老年住院患者衰弱综合征与认知功能障碍和抑郁的相关性分析

胡寅田; 胡希文

doi:10.16766/j.cnki.issn.1674-4152.002734

老年住院患者衰弱综合征与认知功能障碍和抑郁的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.002734

胡寅田^,,
胡希文

杭州市第七人民医院浙江大学医学院精神卫生中心精神科，浙江杭州 310013

基金项目:

浙江省医药卫生科技计划项目 2020KY747

详细信息

通讯作者:
胡寅田, E-mail: polibomi@163.com

中图分类号: R749.16
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- 文章访问数: 147
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- 被引次数: 0
出版历程
- 收稿日期: 2021-10-14
- 网络出版日期: 2022-12-30

Correlation analysis of frailty syndrome with cognitive dysfunction and depression among elderly inpatients

HU Yin-tian^,,
HU Xi-wen

Psychiatry Department, Mental Health Center Zhejiang University School of Medicine, Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang 310013, China

摘要

摘要: 目的探讨老年住院患者衰弱综合征与认知功能障碍及抑郁的相关性。方法选取2019年2月—2020年2月在杭州市第七人民医院治疗的老年患者178例，根据Fried衰弱评估量表将患者分为非衰弱组(42例)、衰弱前期组(64例)和衰弱组(72例)。比较3组患者的一般临床资料，分析衰弱与认知功能障碍和抑郁的相关性，并探讨影响衰弱的危险因素。结果 3组患者性别、年龄、慢性疾病数量、IL-6、CRP、ALB等方面比较差异有统计学意义(均P＜0.05)；衰弱组认知功能障碍和抑郁发生率[43(59.72%)、31(43.06%)]明显高于非衰弱组[3(7.14%)、1(2.38%)]和衰弱前期组[21(32.81%)、15(23.43%)]，均P＜0.017，而衰弱前期组明显高于非衰弱组(均P＜0.017)；衰弱严重程度与认知功能和抑郁发生率呈正相关关系(r=0.138，P=0.017；r=0.163，P=0.004)；Logistic回归分析显示，年龄、慢性疾病数量、认知功能障碍、抑郁是老年患者衰弱发生的独立影响因素。结论老年住院衰弱综合征患者的衰弱程度与认知功能障碍、抑郁呈正相关关系；高龄、认知功能障碍、抑郁、慢性疾病数量多是影响老年衰弱综合征的独立危险因素。
- 衰弱综合征 /
- 认知功能障碍 /
- 抑郁 /
- 老年住院患者
Abstract: Objective To investigate the correlation between frailty syndrome and cognitive dysfunction and depression in elderly inpatients. Methods A total of 178 cases of hospitalised elderly inpatients were selected in Hangzhou Seventh People's Hospital from February 2019 to February 2020. Based on the Fried scale, the inpatients were divided into non-frailty group (42 cases), pre-frailty group (72 cases) and frailty group (64 cases). The general clinical data of the three groups were compared to analyse the correlation between frailty and cognitive dysfunction and depression as well as to explore the risk factors affecting frailty. Results There was statistical significance found in gender, age, number of chronic diseases, IL-6, CRP and ALB among the three groups (all P < 0.05). The incidence of cognitive dysfunction and depression in the frailty group [43 (59.72%), 31 (43.06%)] was significantly higher than that in the non-frailty group [3 (7.14%), 1 (2.38%)] and the pre-frailty group [21 (32.81%), 15 (23.43%)], all P < 0.017, and the pre-frailty group was significantly higher than that in the non-frailty group (all P < 0.017). Meanwhile, the severity of frailty were significantly positively correlated with cognitive function and the incidence of depression (r=0.138, P=0.017; r=0.163, P=0.004), respectively. Logistic regression analysis showed that age, number of chronic diseases, cognitive dysfunction and depression were independent risk factors for frailty in elderly inpatients. Conclusion The frailty degree of elderly inpatient frailty syndrome is positively correlated with cognitive dysfunction and depression. Therefore, old age, cognitive dysfunction, depression and several chronic diseases are independent risk factors for elderly frailty syndrome.
- Frailty syndrome /
- Cognitive dysfunction /
- Depression /
- Elderly inpatients

