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北京大学学报（医学版） ›› 2024, Vol. 56 ›› Issue (3): 456-461. doi: 10.19723/j.issn.1671-167X.2024.03.012

• 论著 • 上一篇    下一篇

北京市老年人认知功能的影响因素

林郁婷1,王华丽2,田宇3,巩俐彤4,常春1,*()   

  1. 1. 北京大学公共卫生学院社会医学与健康教育系，北京 100191
    2. 北京大学第六医院记忆障碍诊疗与研究中心/国家精神心理疾病临床医学研究中心，北京 100191
    3. 北京市新街口社区卫生服务中心，北京 100035
    4. 北京市大兴区疾病预防控制中心，北京 102699
  • 收稿日期:2024-02-18 出版日期:2024-06-18 发布日期:2024-06-12
  • 通讯作者: 常春 E-mail:changchun@bjmu.edu.cn
  • 基金资助:
    中国社区卫生协会社区卫生科研基金(20212041)

Factors influencing cognitive function among the older adults in Beijing

Yuting LIN1,Huali WANG2,Yu TIAN3,Litong GONG4,Chun CHANG1,*()   

  1. 1. Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
    2. Peking University Sixth Hospital Dementia Care and Research Center/National Clinical Research Center for Psychiatric Diseases, Beijing 100191, China
    3. Beijing Xinjiekou Community Health Service Center, Beijing 100035, China
    4. Beijing Daxing District Center for Disease Control and Prevention, Beijing 102699, China
  • Received:2024-02-18 Online:2024-06-18 Published:2024-06-12
  • Contact: Chun CHANG E-mail:changchun@bjmu.edu.cn
  • Supported by:
    China Community Health Association Community Health Research Fund(20212041)

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摘要：

目的: 探讨老年人认知功能现况，基于生命历程理论分析老年人认知功能的影响因素。方法: 采用横断面研究，于2023年对北京市西城区、大兴区部分老年人进行问卷调查，使用香港简短认知功能检测(Hong Kong brief cognitive test，HKBC)量表评估老年人的认知功能，采用SPSS 27.0软件对老年人认识功能的影响因素进行描述性分析和多元线性回归分析。结果: 纳入349名老年人，年龄在60~69岁的调查对象占比最高(41.3%)，58.7%为女性，文化程度初中及以上者占比88.0%，退休前每周工作时长多集中在35~48 h(68.8%)，14.0%的老年人有痴呆家族史。在控制年龄、性別等变量后，线性回归分析结果显示，婚姻状况为已婚(β=0.501，95%CI：0.144~0.859)和每周运动3~4次是老年人认知功能的保护因素(β=0.617，95%CI：0.087~1.148)，抑郁症状是其危险因素(β=-0.723，95%CI：-1.198~-0.247)。结论: 从生命全周期的视角看待认知功能影响因素，缺乏体育锻炼与抑郁症状均是认知功能的危险因素，加强体育锻炼，改善老年人心理健康，将预防性干预关口前移，有助于预防和减缓老年人认知功能衰退。

关键词: 认知障碍, 危险因素, 老年人, 生命历程理论

Abstract:

Objective: To explore the current status of cognitive function of the older adults in Beijing, and to analyze the factors affecting their cognitive function. Methods: It was a cross-sectional study. A questionnaire survy was conducted in 2023 among the older adults in Beijing. The cognitive function of the older adults was assessed with the Hong Kong brief cognitive test (HKBC) scale, a simple cognitive assessment tool. Using SPSS 27.0 to perform the descriptive analysis and multiple linear regression analysis of factors, which affect cognitive function among the older adults. Results: Totally 349 older adults were recruited, with the highest percentage of respondents aged 60-69 years (41.3%), of whom 58.7% were female, 88.0% of the respondents had a junior high school or above education level. Most of the older adults (68.8%) worked 35-48 h/week before they retired, and 14.0% of the older adults had a family history of dementia. After controlling age and gender, the linear regression analysis showed that marital status married (β=0.501, 95%CI: 0.144-0.859) and 3-4 times physical activity per week (β=0.617, 95%CI: 0.087-1.148) were protective factors of cognitive function in the older adults, and depressive symptoms were a risk factor (β= -0.723, 95%CI: -1.198 to -0.247) of cognitive function for the older adults. Conclusion: In this study, the factors influencing cognitive function among the older adults was analyzed based on a life-cycle perspective. Lack of physical activity and depressive symptoms were risk factors for cognitive function among the older adults. It was suggested that strengthening physical activity, improving mental health of the older adults, as well as conducting preventive intervention in early stages of the life-cycle will be benefit for preventing and slowing cognitive decline in the older adults.

