多病共存住院老年人常见慢性病对轻度认知功能障碍的影响

Influencing factors of common chronic diseases on mild cognitive impairment in elderly inpatients with multiple comorbidities

【摘要】目的 分析多病共存住院老年人常见慢性病对轻度认知功能障碍(MCI)的影响。方法 选择新疆医科大学第一附属医院2022年1月至2023年8月多病共存住院老年人1591例,收集人口学资料、生化结果、病史资料、量表评估等信息。参照MCI诊断标准将多病共存住院老年人分为非MCI组(n=1211例)和MCI组(n=380例)。采用SPSS 26.0软件进行数据分析。根据数据类型,组间比较分别采用非参数检验及χ²检验。采用多因素logistic回归分析多病共存住院老年人常见慢性病对MCI的影响因素。结果 多病共存住院老年人MCI检出率为23.88%(380/1591)。MCI组和非MCI组多病共存住院老年人在年龄、文化程度、婚姻状况、居住情况、空腹血糖、肌酐、尿酸、甘油三酯、血清总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、多病共存、用药种数、高血压、糖尿病、冠心病、脑血管病、慢性阻塞性肺疾病、甲状腺功能减退、日常生活能力评分、Morse跌倒风险评分、Fried衰弱量表评分方面比较,差异均有统计学意义(均P<0.05)。logistic回归分析结果显示:多病共存住院老年人常见慢性病如糖尿病(OR=1.590,95%CI 1.083~2.335)、冠心病(OR=2.199,95%CI 1.571~3.078)、脑血管病(OR=1.603,95%CI 1.113~2.310)、慢性阻塞性肺疾病(OR=1.794,95%CI 1.222~2.634)、甲状腺功能减退(OR=2.489,95%CI 1.597~3.879)、多病共存数量增加(OR=2.711,95%CI 2.292~3.206)是多病共存住院老年人发生MCI的危险因素(均P<0.05)。结论 多病共存住院老年人MCI检出率较高,常见慢性病如糖尿病、冠心病、脑血管病、慢性阻塞性肺疾病、甲状腺功能减退、多病共存数量增加是多病共存老年人发生MCI的危险因素。

基金项目:国家自然科学基金(U1503223)；新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-202148)；新疆护理学会年度科研项目(2022XH16,2023XH040)；新疆医科大学第一附属医院“青年科研起航”专项(2022YFY-QNRC-07)

【Abstract】Objective To explore the influencing factors of common chronic diseases on mild cognitive impairment (MCI) in elderly inpatients with multiple comorbidities. Methods From January 2022 to August 2023,1591 elderly inpatients with multiple comorbidities were selected in the First Affiliated Hospital of Xinjiang Medical University, and their demographic data, biochemical results, medical history data, and scale evaluations were collected. According to the diagnostic criteria of MCI, the inpatients were divided into non-MCI group (n=1 211) and MCI group (n=380). SPSS 26.0 was used for data analysis. According to the data type, nonparametric tests and Chi square tests were used for intergroup comparisons. Multiple logistic regression analysis was used to investigate the influencing factors of common chronic diseases on MCI in elderly inpatients with multiple comorbidities. Results The detection rate of MCI among the elderly inpatients with multiple comorbidities was 23.88% (380/1591). There were significant differences between the MCI group and the non-MCI group in age, education level, marital status, residence status, fasting blood glucose, creatinine, uric acid, triglyceride, serum total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, multiple comorbidities, number of medications, hypertension, diabetes, coronary heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, hypothyroidism, daily living ability, Morse fall risk score, and Fried frailty scale (all P<0.05). Logistic regression analysis showed that common chronic diseases such as diabetes (OR=1.590,95%CI 1.083-2.335), coronary heart disease (OR=2.199,95%CI 1.571-3.078), cerebrovascular disease (OR=1.603,95%CI 1.113-2.310), chronic obstructive pulmonary disease (OR=1.794,95%CI 1.222-2.634), hypothyroidism (OR=2.489,95%CI 1.597-3.879), and increased number of multiple comorbidities (OR=2.711,95%CI 2.292-3.206) were risk factors of MCI in the elderly inpatients with multiple comorbidities (all P<0.05). Conclusion The detection rate of MCI in elderly inpatients with multiple comorbidities is high. Common chronic diseases such as diabetes, coronary heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, hypothyroidism, and the increase in the number of multiple comorbidities are risk factors of MCI in elderly patients with multiple comorbidities.

This work was supported by the National Natural Science Foundation of China(U1503223), Special Research Project for Health and Health Young Medical Science and Technology Talents in Xinjiang Uygur Autonomous Region (WJWY-202148), Annual Research Projects of Xinjiang Nursing Association (2022XH16,2023XH040) and Special Project for "Youth Research Launch" of the First Affiliated Hospital of Xinjiang Medical University′s (2022YFY-QNRC-07).