多重疾病在中国上海老年人疑似痴呆中的作用：一项基于社区的横断面研究。
The role of multimorbidity in suspected dementia among elderly in Shanghai, China: a community-based cross-sectional study.
作者信息
Zhu Tingting, Wang Changying, Zhang Yunwei, Wang Xiaqing, Niu Yuhong
机构信息
Shanghai Health Development Research Center (Shanghai Medical Information Center), Research Management Affairs Department, Shanghai, China.
出版信息
Front Psychiatry. 2025 Jul 17;16:1596281. doi: 10.3389/fpsyt.2025.1596281. eCollection 2025.
INTRODUCTION
Many studies have shown some chronic diseases are one of the key risk factors for accelerating cognitive decline. and multimorbidity are common in the elderly population. The evidence of the impact of multimorbidity on dementia among elderly people in China is scarce in detail. This study was performed to examine the association between the prevalence of suspected dementia and multimorbidity, as well as pattern of multimorbidity among the elderly in Shanghai.
METHODS
This was a cross-sectional study, with 5040 elderly individuals from 21 communities enrolled. The prevalence of suspected dementia was assessed using the Mini-Mental State Examination (MMSE). In addition, the diagnosed chronic diseases including hypertension, diabetes, hyperlipidemia and coronary heart disease (CHD) were investigated such that multimorbidity was defined as individuals suffering from two or more chronic diseases at the same time. Binary logistic regression models were utilized to analyze the impact of multimorbidity and its patterns on suspected dementia.
RESULTS
Data of 4945 older adults were analyzed. The overall prevalence of suspected dementia and multimorbidity were 15.73% and 35.98%. The influencing factors of dementia from the perspective of single disease, including diabetes, hyperlipidemia, abnormal control of blood glucose and abnormal control of blood lipid. Multivariate analysis showed multimorbidity (OR=1.491, 95%: 1.260-1.765) was significantly negatively associated with dementia, and the risk of dementia in elderly individuals with 2, 3 or more chronic diseases was 1.283 (95%: 1.058-1.555) and 2.034 (95%: 1.600-2.586) times greater, respectively, than those who with no multimorbidity. Notably, elderly individuals with both diabetes and hyperlipidemia had the highest risk of dementia (OR=3.253, 95%: 1.705-6.207).
CONCLUSION
Multimorbidity played a negative role in dementia among elderly people, dementia risk increases with the number of comorbidities, and the combination of diabetes and hyperlipidemia accentuates dementia risk at a greater level.
引言
许多研究表明，一些慢性疾病是加速认知衰退的关键风险因素之一，且多种疾病并存的情况在老年人群中很常见。在中国，关于多种疾病并存对老年人痴呆症影响的详细证据很少。本研究旨在探讨上海老年人疑似痴呆症患病率与多种疾病并存之间的关联，以及多种疾病并存的模式。
方法
这是一项横断面研究，纳入了来自21个社区的5040名老年人。使用简易精神状态检查表（MMSE）评估疑似痴呆症的患病率。此外，对已诊断的慢性疾病进行调查，包括高血压、糖尿病、高脂血症和冠心病（CHD），多种疾病并存定义为同时患有两种或更多种慢性疾病的个体。采用二元逻辑回归模型分析多种疾病并存及其模式对疑似痴呆症的影响。
结果
对4945名老年人的数据进行了分析。疑似痴呆症和多种疾病并存的总体患病率分别为15.73%和35.98%。从单一疾病角度来看，痴呆症的影响因素包括糖尿病、高脂血症、血糖控制异常和血脂控制异常。多变量分析显示，多种疾病并存（比值比=1.491，95%置信区间：1.260-1.765）与痴呆症显著负相关，患有2种、3种或更多种慢性疾病的老年人患痴呆症的风险分别是无多种疾病并存者的1.283倍（95%置信区间：1.058-1.555）和2.034倍（95%置信区间：1.600-2.586）。值得注意的是，同时患有糖尿病和高脂血症的老年人患痴呆症的风险最高（比值比=3.253，95%置信区间：1.705-6.207）。
结论
多种疾病并存对老年人痴呆症起负面作用，痴呆症风险随合并症数量增加而升高，糖尿病和高脂血症并存会在更大程度上加剧痴呆症风险。
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