| 蒋明金,冯天天,姚 雪,马丽月,刘 蕊.老年2型糖尿病患者认知衰弱危险因素的Logistic回归分析及对执行功能和跌倒恐惧发生风险的影响[J].,2022,(21):4076-4080 |
| 老年2型糖尿病患者认知衰弱危险因素的Logistic回归分析及对执行功能和跌倒恐惧发生风险的影响 |
| Logistic Regression Analysis of Risk Factors for Cognitive Frailty in Elderly Patients with Type 2 Diabetes Mellitus and Their Impact on Executive Function and Occurrence Risk of Fall Fear |
| 投稿时间：2022-06-07 修订日期：2022-06-30 |
| DOI：10.13241/j.cnki.pmb.2022.21.013 |
| 中文关键词: 老年 2型糖尿病 认知衰弱 执行功能 跌倒恐惧 |
| 英文关键词: Elderly Type 2 diabetes mellitus Cognitive frailty Executive function Fall fear |
| 基金项目:北京市医院管理局临床技术创新项目（XML201709） |
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| 中文摘要: |
| 摘要 目的：探讨老年2型糖尿病患者认知衰弱的危险因素，并分析认知衰弱对患者执行功能和跌倒恐惧发生风险的影响。方法：选择2019年3月至2022年3月首都医科大学附属北京朝阳医院京西院区收治的350例老年2型糖尿病患者，根据是否发生认知衰弱将患者分为认知衰弱组（31例）和无认知衰弱组（319例）。收集患者临床资料，分析影响老年2型糖尿病患者认知衰弱的危险因素。采用执行缺陷综合征行为学评价（BADS）、修订版跌倒效能量表（MFES）分别评价执行功能和跌倒恐惧，比较认知衰弱组、无认知衰弱组BADS、MFES评分以及跌倒恐惧发生率。结果：认知衰弱发生率为8.86%。单因素分析显示：认知衰弱组年龄≥70岁、文化程度为小学和初中、家庭月收入＜3 000元/月、未婚或离异、丧偶、运动次数＜3次/周、睡眠时间＜6 h、合并慢性病种类≥2种、2型糖尿病病程≥10年、合并营养不良、合并抑郁比例高于无认知衰弱组（P＜0.05）。多因素Logistic回归分析显示：年龄≥70岁、合并慢性病种类≥2种、营养不良、抑郁是老年2型糖尿病患者认知衰弱的危险因素（P＜0.05）。认知衰弱组转换卡片、动作计划、找钥匙、时间判断、动物园分布图和修订六元素测验得分和BADS总分、MFES评分低于无认知衰弱组（P＜0.05），跌倒恐惧发生率高于无认知衰弱组（P＜0.05）。结论：年龄≥70岁、合并慢性病种类≥2种、营养不良、抑郁是老年2型糖尿病患者认知衰弱的危险因素，认知衰弱可影响老年2型糖尿病患者的执行功能，增加跌倒恐惧发生风险。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the risk factors of cognitive frailty in elderly patients with type 2 diabetes mellitus, and to analyze the impact of cognitive frailty on executive function and occurrence risk of fall fear. Methods: A total of 350 elderly patients with type 2 diabetes mellitus who were admitted to West Beijing Hospital of Beijing Chaoyang Hospital Affiliated to Capital Medical University from March 2019 to March 2022 were selected, and they were divided into cognitive frailty group (31 cases) and non-cognitive frailty group (319 cases) according to the incidence of cognitive frailty. Clinical data of patients were collected, the risk factors of cognitive frailty in elderly patients with type 2 diabetes mellitus were analyzed. The executive function and fall fear were evaluated by the behavioral assessment of dysexecutive syndrome (BADS) and the modified falls efficacy scale (MFES), the BADS, MFES scores and the incidence of fall fear were compared between the cognitive frailty group and the non-cognitive frailty group. Results: The incidence of cognitive frailty was 8.86%. Univariate analysis showed that the age ≥70 years, educational level of primary school and junior high school, family monthly income ＜ 3000 yuan/month, unmarried or divorced, widowed, exercise frequency ＜ 3 times/week, sleep time ＜ 6 hours, combined types of chronic diseases ≥ 2 kinds, course of type 2 diabetes mellitus ≥10 years, combined malnutrition and combined depression in the cognitive frailty group were higher than those in the non-cognitive frailty group(P＜0.05). Multivariable Logistic regression analysis showed that age ≥ 70 years, combined types of chronic diseases ≥ 2 kinds, malnutrition and depression were the risk factors for cognitive frailty in elderly patients with type 2 diabetes mellitus(P＜0.05). The scores of card switching, action planning, key finding, time judgment, zoo distribution map, revised six element test, total BADS score and MFES score in the cognitive frailty group were lower than those in the non cognitive frailty group (P＜0.05), and the incidence of fall fear was higher than that in the non-cognitive frailty group (P＜0.05). Conclusion: The age ≥ 70 years, combined types of chronic diseases ≥ 2 kinds, malnutrition and depression are the risk factors of cognitive frailty in elderly patients with type 2 diabetes mellitus. Cognitive frailty can affect the executive function of elderly patients with type 2 diabetes mellitus and increase the occurrence risk of fall fear. |
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