目的探讨社区老年人轻度认知功能障碍影响因素。方法采用n:m不等比匹配的病例对照研究方法,应用SPSS软件中的Cox回归模型进行不等比匹配logistic回归分析。结果最终入选病例423例,对照925名。通过单因素和多因素Cox回归分析,得出轻度认知功能障碍发生危险因素,其OR值及95%CI分别是:从事体力劳动1.396(1.092~1.785),吸烟1.551(1.021~2.359),血清中较高血糖浓度1.354(1.102~1.664),较高HDL—C1.543(1.232~1.932),较高LDL—C1.299(1.060~1.592),低雌激素水平1.263(1.031~1.547),高血压1.967(1.438~2.689),糖尿病1.381(1.139~1.675),抑郁症1.406(1.110~1.780),脑血栓1.593(1.307~1.943),较高SBP1.331(1.129~1.569),ApoEe4型等位基因1.462(1.140~1.873);保护因素有:常读书看报0.610(0.503~0.740),常参加公益活动0.617(0.502~0.757),常做家务0.804(0.665~0.973),退休后有第二职业0.759(0.636~0.906),嗅觉敏锐0.900(0.845~0.958),性格外向0.829(0.699~0.984),性格果断0.811(0.662~0.993)。结论从事脑力劳动、健康生活方式以及降低糖尿病、高血压、高血糖、高血脂、抑郁症、脑血管病变发生风险是预防老年人轻度认知功能障碍发生的主要手段。
Objective To explore the influencing factors on mild cognitive impairment among the community-based elderly population. Methods A ' n : m ' matched case-control study was conducted to analyze the risk factors. Cox regression model of survival analysis was selected to deal with non-geometric proportional matched data which was difficult to analyze by logistic regression model. Results Four hundred and twenty-three cases together with nine hundred and twenty-five controls were interviewed with an uniformed questionnaire. Through univariate and multivariate cox regression analysis, the odds ratio and 95 % CI of these risk factors appeared to be: physical labor as 1. 396 ( 1. 092-1. 785) ; smoking as 1. 551 (1. 021-2. 359) ; higher level of blood glucose as 1,354 ( 1. 102-1. 664) ; HDL-C in the serum as 1,543 (1. 232-1. 932) ; LDL-C in the serum as 1,299 ( 1,060-1,592 ) ; lower level of estrogen in the serum as 1. 263(1. 031-1. 547) ; hypertension as 1,967 ( 1. 438- 2,689) ; diabete: 1. 381 ( 1. 139-1. 675 ) ; depressive disorder: 1. 406(1. 110-1. 780) ;cerebral thrombosis as 1. 593(1,307-1. 943) ; higher SBP as 1. 331(1. 129- 1. 569) and ApoEε4 carrier as 1. 462 ( 1. 140-1. 873) respectively. Odds ratio and 95 % CI on protection factors appeared to be: reading newspaper frequently as 0. 610 (0. 503-0,740) ;frequently doing housework as 0. 804 (0. 665-0. 973 ) ; frequently engaging in social activities as 0. 617 (0. 502-0. 757 ) ; reemployment after formal retirement as 0. 759(0. 636-0. 906) ; having acumen olfaction as 0. 900(0,845-0. 958) ; having extrovert personality as 0. 829 (0. 699-0. 984) ; being decisive as 0. 811 (0. 662-0. 993). Conclusion The major measures to prevent MCI seemed to be including the following factors as: being intellectuals, engaging in healthy life style and decreasing the risk in developing hypertension, diabetes, depressive disorder and cerebrovascular disease. However, olfactory hypoesthesia, c