收稿日期: 2021-07-09
网络出版日期: 2022-06-21
基金资助
广西哲学社会科学规划研究课题(17BRK005)
The mild cognitive dysfunction and its influencing factors in community dwelling older patients with hypertension in Nanning
目的 调查南宁市社区老年高血压患者轻度认知障碍(mild cognitive impairment,MCI)的现状及影响因素,为社区医务人员尽早评估老年高血压患者MCI,积极早期干预、延缓其发生发展提供参考。方法 采用随机抽样法,在南宁市3个社区抽取老年高血压患者738例,对其认知功能情况、一般人口学、疾病相关、生活方式及社会心理情况进行问卷调查。 结果 738例老年高血压患者中,MCI发生率为53.8%。Logistic回归分析显示,高血压分级、合并糖尿病、高血压患病年限、1年内应激史、吸烟、抑郁、睡眠障碍是MCI的危险因素(P<0.05),较高的文化程度、经常食用肉类、经常运动、经常阅读、较高的服药依从性及社会支持是MCI的保护因素(P<0.05)。 结论 南宁市社区老年高血压患者MCI的发生率较高,提示社区医务人员应重视老年高血压患者认知功能的评估,并根据其危险因素和保护因素有针对性地预防和延缓MCI的发生和发展,避免或减缓痴呆的发生,提高其生活质量。
陈玲 , 杨连招 , 陆静钰 , 高慧 . 南宁市社区老年高血压患者轻度认知障碍现状及影响因素研究[J]. 中华护理教育, 2022 , 19(6) : 566 -571 . DOI: 10.3761/j.issn.1672-9234.2022.06.017
Objective To investigate the status and influencing factors of mild cognitive impairment(MCI) in community dwelling older patients with hypertension in Nanning. Methods The random sampling method was used and 738 older patients with hypertension were selected in 3 communities in Nanning. Patients’ general demographic characteristics,cognitive function,disease-related information,lifestyle and social psychological factors were investigated. Results Out of 738 older patients with hypertension,prevalence of MCI was 53.8%. Multifactor logistic regression analysis showed that hypertension classification,diabetes,duration of hypertension,stress history within one year,smoking,depression,and sleep disorders were risk factors of MCI(P<0.05). Higher educational level,regular meat consumption,regular exercise,reading,higher medication compliance,and social support were protective factors of MCI(P<0.05). Conclusion The high incidence of MCI in older patients with hypertension suggests that community medical professionals should pay attention to the cognitive function assessment of older patients with hypertension. Targeted measures of prevention and delay of the occurrence and development of MCI according to their risk factors and protective factors are needed. By these ways,MCI can be avoided or slowed and quality of life of older adults can be improved.
| [1] | Bozoki A, Giordani B, Heidebrink JL, et al. Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss[J]. Arch Neurol, 2001, 58(3):411-416. |
| [2] | Iadecola C, Yaffe K, Biller J, et al. Impact of hypertension on cognitive function:a scientific statement from the American heart association[J]. Hypertension, 2016, 68(6):e67-e94. |
| [3] | 胡盛寿, 高润霖, 刘力生, 等. 《中国心血管病报告2018》概要[J]. 中国循环杂志, 2019, 34(3):209-220. |
| [4] | 李静, 范利, 华琦, 等. 中国老年高血压管理指南2019[J]. 中国心血管杂志, 2019(1):1-23. |
| [5] | 中国高血压防治指南修订委员会高血压联盟中国, 中华医学会心血管病学分会, 中国医师协会高血压专业委员会, 等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019(1):24-56. |
| [6] | 孙振球. 医学统计学[M]. 3版. 北京: 人民卫生出版社, 2010. |
| [7] | 周恬. 高血压伴轻度认知功能损伤患者的中医证候初步研究[D]. 北京: 北京中医药大学, 2011. |
| [8] | 杨慧锋, 王可心, 牛伟华. 原发性高血压患者认知功能现状及其影响因素分析[J]. 临床医学研究与实践, 2019, 4(30):26-27,35. |
| [9] | Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a medication adherence measure in an outpatient setting[J]. J Clin Hypertens (Greenwich), 2008, 10(5):348-354. |
| [10] | Buysse DJ, Reynolds CF, Monk TH, et al. Quantification of sub-jective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index(PSQI)[J]. Sleep, 1991, 14(4):331-338. |
| [11] | Hinz A, Zweynert U, Kittel J, et al. Measurement of change with the Hospital Anxiety and Depression Scale(HADS):sen-sitivity and reliability of change[J]. Psychother Psychosom Med Psychol, 2009, 59(11):394-400. |
| [12] | 肖水源. 《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994, 4(2):98-100. |
| [13] | Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment,MoCA:a brief screening tool for mild cognitive impairment[J]. J Am Geriatr Soc, 2005, 53(4):695-699. |
| [14] | Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician[J]. J Psychiatr Res, 1975, 12(3):189-198. |
| [15] | Lawton MP, Brody EM. Assessment of older people:self-maintaining and instrumental activities of daily living[J]. Geronto-logist, 1969, 9(3):179-186. |
| [16] | Petersen RC, Smith GE, Waring SC, et al. Mild cognitive impairment:clinical characterization and outcome[J]. Arch Neurol, 1999, 56(3):303-308. |
| [17] | 中国痴呆与认知障碍诊治指南写作组, 中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018中国痴呆与认知障碍诊治指南(五):轻度认知障碍的诊断与治疗[J]. 中华医学杂志, 2018, 98(17):1294-1301. |
| [18] | 王晓楠, 白小涓, 齐国先, 等. 老年H型高血压与认知功能障碍的关系[J]. 中国动脉硬化杂志, 2013, 21(10):894-898. |
| [19] | 潘惠英, 王君俏, 潘超君, 等. 金华市农村老年人轻度认知功能障碍患病率及影响因素[J]. 中国老年学杂志, 2020, 40(20):4448-4451. |
| [20] | Escher C, Jessen F. Prevention of cognitive decline and de-mentia by treatment of risk factors[J]. Nervenarzt, 2019, 90(9):921-925. |
| [21] | 胡鹏娟, 肖丹. 烟草对认知功能影响的研究进展[J]. 中华医学杂志, 2018, 98(26):2131-2133. |
| [22] | Burke SL, Hu TY, Spadola CE, et al. Mild cognitive impairment:associations with sleep disturbance,apolipoprotein e4,and sleep medications[J]. Sleep Med, 2018, 52:168-176. |
| [23] | 张微, 严亚琼, 王亮, 等. 老年高血压患者身体活动能力对认知功能的影响[J]. 中华高血压杂志, 2020, 28(2):137-143. |
| [24] | 赵羚, 孙文悦, 刘金玲, 等. 老年血管性认知功能障碍患者MOCA评分与焦虑、抑郁的相关性[J]. 中国老年学杂志, 2020, 40(22):4810-4812. |
/
| 〈 |
|
〉 |