杭州市社区老年2型糖尿病患者认知衰弱相关因素分析

李修英; 杨湘英; 吴清清; 孔利萍; 朱群英

doi:10.16766/j.cnki.issn.1674-4152.002331

杭州市社区老年2型糖尿病患者认知衰弱相关因素分析

doi: 10.16766/j.cnki.issn.1674-4152.002331

1.
浙江大学医学院附属杭州市第一人民医院内分泌科，浙江杭州 310006
2.
杭州市拱墅区长庆潮鸣社区服务中心，浙江杭州 310003

基金项目:

浙江省医药卫生科技计划项目 2019KY491

2020—2024年杭州市医学重点学科建设项目杭卫发[2021]21号

详细信息

通讯作者:
杨湘英，E-mail：yangxiangying007@163.com

中图分类号: R197.61 R587.1
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出版历程
- 收稿日期: 2021-07-29
- 网络出版日期: 2022-03-04

Analysis of related factors of cognitive decline in elderly patients with type 2 diabetes in Hangzhou community

1.
Department of Endocrinology, Hangzhou First People's Hospital Affiliated to Medical College of Zhejiang University, Hangzhou, Zhejiang 310006, China

摘要

摘要: 目的了解杭州市社区老年2型糖尿病患者认知衰弱的患病现状并分析其相关因素，以期为老年糖尿病患者认知衰弱的预防和干预提供参考。方法采取便利抽样法选取2020年8—12月杭州市3个社区的252例老年2型糖尿病患者(≥60岁)为研究对象，采用一般资料调查表、衰弱(FRAIL)量表、简易精神状态检查量表(MMSE)、简版老年抑郁量表(GDS-15)、微型营养评定法简版(MNA-SF)进行调查，采用单因素及多因素logistic回归模型分析老年2型糖尿病患者认知衰弱相关影响因素。结果 252例老年2型糖尿病患者中，认知衰弱者22例，占8.73%，单因素分析显示，年龄、家庭人均月收入、居住方式、文化程度、婚姻状况、有无规律运动、每晚睡眠时长、听力障碍、合并慢性种类、营养状况、是否存在抑郁与老年糖尿病患者认知衰弱存在关联(均P＜0.05)。Logistic回归分析显示，文化程度(高中：OR=0.191；大专及以上：OR=0.287)、规律运动(OR=0.325)、营养不良(OR=4.081)、抑郁(OR=2.754)是老年2型糖尿病患者认知衰弱的影响因素(均P＜0.05)。结论社区老年2型糖尿病患者认知衰弱发生率较高，医护工作者应加强关注文化水平低、无运动习惯、营养缺失及存在抑郁症状的老年糖尿病患者认知衰弱筛查和干预。
- 老年 /
- 2型糖尿病 /
- 认知衰弱 /
- 影响因素
Abstract: Objective To understand the prevalence of cognitive decline in elderly patients with type 2 diabetes in Hangzhou community and analyze the related factors in order to provide reference for prevention and intervention of cognitive decline in elderly diabetic patients. Methods From August to December 2020, 252 elderly patients with type 2 diabetes mellitus (over 60 years old) in 3 communities in Hangzhou were selected by convenience sampling method. The general data inventory, the fatigue, resistance, ambulation, illness, and loss of weight scale (FRAIL scale), mini mental state examination scale (MMSE), simplified version of the Depression Scale (GDS-15) and mini nutritional assessment (MNA-SF) were used for the investigation. Univariate and multivariate logistic regression models were used to analyze the related factors of cognitive decline in elderly patients with type 2 diabetes. Results Among the 252 elderly patients with type 2 diabetes, there were 22 cases of cognitive impairment, accounting for 8.73%. Univariate analysis showed that age, family income per month, living style, educational level, marital status, regular exercise, sleep duration, hearing impairment, combined chronic type, nutritional status, and depression were associated with cognitive decline in elderly diabetic patients (P < 0.05). Logistic regression analysis showed that education level (high school: OR=0.191; college and above: OR=0.287), regular exercise (OR=0.325), malnutrition (OR=4.081) and depression (OR=2.754) were the influencing factors of cognitive decline in elderly patients with type 2 diabetes (P < 0.05). Conclusion The incidence of cognitive decline in elderly patients with type 2 diabetes mellitus is relatively high. Health care workers should pay close attention to the screening and intervention of cognitive decline in elderly diabetic patients with low cultural level, no exercise habits, lack of nutrition and depressive symptoms.
- Elderly /
- Type 2 diabetes /
- Cognitive decline /
- Influencing factors

