中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2015年
2期
93-97
,共5页
王秋梅%朱鸣雷%曾平%康琳%葛楠%曲璇%刘晓红
王鞦梅%硃鳴雷%曾平%康琳%葛楠%麯璇%劉曉紅
왕추매%주명뢰%증평%강림%갈남%곡선%류효홍
老年人%糖尿病%老年综合评估%老年综合征
老年人%糖尿病%老年綜閤評估%老年綜閤徵
노년인%당뇨병%노년종합평고%노년종합정
elderly%diabetes mellitus%comprehensive geriatric assessment%geriatric syndrome
目的：探讨住院老年糖尿病患者的老年综合征罹患情况。方法对北京协和医院内科老年病房2012年7月至2014年9月收治的213例≥65岁老年糖尿病患者进行老年综合评估，评估患者的认知、情绪、睡眠障碍、跌倒、尿失禁、营养风险和日常生活能力。结果入组患者年龄（74.7±6.6）岁，糖尿病病程（12.4±8.9）年（中位数为10年），共病3～27种，平均患老年综合征数3.3±1.7。60%存在多重用药，40%～50%存在日常生活能力下降；认知损害、情绪障碍、慢性疼痛和跌倒高风险的发生率分别为39.0%，29.0%，31.9%和43.0%。病程长的患者跌倒风险发生率较高[54.8%（病程＞10年组） vs 37.9%（病程≤10年组）]；血糖控制较差组（HbA1c＞7.5%）糖尿病平均病程较长[（17.7±10.5） vs （10.9±7.7）年]，跌倒高风险的发生率（61.7% vs 38.5%）和睡眠障碍发生率（51.1%vs 34.9%）均较高，但认知功能损害发生率较低（27.6%vs 44.8%），且差异均有统计学意义（P＜0.05）。结论老年糖尿病患者的认知损害、情绪障碍、慢性疼痛、跌倒高风险等老年综合征发生率高，需要进行老年综合征评估和个体化的管理。
目的：探討住院老年糖尿病患者的老年綜閤徵罹患情況。方法對北京協和醫院內科老年病房2012年7月至2014年9月收治的213例≥65歲老年糖尿病患者進行老年綜閤評估，評估患者的認知、情緒、睡眠障礙、跌倒、尿失禁、營養風險和日常生活能力。結果入組患者年齡（74.7±6.6）歲，糖尿病病程（12.4±8.9）年（中位數為10年），共病3～27種，平均患老年綜閤徵數3.3±1.7。60%存在多重用藥，40%～50%存在日常生活能力下降；認知損害、情緒障礙、慢性疼痛和跌倒高風險的髮生率分彆為39.0%，29.0%，31.9%和43.0%。病程長的患者跌倒風險髮生率較高[54.8%（病程＞10年組） vs 37.9%（病程≤10年組）]；血糖控製較差組（HbA1c＞7.5%）糖尿病平均病程較長[（17.7±10.5） vs （10.9±7.7）年]，跌倒高風險的髮生率（61.7% vs 38.5%）和睡眠障礙髮生率（51.1%vs 34.9%）均較高，但認知功能損害髮生率較低（27.6%vs 44.8%），且差異均有統計學意義（P＜0.05）。結論老年糖尿病患者的認知損害、情緒障礙、慢性疼痛、跌倒高風險等老年綜閤徵髮生率高，需要進行老年綜閤徵評估和箇體化的管理。
목적：탐토주원노년당뇨병환자적노년종합정리환정황。방법대북경협화의원내과노년병방2012년7월지2014년9월수치적213례≥65세노년당뇨병환자진행노년종합평고，평고환자적인지、정서、수면장애、질도、뇨실금、영양풍험화일상생활능력。결과입조환자년령（74.7±6.6）세，당뇨병병정（12.4±8.9）년（중위수위10년），공병3～27충，평균환노년종합정수3.3±1.7。60%존재다중용약，40%～50%존재일상생활능력하강；인지손해、정서장애、만성동통화질도고풍험적발생솔분별위39.0%，29.0%，31.9%화43.0%。병정장적환자질도풍험발생솔교고[54.8%（병정＞10년조） vs 37.9%（병정≤10년조）]；혈당공제교차조（HbA1c＞7.5%）당뇨병평균병정교장[（17.7±10.5） vs （10.9±7.7）년]，질도고풍험적발생솔（61.7% vs 38.5%）화수면장애발생솔（51.1%vs 34.9%）균교고，단인지공능손해발생솔교저（27.6%vs 44.8%），차차이균유통계학의의（P＜0.05）。결론노년당뇨병환자적인지손해、정서장애、만성동통、질도고풍험등노년종합정발생솔고，수요진행노년종합정평고화개체화적관리。
Objective To investigate the prevalence of geriatric syndrome in the hospitalized elderly with diabetes mellitus. Methods A total of 213 elderly patients at an age of over 65 years with type 2 diabetes mellitus admitted in our department from July 2012 to September 2014 were enrolled in this study. Each subject was assessed for cognitive impairment, mood, sleep problems, falls risk, urinary incontinence, nutrition risk, and impairment of activity of daily living within 48h after admission. Results The cohort was at an age of (74.7±6.6) years, with a duration of diabetes for (12.4±8.9) years (median 10 years), and with 3 to 27 types of comorbidities. They averagely had (3.3±1.7) geriatric syndrome. Sixty percent of them had polypharmacy, and 40%to 50% had impairment in activities of daily living. The prevalence of cognitive impairment, emotional disorder, chronic pain and high risk of falling was 39.0%, 29.0%, 31.9%and 43.0%, respectively. The incidence of falling risk was higher in the patients with longer disease course [54.8%(course>10 years) vs 37.9%(course≤10 years)]. When compared with the well-controlled diabetic patients (HbA1c ≤7.5%), the poor-controlled patients (HbA1c>7.5%) were found to have longer disease course [(17.7±10.5) vs (10.9±7.7) years], higher risk rate of falling (61.7% vs 38.5%), and higher incidences of sleep disorder (51.1% vs 34.9%), but lower incidence of cognitive impairment (27.6% vs 44.8%; all P<0.05). Conclusion The elderly with diabetes mellitus have high risks of cognitive impairment, emotional disorder, chronic pain and falling risks. We need to make comprehensive geriatric assessment and individualized intervention for them.
