = 9.926, 95%CI: 4.117-23.934, P < 0.001), diabetic retinopathy (OR = 6.489, 95%CI: 1.969-21.384, P = 0.002), history of diabetic ketoacidosis (OR = 12.024, 95%CI: 1.724-83.872, P = 0.012).

CONCLUSION

The prevalence of cognitive frailty in older persons with type 2 diabetes mellitus was higher. It was closely related to age, hypomnesia, depression, diabetic retinopathy and history of diabetic ketoacidosis. Early detection of the risk and effective intervention can reduce the incidence of adverse events and improve the quality of life of patients.

摘要

背景

糖尿病与认知衰弱之间的相关性仍存在争议。本研究旨在探讨2型糖尿病老年患者认知衰弱的相关因素，为实现糖尿病患者健康老龄化提供新思路。

方法

于2024年1月15日至6月30日在电子科技大学附属绵阳中心医院进行此项调查。研究对象为60岁及以上的2型糖尿病老年患者。采用Fried表型和简易精神状态检查表评估认知衰弱情况。使用SPSS 25.0和R 4.3.3进行统计分析和绘图。采用最小绝对收缩和选择算子（LASSO）回归对收集的30项临床特征进行降维，初步筛选出不重要的因素。将LASSO回归确定的非零系数的重要因素纳入多因素逻辑回归分析，以探讨影响老年糖尿病患者认知衰弱的因素。

结果

本研究纳入301例2型糖尿病老年患者。其中，发生认知衰弱91例（30.2%）。2型糖尿病老年患者认知衰弱的相关因素包括：年龄（比值比（OR）=6.417，95%置信区间：1.882 - 21.876，P = 0.003）、记忆力减退（OR = 2.985，95%置信区间：1.143 - 7.797，P = 0.026）、抑郁（OR = 9.926，95%置信区间：4.117 - 23.934，P < 0.001）、糖尿病视网膜病变（OR = 6.489，95%置信区间：1.969 - 21.384，P = 0.002）、糖尿病酮症酸中毒病史（OR = 12.024，95%置信区间：1.724 - 83.872，P = 0.012）。