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表 1 老年糖尿病患者认知衰弱单因素分析结果[例(%)]

项目	类别	非认知衰弱(n=230)	认知衰弱(n=22)	统计量	P值
性别	男性	132(57.4)	16(72.7)	1.948^a	0.163
	女性	98(42.6)	6(27.3)
年龄(岁)	60~69	169(73.5)	10(45.5)	7.784^b	0.029
	70~79	43(18.7)	8(36.4)
	≥80	18(7.8)	4(18.1)
家庭人均月收入(元)	＜2 000	42(18.3)	10(45.5)	7.156^b	0.033
	≥2 000~≤4 000	150(65.2)	9(40.9)
	＞4 000	38(16.5)	3(13.6)
居住方式	非独居	202(87.8)	15(68.2)	6.479^a	0.011
	独居	28(12.2)	7(31.8)
文化程度	初中及以下	94(40.9)	17(77.3)	11.182^b	＜0.001
	高中	80(34.8)	4(18.2)
	大专及以上	56(24.3)	1(4.5)
婚姻状况	在婚	198(86.1)	15(68.2)	4.921^a	0.030
	丧偶或其他	32(13.9)	7(31.8)
病程(年)	≤10	132(57.4)	9(40.9)	2.213^a	0.159
	＞10	98(42.6)	13(59.1)
规律运动	否	89(38.7)	19(86.4)	18.418^a	＜0.001
	是	141(61.3)	3(13.6)
每晚睡眠时长(h)	＜5	27(11.7)	7(31.8)	6.548^b	0.040
	5~8	125(54.4)	11(50.0)
	＞8	78(33.9)	4(18.2)
饮酒	无	174(75.7)	13(59.1)	2.632^a	0.149
	有	56(24.3)	9(40.9)
吸烟	无	128(55.7)	10(45.5)	0.843^a	0.361
	有	102(44.3)	12(54.5)
糖化血红蛋白(%)	＜7.0	78(33.9)	6(27.2)	2.601^b	0.155
	7.0~8.4	103(44.8)	8(36.4)
	≥8.5	49(21.3)	8(36.4)
听力障碍	无	213(92.6)	16(72.7)	9.373^a	0.005
	有	17(7.4)	6(27.3)
合并慢性种类	＜2	141(61.3)	8(36.4)	5.169^a	0.026
	≥2	89(38.7)	14(63.6)
营养不良	否	188(81.7)	7(31.8)	28.589^a	＜0.001
	是	42(18.3)	15(68.2)
抑郁状况	否	212(92.2)	13(59.1)	19.307^a	＜0.001
	是	18(7.8)	9(40.9)
注：^a为χ²值，^b为Z值。

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表 2 Logistic回归分析自变量赋值表

变量	赋值方法
年龄(岁)	60~69=1，70~79=2，≥80=3
个人月收入(元)	＜2 000=1，≥2 000~≤4 000=2，＞4 000=3
文化程度	初中及以下=1，高中=2，大专及以上=3
居住方式	非独居=0，独居=1
婚姻状况	在婚=0，丧偶或其他=1
规律运动	否=0，是(每周4次，每次＞1 h)=1
夜间睡眠时长(h)	＜5=1, 5~8=2, ＞8=3
听力障碍	否=0，是=1
合并慢性种类	＜2=0，≥2=1
营养不良	否=0，是=1
抑郁	否=0，是=1

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表 3 认知衰弱logistic回归分析

变量	B	SE	Wald χ²	P值	OR值	95% CI
文化程度(以初中及以下为参照)
高中	-1.655	0.769	4.631	0.018	0.191	0.054~0.763
大专及以上	-1.248	0.541	5.322	0.013	0.287	0.071~0.822
规律运动	-1.124	0.449	6.267	0.005	0.325	0.102~0.801
营养不良	1.406	0.581	5.856	0.008	4.081	1.517~9.205
抑郁	1.013	0.422	5.762	0.009	2.754	1.055~7.410

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