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高龄老人中与轻度认知障碍和痴呆相关的因素:基于具有全国代表性的“德国老年(80岁及以上)”研究的结果

Factors associated with mild cognitive impairment and dementia amongst the oldest old: findings based on the nationally representative "old age in Germany (D80+)" study.

作者信息

Hajek André, Gyasi Razak M, Chen Liang-Kung, Peltzer Karl, König Hans-Helmut

机构信息

Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.

African Population and Health Research Center, Nairobi, Kenya.

出版信息

Aging Clin Exp Res. 2025 Apr 2;37(1):110. doi: 10.1007/s40520-025-03022-7.

Abstract

BACKGROUND/AIMS: Particularly among the oldest old, there is restricted knowledge regarding the factors associated with mild cognitive impairment and dementia using data from large, nationally representative samples. Thus, our aim was to address this knowledge gap.

METHODS/DESIGN: We used data from the nationally representative "Old Age in Germany (D80+)" study covering community-dwelling and institutionalized individuals in the entire country (n = 2,555). Mean age was 85.5 years (SD: 4.2), ranging from 80 to 100 years (61.7% of the participants were female). The DemTect was used to measure cognitive impairment in terms of probable mild cognitive impairment and probable dementia. Sociodemographic, lifestyle-related, psychosocial and health-related independent variables were included in the multinomial regression analysis.

RESULTS

In the analytic sample, 57.8% of the individuals did not have cognitive impairment, 24.2% of the individuals had mild cognitive impairment and 18.0% had probable dementia. Regression analysis identified some sociodemographic (e.g., advanced age, being male, lower education), lifestyle-related (lower cognitive activities), psychosocial (higher loneliness and absence of meaning in life), as well as health-related (e.g., functional impairment) factors associated with probable MCI and probable dementia. Loneliness was only associated with these outcomes among women, but not men.

DISCUSSIONS

Based on large, nationally representative data, this study revealed several factors associated with probable MCI and dementia - which enhances our current understanding mainly based on small or selective samples.

CONCLUSION

Such knowledge may help to address those at risk for cognitive impairment. Longitudinal studies are required to gain further insights.

摘要

背景/目的:特别是在高龄老人中,利用来自具有全国代表性的大样本数据,关于与轻度认知障碍和痴呆相关因素的了解有限。因此,我们的目的是填补这一知识空白。

方法/设计:我们使用了具有全国代表性的“德国老年人(80岁及以上)”研究的数据,涵盖了全国范围内居住在社区和机构中的个体(n = 2555)。平均年龄为85.5岁(标准差:4.2),年龄范围从80岁到100岁(61.7%的参与者为女性)。使用德美心理认知筛查量表(DemTect)来测量可能的轻度认知障碍和可能的痴呆方面的认知损害。多项回归分析纳入了社会人口学、生活方式相关、心理社会和健康相关的自变量。

结果

在分析样本中,57.8%的个体没有认知障碍,24.2%的个体有轻度认知障碍,18.0%的个体有可能的痴呆。回归分析确定了一些与可能的轻度认知障碍和可能的痴呆相关的社会人口学因素(如高龄、男性、低教育程度)、生活方式相关因素(较低的认知活动)、心理社会因素(较高的孤独感和生活无意义感)以及健康相关因素(如功能损害)。孤独感仅在女性中与这些结果相关,而在男性中则不然。

讨论

基于具有全国代表性的大样本数据,本研究揭示了一些与可能的轻度认知障碍和痴呆相关的因素——这增强了我们目前主要基于小样本或选择性样本的理解。

结论

此类知识可能有助于识别认知障碍风险人群。需要进行纵向研究以获得进一步的见解。

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