【摘要】：目的 輕度認知功能障礙(Mild Cognitive Impairment,MCI)是老年癡呆的早期表現(xiàn)，MCI的高危因素比較復雜,且預后較差。本研究通過流行病學調(diào)查研究，闡明老年人MCI的患病率、危險因素；采用體育鍛煉、心理、社會交往、思維鍛煉等進行干預，尋找和評估社區(qū)老年人MCI干預的有效方法與措施。 方法 對社區(qū)內(nèi)60歲以上老人進行MoCA Version量表和一般健康問題問卷調(diào)查。采用病例-對照的流行病學研究方法，確定MCI發(fā)生的危險因素。 以社區(qū)為干預單位，隨機分為干預組和對照組。采用體育鍛煉、心理、社會交往、思維鍛煉等進行干預，觀察老年人MCI的發(fā)展結局。在1年后，再次通過篩查，了解MCI的康復、惡化、遷延及生存質(zhì)量等病情情況。通過比較研究人群的綜合干預的效果。 結果 1.去除癡呆、癱瘓、嚴重腦血管病后遺癥導致認知功能障礙者以及拒絕配合調(diào)查者調(diào)查2460人，輕度認知功能障礙450人，MCI的患病率為18.29%。 2.人口學資料中女性的MCI患病率高于男性（χ2=4.779，P＜0.05）；隨著年齡的增長MCI患病率逐步增高（χ2=112.773，P＜0.05）；腦力勞動MCI患病率低于體力勞動（χ2=13.311，P＜0.05）；MCI患病率在不同文化程度之間無顯著差異（χ2=0.001，P＞0.05）。 3.疾病史中MCI患病率在高血壓之間無顯著差異（χ2=0.007，P＞0.05）；在糖尿病之間無顯著差異（χ2=0.052，P＞0.05）。 4.社會活動中社區(qū)活動、親友交往、鄰居交往、家務勞動、子女交流均有統(tǒng)計學意義（χ2分別為16.668，8.624，，7.857，31.061，16.408， P＜0.05）。 5.生活習慣中吸煙與MCI患病率無顯著差異（χ2=1.652，P＞0.05）；與飲酒無顯著差異（χ2=3.814，P＞0.05）；與業(yè)余愛好有統(tǒng)計學意義（χ2=7.173，P＜0.05）；與體育鍛煉有統(tǒng)計學意義（χ2=4.714，P＜0.05）。 結論 1.社區(qū)老年人中，存在認知功能障礙的人較多。 2.女性MCI患病率高于男性，隨著年齡的增長MCI患病率逐步增高。 3.MCI患病率與高血壓、糖尿病的患病無關。 4.參加社區(qū)活動、親友交往多、鄰居交往多、家務勞動多、子女交流多、有業(yè)余愛好及參加體育鍛煉是MCI的保護因素，社區(qū)干預應以多開展人際交流、體育鍛煉為主。
[Abstract]:Objective mild cognitive impairment (Mild Cognitive Impairment,MCI) is an early manifestation of Alzheimer's disease. The high risk factors of MCI are complicated and the prognosis is poor. In this study, the prevalence and risk factors of MCI in the elderly were elucidated by epidemiological investigation, and the effective methods and measures of MCI intervention were found and evaluated by using physical exercise, psychology, social interaction, thinking exercise and so on. Methods MoCA Version scale and general health questionnaire were applied to the elderly over 60 years old in the community. Case-control epidemiological study was used to determine the risk factors of MCI. Community as intervention unit, randomly divided into intervention group and control group. In order to observe the development outcome of MCI in the elderly, physical exercise, psychology, social interaction and thinking exercise were used to intervene. One year later, the patients were screened again to understand the recovery, deterioration, prolongation and quality of life of MCI. The effect of comprehensive intervention was compared. Result 1. Eliminating dementia, paralysis, and sequelae of severe cerebrovascular disease, and refusing to cooperate with investigators to investigate 2460 people with mild cognitive impairment, the prevalence of MCI was 18.29. 2. The prevalence rate of MCI in female was higher than that in male (蠂 ~ 2 = 4.779, P < 0. 05), and the prevalence rate of MCI increased gradually with age (蠂 ~ 2, 112.773, P < 0. 05). The prevalence rate of MCI in mental labor was lower than that in manual labor (蠂 2 + 13.311% P < 0. 05). There was no significant difference in the prevalence of MCI among different education levels (蠂 2 + 0. 001 P > 0. 05). 3. There was no significant difference in the prevalence of MCI between hypertension and diabetes mellitus (蠂 ~ 2 / 0. 007) and diabetes (蠂 ~ 2 / 0. 052 / P > 0. 05). 4. There were significant differences in community activities, relatives and friends, neighbors, housework and children's communication in social activities (蠂 ~ 2 = 16.668 / 8.624 / 7.857 / 31.061 / 16.408, P < 0.05). 5. There was no significant difference between smoking and MCI in life habits (蠂 2 + 1.652P > 0. 05), there was no significant difference between smoking and alcohol consumption (蠂 2 + 3. 814 P > 0. 05), and there was statistical significance between smoking and hobbies (蠂 2 7. 173 P < 0 05), and there was no significant difference between smoking and alcohol consumption (蠂 2 2 = 3. 814 P > 0. 05). There was significant difference between physical exercise and physical exercise (蠂 2, 4.714, P < 0.05). Conclusion 1. Among the elderly in the community, there are more people with cognitive impairment. 2. The prevalence of MCI in women was higher than that in men, and the prevalence of MCI increased with age. The prevalence of 3.MCI was not associated with hypertension and diabetes. 4. Participation in community activities, more contacts between relatives and friends, more neighbors, more housework, more children exchange, have hobbies and participate in physical exercise are the protection factors of MCI, community intervention should focus on more interpersonal communication, physical exercise.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R749.1

【參考文獻】

相關期刊論文 前7條

1 洪震;;我國近年阿爾茨海默病流行病學研究現(xiàn)狀與展望[J];老年醫(yī)學與保健;2005年04期

2 郭明賢;郭峰;高麗;張桂紅;張秀芬;呂淑萍;;西安城區(qū)群居老人癡呆的流行病學調(diào)查與分析[J];實用老年醫(yī)學;2010年02期

3 陳艷春;周曉輝;;老年輕度認知功能障礙影響因素研究進展[J];實用老年醫(yī)學;2012年01期

4 王琦;毛禮煒;劉娟;趙合慶;劉春風;李文;;蒙特利爾認知評估量表在老年輕度認知損害中的應用[J];蘇州大學學報(醫(yī)學版);2011年04期

5 張建平;胡永濤;張新顏;;腦脈泰膠囊對血管性癡呆患者認知功能障礙的康復作用[J];中國醫(yī)藥導報;2006年29期

6 孟琛,湯哲;社區(qū)老年人認知功能變化及其預后的五年前瞻性研究[J];中華神經(jīng)科雜志;2000年03期

7 彭丹濤,許賢豪,劉江紅,矯玉娟,張華,殷劍,孟曉梅,謝琰臣,馮凱;簡易智能精神狀態(tài)檢查量表檢測老年期癡呆患者的應用探討[J];中國神經(jīng)免疫學和神經(jīng)病學雜志;2005年04期

本文編號：2387487