目的:分析上海社区老年人发展为阿尔茨海默病(AD)的影响因素。方法:对2005年2月至2007年2月期间入组的695名65岁以上、无伴随痴呆的社区老人,进行入组时和间隔2年后的2次访谈,同时完成简易智能量表(MMSE)、日常生活功能量表(ADL)的评估。根据美国精神障碍诊断与统计手册第4版AD的诊断标准,695名老人经过2年随访后被诊断为AD的有103例(AD组:男45例,女58例),正常老年人(正常对照组)535名。分析两组在性别、年龄、婚姻状况、文化程度、职业、居住情况、躯体疾病及治疗情况、吸烟史、饮酒史、MMSE和ADL方面的差异,并且应用逐步多元回归分析AD的独立危险因素。结果:与AD独立相关的危险因素是年龄(OR=1.074,P〈0.001)、受教育程度(OR=1.734,P〈0.05)、认知功能损害(OR=2.112,P〈0.01)、ADL体力功能状态(OR=2.296,P〈0.01)。结论:年龄、受教育程度、MMSE及ADL是AD发生的独立危险因素,可以作为AD的预测指标。
Objective: To analyze the clinic factors associated with Alzheimer's disease (AD) in commu- nity of Shanghai. Method : Total 695 old persons in community more than 65 years excluding dementia, were enrolled in this study from Feb 2005 to Feb 2007. They were interviewed and evaluated by using mini mental state examination (MMSE) and activity of daily living scale (ADL) two times at the time of baseline and 2 years later. After 2 years later,total 103 subiects (45 male,58 female) were diagnosed as AD according to dial-nostic and statistical manul of mental disorders-IV , while 535 subjects were healthy controls. Then, these two groups were compared on gender, age, marital status, educational status, living status, physical illness, smoking status,drinking status,MMSE and ADL. Results :The results showed that age( OR = 1. 074 ,P 〈 0.001 ) ,edu-cation ( OR = 1. 734, P 〈 0.05 ), cognition impairment ( OR = 2. 112, P 〈 0.01 ), and ADL ( OR = 2. 296, P 〈 0.01 ) were associated with AD. Conclusion: Our study suggested that age, education, cognition impairment, and ADL were associated with AD, which may predict the occurrence of AD.