A 3-year follow-up study of social, lifestyle and health predictors of cognitive impairment in a Chinese older cohort
A 3-year follow-up study of social, lifestyle and health predictors of cognitive impairment in a Chinese older cohort
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DOI：
10.1093/ije/30.6.1389
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发表时间：
2001-12-01
影响因子：
7.7
通讯作者：
Yu, ALM
中科院分区：
文献类型：
--
作者：
Ho, SC;Woo, J;Yu, ALM
背景亚洲老年人群的纵向数据有限。本文报道了一组70岁以上老年人认知功能损害（CI）的相关因素。认知功能的基线信息，以及一些社会和健康的变量，通过面对面的访谈，在受访者的居住地。结果变量是988名最初没有CL并且可以在36个月随访时联系到的队列成员中CI的发展。CI的评估工具是基于老年人克利夫顿评估程序（CAPE）的信息/定向部分，使用7分作为分界点。结果随访3年时，男性有6.7%，女性有22.2%的CI。年龄校正的CI年发病率男性为1.52%，女性为6.37%。多因素Logistic回归分析显示，女性患CI的风险是男性的2.5倍。年龄每增加5岁，风险增加约1.5倍。通过16英尺步行评估的缓慢步态时间是两种性别CI的预测因子（比值比[OR] = 1.03/秒增加，95%CI：1.0-1.07）。与居住在社区的男性相比，居住在机构中的男性患CI的风险增加了4.4倍（95%CI：1.7-11.1），而女性的OR为2.5（95%CI：1.3-4.9）。在女性中，没有接受过正规教育的女性患CI的风险增加了3.2倍（95% CI：1.8-5.5）。收入依赖也增加了CI的风险约四倍，基线时没有运动与CI风险增加两倍相关。随访期间发生脑卒中也增加了脑梗死的危险性（OR = 8.4，9.5%CI：1.2-59.4）。没有正规教育，缓慢的步态时间和机构增加了CI的风险在两种性别。虽然教育对妇女的影响更大，但机构化对男子的影响更大。经济依赖、缺乏锻炼和意外中风在女性中起着重要作用。
Background Longitudinal data on the older population in the Asian setting are limited. This paper reports the factors associated with the development of cognitive impairment (CI) in a cohort of Chinese elderly aged greater than or equal to70 years.Methods The study cohort comprising 2030 subjects aged greater than or equal to70 years was assembled in 1991-1992 and followed for 36 months. Baseline information on cognitive function, as well as a number of social and health variables were obtained through face-to-face interview at the respondent's place of residence. The outcome variable was the development of CI among 988 cohort members who were initially free from CL and who could be contacted at the 36-month follow-up. The instrument used to assess CI was based on the information/orientation part of the Clifton Assessment Procedure for the elderly (CAPE), using a cut-off point of 7.Results Of the men, 6.7%, but 22.2% of women had CI at 3-year follow-up. The age-adjusted annual incidence of CI was 1.52% in men, and 6.37% in women. Multivariate logistic regression analysis showed that women had a 2.5-fold increased risk of having CI, compared with men. The risk increased by about 1.5-fold with every 5-year increase in age. Slow gait time, as assessed by the 16-foot walk, was a predictor of CI in both sexes (odds ratio [OR] = 1.03 per second increase, 95% CI: 1.0-1.07). Men residing in institutions had a 4.4-fold increased risk of having CI (95% CI: 1.7-11.1) compared with those residing in community, while the OR among women was 2.5 (95% CI : 1.3-4.9). Among women, no formal education increased the risk of having CI by 3.2-fold (95% CI : 1.8-5.5). Income dependency also increased the risk of CI by about fourfold, and no exercise at baseline was associated with a twofold increased risk of CI. Incident stroke during follow-up also increased the risk of CI (OR = 8.4, 9 5 % CI : 1.2-59.4).Conclusions Older age and female sex were independent factors associated with CI. No formal education, slow gait time and institutionalization increased the risk of CI in both sexes. While education had a stronger effect in women, institutionalization had a stronger effect in men. Financial dependency, lack of exercise and incident stroke played a significant role in women.