Key words: Cognition disorders, Risk factors, Aged, Life course theory

中图分类号: 

  • R395.6

表1

研究对象的社会人口学特征(n=349)"

Items n(%)
Gender
  Male 144 (41.3)
  Female 205 (58.7)
Age/years
  60- 144 (41.3)
  70- 101 (28.9)
  ≥80 104 (29.8)
Marital status
  Single/Divorced/Widowed 186 (53.3)
  Married 163 (46.7)
Education level
  Primary school or less 42 (12.0)
  Middle school 178 (51.0)
  High school or higher 129 (37.0)
Family history of dementia
  Yes 49 (14.0)
  No 300 (86.0)
Weekly working hours before retirement
  ＜35 56 (16.0)
  35- 122 (35.0)
  41- 118 (33.8)
  ≥49 53 (15.2)

表2

认知功能得分的单因素分析"

Variable Cognitive function score ($\bar x \pm s$) t/F P
Early life course factors
  Education level 3.872 0.022
    Primary school or below 23.76±1.61
    Middle school 24.25±1.65
    High school or above 24.51±1.34
  Family history of dementia 0.751 0.455
    No 24.31±1.57
    Yes 24.14±1.46
Midlife course factors
  Weekly working hours before retirement 1.998 0.114
    ＜35 23.89±1.85
    35- 24.32±1.42
    41- 24.49±1.57
    ≥49 24.19±1.40
  Marital status -3.331 0.001
    Single/Divorced/Widowed 24.04±1.66
    Married 24.58±1.36
Late life course factors
  Times of physical activity per week 6.872 0.001
    0-2 23.97±1.81
    3-4 24.76±0.88
    ≥5 24.49±1.34
  Smoking 0.105 0.917
    Never 24.29±1.58
    Everyday/Quit 24.27±1.34
  Drinking -0.997 0.321
    No 24.26±1.61
    Yes 24.44±1.11
  Social participation -1.037 0.300
    Low level 24.21±1.69
    High level 24.38±1.36
  3H 1.038 0.304
    No 24.31±1.59
    Yes 24.09±1.38
  Depression 3.759 ＜0.001
    No 24.42±1.32
    Yes 23.59±2.33
  Insomnia 2.486 0.013
    No 24.46±1.36
    Yes 24.04±1.77
  Social support 0.503 0.615
    Low level 24.33±1.50
    High level 24.24±1.61

表3

认知功能相关因素的多元回归分析"

VariablesModel 1 Model 2 Model 3
β(95%CI) t P β(95%CI) t P β(95%CI) t P
Sociodemographic factors
  Gender (Female) 0.119(-0.211, 0.450) 0.710 0.478 0.077(-0.254, 0.407) 0.457 0.648 0.015(-0.316, 0.345) 0.088 0.930
Early life course factors
  Education level
    Middle school 0.469(-0.054, 0.992) 1.762 0.079 0.344(-0.191, 0.879) 1.265 0.207 0.309(-0.264, 0.881) 1.061 0.289
    High school or above 0.756(0.205, 1.308) 2.699 0.007 0.479(-0.089, 1.048) 1.658 0.098 0.325(-0.286, 0.935) 1.045 0.297
  Family history of dementia (Yes) -0.133(-0.606, 0.341) -0.550 0.582 -0.131(-0.605, 0.343) -0.542 0.588 -0.107(-0.579, 0.365) -0.446 0.656
Midlife course factors
  Weekly working hours before retirement
    35-40 0.353(-0.137, 0.842) 1.418 0.157 0.270(-0.216, 0.756) 1.094 0.275
    41-48 0.526(0.034, 1.018) 2.105 0.036 0.341(-0.153, 0.836) 1.359 0.175
    ≥49 0.344(-0.263, 0.950) 1.115 0.266 0.126(-0.482, 0.734) 0.407 0.684
  Marital status (Married) 0.539(-0.183, 0.896) 2.978 0.003 0.501(0.144, 0.859) 2.759 0.006
Late life course factors
  Times of physical activity per week
    3-4 0.617(0.087, 1.148) 2.291 0.023
    ≥5 0.270(-0.109, 0.649) 1.402 0.162
  Smoking (Everyday/Quit) -0.119(-0.629, 0.391) -0.458 0.647
  Drinking (Yes) -0.002(-0.472, 0.467) -0.009 0.993
  Social participation (High level) 0.228(-0.131, 0.588) 1.250 0.212
  3H (Yes) -0.205(-0.754, 0.344) -0.735 0.463
  Depression (Yes) -0.723(-1.198, -0.247) -2.991 0.003
  Insomnia (Yes) -0.129(-0.475, 0.217) -0.736 0.462
  Social support (High level) -0.222(-0.574, 0.129) -1.245 0.214
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ISSN 1671-167X
CN 11-4691/R
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