CAJ | 학술논문

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MCI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%CI:2.98～7.46)、患高血压(RR=3.28,95%CI:3.02～8.48)、高血脂(RR=2.22,95%CI:1.29～3.82)、糖尿病(RR=4.87,95%CI:2.56～9.25)、较少运动(RR=2.02,95%CI:1.29～3.14)、焦虑(RR=4.46,95%CI:3.07～8.14)、害怕(RR=4.08,95%CI:3.52～5.25)、非乐群型(RR=1.89,95%CI:1.13～3.16)、焦虑人格(RR=5.07,95%CI:2.56～10.04)、性格内向(RR=2.05,95%CI:1.33～3.15)、携带ApoE4(RR=1.73,95%CI: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:0.07～0.43)、脑力劳动(RR=0.14,95%CI:0.05～0.32)、常读书看报(RR=0.30,95%CI:0.15～0.58)、常参加活动(RR=0.41,95%CI:0.23～0.75)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.
목적 탐토태원시사구경도인지공능장애(MCI)노년인향아이자해묵병(AD)적전귀솔,병분석영향인소.방법 종태원시9개사구6152명≥65세노년인중사사출600례MCI,실제수방557례,종인지정상(NC)중선택557명여MCI상필배적노년인진행배대,대MCI조화NC조진행3년수방연구.채용자제문권면대면조사MCI조적일반인구학자료、생활행위방식、만성병사、주관감수등,채용16PF조사MCI적인격특정,정맥혈채양진행실험실유전기인학분석,대NC조노년인진행전화방문이득도질병결국화발병시간.용SPSS 13.0연건진행수거록입급분석,통계학방법채용log-rank검험화Cox회귀.결과 MCI조노년인향AD적평균년전귀솔위6.53%인년.NC조노년인향AD적평균년전귀솔위1.24%인년,MCI조발생AD적위험성시NC조적5.27배(95%CI:3.01～9.82).Cox회귀분석결과현시,고령(RR=3.14,95%CI:2.98～7.46)、환고혈압(RR=3.28,95%CI:3.02～8.48)、고혈지(RR=2.22,95%CI:1.29～3.82)、당뇨병(RR=4.87,95%CI:2.56～9.25)、교소운동(RR=2.02,95%CI:1.29～3.14)、초필(RR=4.46,95%CI:3.07～8.14)、해파(RR=4.08,95%CI:3.52～5.25)、비악군형(RR=1.89,95%CI:1.13～3.16)、초필인격(RR=5.07,95%CI:2.56～10.04)、성격내향(RR=2.05,95%CI:1.33～3.15)、휴대ApoE4(RR=1.73,95%CI:1.15～2.63)시MCI전귀위AD적위험인소,문화정도고(RR=0.29,95%CI:0.07～0.43)、뇌력노동(RR=0.14,95%CI:0.05～0.32)、상독서간보(RR=0.30,95%CI:0.15～0.58)、상삼가활동(RR=0.41,95%CI:0.23～0.75)시MCI전귀위AD적보호인소.결론 환유MCI적노년인경역발전위AD,응장기감측.
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 MCI were collected through face to face interview. Characteristics of the elderly with MCI aged people were tested by 16PF. The content of Apoe was tested by 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 people to AD was 1.24% person-years. The hazard of MCI to AD was 5.27 times (95%CI: 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% CI: 2.98-7.46) , hypertension (RR=3.28, 95% CI: 3.02-8.48) ,hyperlipermia (RR = 2.22,95%CI: 1.29-3.82), diabetes (RR=4.87,95%CI: 2.56-9.25), lack of sports (RR=2.02, 95%CI: 1.29-3.14), anxiety (RR=4.46, 95%CI: 3.07-8.14), dread fulness (RR=4.08,95% CI: 3.52-5.25), loneliness (RR= 1.89,95% CI: 1.13-3.16), characteristics of anxiety (RR= 5.07,95%CI: 2.56-10.04, introvert characteristics (RR=2.05,95%CI: 1.33-3.15) and ApoE4 (RR= 1.73,95% CI: 1.15-2.63) were the risk factors of MCI to AD. Higher education (RR=0.29, 95% CI:0.07-0.43), intellectual work(RR=0.14,95%CI: 0.05-0.32), often reading books(RR=0.30,95%CI:0.15-0.58), often taking part in recreational activities (RR=0.41,95%CI: 0.23-0.75) seemed to be the protective of MCI to AD. Conclusion 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.