住院老年患者衰弱与认知功能障碍的关系-现代医学

住院老年患者衰弱与认知功能障碍的关系

单位：湖北医药学院附属东风医院综合医疗科, 湖北十堰 442008

分类号：R749.16

出版年·卷·期（页码）：2018·46·第三期（326-330）

摘要：

目的：探讨住院老年患者衰弱与认知功能障碍之间的关系，为住院老年患者认知功能障碍的防治提供依据。方法：选取2015年7月至2016年12月在湖北医药学院附属东风医院综合医疗科住院的184例老年患者（年龄≥ 65岁）作为研究对象。收集住院患者临床数据信息，包括年龄、性别、体重指数（BMI）、血液常规、临床生化指标、糖化血红蛋白、用药情况等指标；采用简易精神状态检查量表（MMSE）评估老年患者认知情况，将老年患者分为认知功能正常组（105例）和认知功能障碍组（79例）；采用国际老年营养学会提出的简易虚弱问卷（FRAIL）评估患者的衰弱情况及住院老年患者认知功能障碍与衰弱的关系。结果：两组患者年龄、收缩压、红细胞数、血红蛋白、红细胞比容、血清总蛋白、前白蛋白、血清白蛋白、糖化血红蛋白比较，差异均有统计学意义（P<0.05）；认知功能障碍组衰弱检出率[35.4%（28/79）]高于认知功能正常组[12.4%（13/105）]（P<0.01）。多因素Logistic回归分析显示，经校正年龄、高血压、肾功能、糖化血红蛋白、营养状态、多重用药后衰弱是住院老年患者认知功能障碍的危险因素（OR=5.263，95% CI：2.465~9.621，P<0.01）。结论：衰弱是老年住院患者认知功能障碍的危险因素。

Objective: To explore the relationship between the frailty and cognitive impairment, provide a criterion for the prevention and treatment of cognitive impairment in hospitalized elderly patients.Methods: One hundred and eighty four patients of aged 65 years or older were recruited from Department of Integrated Medicine, Dongfeng Hospital, Hubei University of Medicine from July 2015 to December 2016. They were surveyed by collecting the clinical data such as age, sex, body mass index (BMI), blood routine, blood biochemical indicators, glycated hemoglobin (HbA_1C), and drug treatment history. The status of cognitive function by the Mini-menta State Examination (MMSE) was assessed, the patients were divided into normal cognitive function group (n=105) and cognitive impairment group (n=79). The debilitating condition of patient was estimated by the international society for elderly nutrition simple weakness questionnaire (FRAIL), according to the results, the relationship between the frailty and cognitive impairment was explored. Results: Two groups of patients had significant differences at age, systolic pressure (SBP), red blood cell, hemoglobin, hematocrit, total serum protein, prealbumin, albumin, and HbA_1C(P<0.05). The prevalence of frailty was significantly higher in the cognitive impairment group than that in the normal cognitive function group[35.4% (28/79) vs 12.4% (13/105)] (P<0.05). Multivariate Logistic regression analysis showed that the frailty increased the risk of cognitive impairment after adjusting for age, blood pressure, renal function, HbA_1C, status of nutrition and multiple drug use (OR=5.263, 95% CI:2.465-9.261, P<0.01).Conclusion: Frailty can be considered as a risk factor for cognitive impairment in hospitalized elderly patients.

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