CAJ | 학술논문

目的探讨社区轻度认知功能损害老年人认知减退影响因素.方法采用巢式病例-对照研究方法,由600名患轻度认知功能损害的社区老年居民组成随访队列,按年龄、性别、文化程度1:1匹配后形成认知减退组和对照组后进行影响因素分析.结果发生认知减退的危险因素有:从事体力劳动(OR=1.949,95％ CI:1.041～ 3.637)、吸烟(OR=2.062,95％ CI:1.029～4.445)、喜欢呆在家里(OR=2.254,95％ CI:1.029～4.937)、血清中较高血糖(OR=3.584,95％ CI:1.891～6.791)、胆固醇(OR=2.204,95％CI:1.137～4.275)、低雌激素水平(OR=1.946,95％CI:1.087～3.411),高血压(OR=3.951,95％ CI:1.822 ～4.637),糖尿病(OR=3.016,95％CI:1.886～4.157),高血脂(OR=4.061,95％ CI:1.724 ～9.568),脑血栓(OR=2.347,95％CI:1.329～4.533),脑出血(OR =2.668,95％CI:1.579 ～4.802),较高收缩压(OR=2.208,95％CI:1.343～ 3.629),载脂蛋白E( ApoEε4)型等位基因(OR =2.717,95％CI:1.084 ～6.743)、ApoEε4型等位基因*胆固醇(OR=1.626,95％CI:1.011～2.618)；保护因素有:常读书看报(OR=0.203,95％CI:0.112～0.411)、常做家务( OR =0.249,95％ CI:0.135 ～0.528)、性格外向(OR =0.544,95％ CI:0.327～0.938).结论从事体力劳动,吸烟,喜欢呆在家里,较高收缩压,血清中较高血糖,胆固醇,低雌激素水平,ApoEε4型等位基因,高血压,糖尿病,高血脂,脑血管病变是认知减退发生的危险因素；常读书看报,常做家务,性格外向是保护因素.
목적 탐토사구경도인지공능손해노년인인지감퇴영향인소.방법 채용소식병례-대조연구방법,유600명환경도인지공능손해적사구노년거민조성수방대렬,안년령、성별、문화정도1:1필배후형성인지감퇴조화대조조후진행영향인소분석.결과 발생인지감퇴적위험인소유:종사체력노동(OR=1.949,95％ CI:1.041～ 3.637)、흡연(OR=2.062,95％ CI:1.029～4.445)、희환태재가리(OR=2.254,95％ CI:1.029～4.937)、혈청중교고혈당(OR=3.584,95％ CI:1.891～6.791)、담고순(OR=2.204,95％CI:1.137～4.275)、저자격소수평(OR=1.946,95％CI:1.087～3.411),고혈압(OR=3.951,95％ CI:1.822 ～4.637),당뇨병(OR=3.016,95％CI:1.886～4.157),고혈지(OR=4.061,95％ CI:1.724 ～9.568),뇌혈전(OR=2.347,95％CI:1.329～4.533),뇌출혈(OR =2.668,95％CI:1.579 ～4.802),교고수축압(OR=2.208,95％CI:1.343～ 3.629),재지단백E( ApoEε4)형등위기인(OR =2.717,95％CI:1.084 ～6.743)、ApoEε4형등위기인*담고순(OR=1.626,95％CI:1.011～2.618)；보호인소유:상독서간보(OR=0.203,95％CI:0.112～0.411)、상주가무( OR =0.249,95％ CI:0.135 ～0.528)、성격외향(OR =0.544,95％ CI:0.327～0.938).결론 종사체력노동,흡연,희환태재가리,교고수축압,혈청중교고혈당,담고순,저자격소수평,ApoEε4형등위기인,고혈압,당뇨병,고혈지,뇌혈관병변시인지감퇴발생적위험인소；상독서간보,상주가무,성격외향시보호인소.
Objective To explore the related factors to cognitive impairment among communitydwelling aged population with mild cognitive impairment (MCI).Methods In this nested case-control study,a two-year follow-up program was conducted among 600 subjects with MCI.According to the changes and trends of cognitive function,114 pairs of cognitive impairment subjects and control subjects were identified,matched with sex,age and educational level. Cox regression model of survival analysis was applied to analyze the related factors.Results Univariate and multivariate cox regression analysis revealed that risk factors were physical labour( OR =1.949,95％ CI:1.041 - 3.637),smoking( OR =2.062,95％ CI:1.029 - 4.445 ),living alone ( OR =2.254,95％ CI:1.029 - 4.937 ),higher level of blood glucose ( OR =3.584,95％ CI:1.891 - 6.791 ),higher serum cholesterol ( OR =2.204,95％ CI:1.137 - 4.275 ),lower level of serum estrogen ( OR =1.946,95 ％ CI:1.087 - 3.411 ),hypertension ( OR =3.951,95 ％ CI:1.822 -4.637),diabete ( OR =3.016,95％ CI:1.886 - 4.157 ),hyperlipemia ( OR =4.061,95％ CI:1.724 -9.568 ),cerebral thrombosis ( OR =2.347,95％ CI:1.329 - 4.533 ),cerebral hemorrhage ( OR =2.668,95 ％ CI:1.579 - 4.802),higher SBP ( OR =2.208,95 ％ CI:1.343 - 3.629 ),ApoEε4 carrier ( OR =2.717,95％ CI:1.084 - 6.743 ),ApoEε4 carrier * serum cholesterol ( OR =1.626,95％ CI:1.011 - 2.618).The protective factors were reading newspaper( OR =0.203,95％ CI:0.112 - 0.411 ),doing household duties frequently ( OR =0.249,95 ％ CI:0.135 - 0.528 ),extroversion character ( OR =0.544,95 ％ CI:0.327 -0.938).Conclusions The risk factors for cognitive impairment may be physical labour,smoking,living alone,higher SBP,higher level of blood glucose and cholesterol,and lower level of serum estrogen,ApoEε4 carrier,hypertension,diabete,hyperlipemia,cerebrovascular disease. While reading newspaper,doing household duties frequently and extroversion character may be protective factors.