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表 1 3组老年患者临床资料比较

Table 1. Comparison of clinical data of the three groups of elderly patients

组别	例数	性别[例(%)]		年龄[例(%)]			慢性疾病数量[例(%)]
组别	例数	男性	女性	65~70岁	71~75岁	76~85岁	0~1种	2~3种	≥4种
非衰弱组	42	25(59.52)	17(40.48)	23(54.76)	11(26.19)	8(19.05)	13(30.95)	22(52.38)	7(16.67)
衰弱前期组	64	37(57.81)	27(42.19)	26(40.62)	18(28.13)	20(31.25)	11(17.19)	31(48.43)	22(34.38)
衰弱组	72	31(43.06)	41(56.94)	14(19.44)	21(29.17)	37(51.39)	8(11.12)	32(44.44)	32(44.44)
统计量		8.124^a		12.001^b			9.335^b
P值		0.034		＜0.001			0.019

组别	例数	文化程度[例(%)]		BMI	IL-6 (x±s, pg/mL)	CRP (x±s, mg/L)	Hb (x±s, g/L)	ALB (x±s, g/L)
组别	例数	初中及以下	高中及以上	BMI	IL-6 (x±s, pg/mL)	CRP (x±s, mg/L)	Hb (x±s, g/L)	ALB (x±s, g/L)
非衰弱组	42	12(28.57)	30(71.43)	22.31±2.45	4.86±0.26	8.98±0.53	119.18±8.26	39.63±3.72
衰弱前期组	64	19(29.69)	45(70.31)	22.87±2.68	5.23±0.25	9.63±0.45	118.95±8.73	38.58±3.82
衰弱组	72	23(31.94)	49(68.06)	22.96±2.97	6.25±0.87	10.30±0.83	119.65±8.69	37.18±3.91
统计量		1.032^a		0.801^c	89.492^c	58.835^c	0.116^c	5.761^c
P值		0.475		0.451	＜0.001	＜0.001	0.891	0.004

组别	例数	WBC (x±s, ×10⁹/L)		TG (x±s, mmol/L)	TC (x±s, mmol/L)	LDL-C (x±s, mmol/L)	HDL-C (x±s, mmol/L)	FPG (x±s, mmol/L)
非衰弱组	42	6.16±0.68		1.93±0.52	3.62±0.25	2.85±0.28	1.78±0.23	6.23±0.12
衰弱前期组	64	6.18±0.73		1.85±0.43	3.65±0.23	2.71±0.41	1.73±0.16	6.19±0.25
衰弱组	72	6.35±0.85		1.96±0.72	3.71±0.21	2.87±0.63	1.68±0.52	6.28±0.57
统计量		1.315^c		1.668^c	2.369^c	2.012^c	1.037^c	0.876^c
P值		0.406		0.096	0.097	0.137	0.357	0.418
注：^a为χ²值，^b为H值, ^c为F值。

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表 2 3组老年患者认知功能障碍、抑郁发生情况比较[例(%)]

Table 2. Comparison of the incidence of cognitive dysfunction and depression among the three groups of elderly patients [cases (%)]

组别	例数	认知功能障碍	抑郁
非衰弱组	42	3(7.14)	1(2.38)
衰弱前期组	64	21(32.81)^a	15(23.43)^a
衰弱组	72	43(59.72)^ab	31(43.06)^ab
χ²值		12.738	15.986
P值		＜0.001	＜0.001
注：3组间两两比较，校正P值为0.017；与非衰弱组比较，^aP＜0.017；与衰弱前期组比较，^bP＜0.017。

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表 3 各变量赋值方法

Table 3. Variable assignment methods

变量	赋值方法
性别	男性=1，女性=2
年龄	65~70岁=1，71~75岁=2，76~85岁=3
慢性疾病数量	0~1种=1，2~3种=2，≥4种=3
IL-6	以实际值赋值
CRP	以实际值赋值
ALB	以实际值赋值
认知功能障碍	无=0，有=1
抑郁	无=0，有=1
衰弱程度	非衰弱=1，衰弱前期=2，衰弱=3

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表 4 影响衰弱的多因素logistic回归分析

Table 4. Logistic regression analysis of multiple factors influencing frailty

变量	B	SE	Wald χ²	P值	OR值	95% CI
性别	0.201	0.103	1.187	0.276	1.223	0.999~1.496
年龄	0.385	0.317	3.852	0.050	1.470	0.790~2.735
慢性疾病数量	0.418	0.381	8.637	0.003	1.519	0.720~3.205
IL-6	0.218	0.112	1.653	0.199	1.244	0.998~1.549
ALB	-0.161	0.582	2.027	0.155	0.851	0.272~2.663
认知功能障碍	0.793	0.672	16.892	＜0.001	2.210	0.592~8.247
抑郁	0.762	0.658	12.981	＜0.001	2.142	0.590~7.779

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