文章摘要
白安颖,胡亦新,徐伟豪,等.北京市社区高龄老年人轻度认知障碍的患病率及其与性别和肌少症的相关性[J].中国临床保健杂志,2021,24(2):175-182.
北京市社区高龄老年人轻度认知障碍的患病率及其与性别和肌少症的相关性
Prevalence of mild cognitive impairment and its correlation with sarcopenia in different genders among community-dwelling very old adults in Beijing
投稿时间：2021-02-20  
DOI：10.3969/J.issn.1672-6790.2021.02.006
中文关键词: 认知障碍  衰弱  肌肉骨骼生理现象  性别因素  老年人, 80以上
英文关键词: Cognition Disorders  Frailty  Musculoskeletal physiological phenomena  Sex factors  Aged,80 and over 〖FL
基金项目:军队重点保健专项科研项目(15BJZ41)；军队保健专项科研项目(20BJZ30)；中国人民解放军总医院第二医学中心2020年度专项科研项目(ZXD2010)
作者单位E-mail
白安颖 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
胡亦新 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
徐伟豪 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
刘娟 北京大学第三医院北方院区综合内科 chhyxcn@126.com 
孙静 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
邹琳 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
左婧 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
刘云霞 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
刘少妮 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
吴林娜 中国人民解放军总医院第二医学中心,急诊科 国家老年疾病临床医学研究中心,北京 100853 chhyxcn@126.com 
范利 中国人民解放军总医院第二医学中心,保健科,北京 100853 chhyxcn@126.com 
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中文摘要:
      目的 了解我国社区高龄老年人轻度认知障碍(MCI)的患病情况,探究MCI与高龄老年人肌少症不同组分的相关性及其性别差异,为我国高龄认知障碍老年人肌肉减少的危险因素管理提供参考。方法 共纳入北京社区80岁以上老年人428例,年龄(86.34±3.57)岁。使用蒙特利尔认知评估量表(MoCA)评价认知功能,分为认知功能正常组和MCI组。根据2019年亚洲肌少症工作组(AWGS)的最新定义诊断肌少症,比较认知功能正常组与MCI组老年人在社会人口学特征、生活方式、慢病患病情况、身体功能等方面的差异；使用二分类logistic模型探究MCI与不同性别肌少症及其诊断组成成分(步速、握力、骨骼肌含量下降)的相关性。结果 (1)在428名研究对象中,MCI的患病率为21.5%(92/428)。MCI患者与认知功能正常组相比,其肌少症患病率更高(47.83%比32.14%,P=0.005),握力和步速也分别显著低于认知功能正常组的老年人(20.6 kg比23.3 kg,P=0.002；0.79 m/s比0.88 m/s,P=0.038)。(2)在总体人群中,多因素logistic回归分析结果显示,肌少症(OR=1.93,95%CI:1.21~3.09)、低握力(OR=2.33,95%CI:1.40~3.87)和低步速(OR=2.33,95%CI:1.13~4.72)与MCI发生风险的增高有关。(3)按性别分层后,多因素分析显示,女性肌少症患者MCI的发生率是女性非肌少症患者的3.26倍(OR=3.26,95%CI:1.47~7.19),低握力女性发生MCI的风险是握力正常女性的3.60倍(OR=3.60,95%CI:1.81~7.16),而低步速女性MCI的发生风险是步速正常女性的3.61倍(OR=3.61,95%CI:1.36~9.63)。在男性老年人群中,肌少症及其组成成分与MCI的发生在单因素和多因素分析中其相关性均未达到统计学意义。结论 我国社区高龄老年人MCI的患病率较高,肌少症及步速下降、握力下降与发生MCI风险均呈显著正相关,并在老年女性中相关性更为显著。
英文摘要:
      Objective To investigate the prevalence of mild cognitive impairment (MCI) in the community-dwelling elders,and explore the correlation between sarcopenia (and its defining components) and risk of MCI.Methods A total of 428 elders aged 80 and over in one Beijing community were included.The participants were divided into MCI group and non-MCI group based on the total scores of the Montreal Cognitive Assessment (MoCA).Sarcopenia participants were diagnosed according to the newest definition of 2019 Asian Working Group for Sarcopenia (AWGS),and their social demographic characteristics,lifestyle,chronic disease condition and physical function were collected and compared.The binary and multivariate logistic models were used to explore the association between sarcopenia,low handgrip strength,low gait speed and risk of MCI.Results The prevalence of MCI among Chinese very old community-dwelling adults was 21.5% (92/428).Compared with non-MCI individuals,the individuals with MCI had higher prevalence of sarcopenia (47.83% vs.32.14%,P=0.005),lower handgrip strength (20.6 kg vs.23.3 kg,P=0.002) and lower gait speed (0.79 m/s vs.0.88 m/s,P=0.038).Multivariate regression analysis showed that sarcopenia (OR=1.93,95%CI:1.21-3.09),decreased handgrip strength (OR=2.33,95%CI:1.40-3.87) and reduced gait speed (OR=2.33,95% CI:1.13-4.72) were independent risk factors of MCI in the whole population.After gender stratification,we found that the risk of MCI among sarcopenia female was 3.26 times higher than non-sarcopenia female,and the risk of MCI in women with low grip strength was 3.60 times higher than that in women with normal grip strength (OR=3.60,95%CI:1.81-7.16),while the risk of MCI in women with low walking speed was 3.61 times higher than that in women with normal walking speed (OR=3.61,95%CI:1.36-9.63)after adjusting for all confounding factors.The correlation between sarcopenia,its defining components and risk of MCI was not statistically significant in univariate and multivariate analysis in males.Conclusions The prevalence of MCI among very old community-dwelling adults is high.Sarcopenia,low handgrip strength and low gait speed are associated with higher risk of MCI among the whole and female population.
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