太原市社区老年人轻度认知功能障碍向阿尔茨海默病转归三年随访研究

王艳平; 翟静波; 朱芳; 张雯雯; 杨晓娟; 曲成毅

Abstract

王艳平,翟静波,朱芳,张雯雯,杨晓娟,曲成毅.太原市社区老年人轻度认知功能障碍向阿尔茨海默病转归三年随访研究[J].Chinese journal of Epidemiology,2011,32(2):105-109

太原市社区老年人轻度认知功能障碍向阿尔茨海默病转归三年随访研究

A three-year fouow-Up study on the transfer of mild cognitive impairment to Alzheimer’s disease among the elderly in Taiyuan city

Received:November 18, 2010

DOI：

KeyWord: 阿尔茨海默病轻度认知功能障碍影响因素

English Key Word: lzheimer’s disease Mild cognitive impairment Influencing factor

FundProject:国家自然科学基金(30571611)

Author Name	Affiliation	E-mail
WANG Yan-ping	Department of Epidemiology, Shanxi Medical Universty, Taiyuan 030001. China
ZHAI Jing-bo	Department of Epidemiology, Shanxi Medical Universty, Taiyuan 030001. China
ZHU Fang	Department of Epidemiology, Shanxi Medical Universty, Taiyuan 030001. China
ZHANG Wen-wen	Department of Epidemiology, Shanxi Medical Universty, Taiyuan 030001. China
Yang Xiao-juan	Department of Epidemiology, Shanxi Medical Universty, Taiyuan 030001. China
Qu Cheng-yi	Department of Epidemiology, Shanxi Medical Universty, Taiyuan 030001. China	quchengyi0012@163．Com

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Abstract:

目的探讨太原市社区轻度认知功能障碍(MCI)老年人向阿尔茨海默病(AD)的转归率，并分析影响因素。方法从太原市9个社区6152名≥65岁老年人中筛查出600例MCI，实际随访557例，从认知正常(Nc)中选择557名与MCI相匹配的老年人进行配对，对MCI组和NC组进行3年随访研究。采用自制问卷面对面调查MCl组的一般人口学资料、生活行为方式、慢性病史、主观感受等，采用16PF调查MCI的人格特征，静脉血采样进行实验室遗传基因学分析，对NC组老年人进行电话访问以得到疾病结局和发病时间。用SPSS 13．0软件进行数据录入及分析，统计学方法采用log．rank检验和Cox回归。结果 MCI组老年人向AD的平均年转归率为6．53％人年。NC组老年人向AD的平均年转归率为1．24％人年，MCI组发生AD的危险性是NC组的5．27倍(95％CI：3．01～9．82)。Cox回归分析结果显示，高龄(RR=3．14，95％C／：2．98-7．46)、患高血压(RR=3．28，95％C／：3．02-8．48)、高血脂(RR=2．22，95％C|，：1．29-3．82)、糖尿病(RR=4．87，95％c／：2．56-9．25)、较少运动(RR-----2．02，95％c，：1．29-3．14)、焦虑(RR=4．46，95％C／：3．07-8．14)、害怕(RR=4．08。95％C／：3．52。5．25)、非乐群型(RR=1．89，95％C／：1．13～3．16)、焦虑人格(欣-----5．07，95％a：2．56～10．04)、性格内向(艘=2．05，95％a：1．33～3．15)、携带ApoE4(RR=1．73，95％C／：1．15-2．63)是MCI转归为AD的危险因素，文化程度高(RR=0．29，95％CI：O．07～O．43)、脑力劳动(艘=O．14，95％c／：0．05～0．32)、常读书看报(RR=0．30，95％C／：0．15～0．58)、常参加活动(肷=0．41，95％CI：O．23～0．75)是MCI转归为AD的保护因素。结论患有MCI的老年人更易发展为AD，应长期监测。

English Abstract:

Objective To explore the incidence rate of people with mild cognitive impairment(MCI)which transferred to Alzheimer’s disease(AD)and to study the related influencing factors．Methods 600 MCI aged people were experienced screening test which was conducted by WHO-BCA，MMSE and DCR A three-year follow-up study was conducted to get the information on the aged people with MCI．Data related to demography，behavior,chronic diseases and perception of the elderly with MCl were collected through face to face interview．Characteristics of the elderly with MCI aged people were tested by l 6P F．Tbe content of Apoe was tested bv PCR． People with NC were investigated by telephone to get the progression and the time to AD． Methodologies on statistics were log-rank test and Cox proportional hazards regression model． Results The incidence rate of MCI to AD was 6．53％person．years．The incidence rate of the normal peopletoADwas 1．24％person．years．ThehazardofMCItoADwas 5．27times(95％C／：3．01-9．82) of the normal people to AD．The result of Cox proportional hazards regression model displayed that：older age(RR=3．14，95％C／：2．98-7．46)，hypertension(RR=3．28，95％C，：3．02-8．48)， hyperlipermia(RR=2．22，95％CI：1．29-3．82),diabetes(RR=4．87，95％C／：2．56-9．25)，lack of sports (RR=2．02，95％C，：1．29-3．14)。anxiety(RR=4．46，95％C，：3．07-8．14) dread fulness(RR=4．08，95％C．，：3．52-5．25)。loneliness(RR=1．89，95％CI，：1．13-3．16)，characteristics ofanxiety(RR=-5．07，95％CI：2．56-10．04，introvert characteristics(Rg=2．05,95％C／：1．33-3．15)and ApoE4(RR=1．73,95％C／：1．15-2．63)were the risk factors of MCI to AD．Hi功er education(RR=O．29，95％C／：O．07-0．43)，intellectual work(RR=O．14，95％C／：0．05-0．32)，often reading books(RR=O．30,95％C／：O．15-0．58)，often taking part in recreational activities(RR=0．41，95％C7：0．23-0．75)seemed to be the protective of MCI to AD．Condusion The rate of the elderly with MCI that developing to AD was high，suggesting further study on the cognitive situation among the MCI aged people should be carried out．

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