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社区老年人社会经济地位与轻度认知功能障碍的相关性研究

范仁嘉 曾燕 许浪 刘丹 程桂荣

范仁嘉, 曾燕, 许浪, 刘丹, 程桂荣. 社区老年人社会经济地位与轻度认知功能障碍的相关性研究[J]. 中华疾病控制杂志, 2023, 27(8): 895-900. doi: 10.16462/j.cnki.zhjbkz.2023.08.005
引用本文: 范仁嘉, 曾燕, 许浪, 刘丹, 程桂荣. 社区老年人社会经济地位与轻度认知功能障碍的相关性研究[J]. 中华疾病控制杂志, 2023, 27(8): 895-900. doi: 10.16462/j.cnki.zhjbkz.2023.08.005
FAN Renjia, ZENG Yan, XU Lang, LIU Dan, CHENG Guirong. Association between socioeconomic status and mild cognitive impairment in community-living older adults[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(8): 895-900. doi: 10.16462/j.cnki.zhjbkz.2023.08.005
Citation: FAN Renjia, ZENG Yan, XU Lang, LIU Dan, CHENG Guirong. Association between socioeconomic status and mild cognitive impairment in community-living older adults[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(8): 895-900. doi: 10.16462/j.cnki.zhjbkz.2023.08.005

社区老年人社会经济地位与轻度认知功能障碍的相关性研究

doi: 10.16462/j.cnki.zhjbkz.2023.08.005
基金项目: 

国家重点研发计划 2020YFC2006000

国家自然科学基金 72174159

详细信息
    通讯作者:

    程桂荣,E-mail: chengguirong@wust.edu.cn

  • 中图分类号: R161.7

Association between socioeconomic status and mild cognitive impairment in community-living older adults

Funds: 

National Key Research and Development Program of China 2020YFC2006000

National Natural Science Foundation of China 72174159

More Information
  • 摘要:   目的  探讨老年人社会经济地位(socioeconomic status,SES)与轻度认知功能障碍(mild cognitive impairment,MCI)患病的关联。  方法  数据来源于湖北老年记忆队列(the Hubei Memory and Aging Cohort Study,HMACS);共纳入7 887名≥65岁老年人,他们完成了3全套神经心理评估和临床体格检查。SES通过受教育程度、职业性质和家庭人均月收入综合评定;MCI由专家组根据Petersen标准和中国痴呆与认知障碍诊治指南进行诊断;多因素logistic回归分析模型分析老年人SES与MCI患病的关联。  结果  共纳入7 887名调查对象,平均年龄(71.74±5.58)岁,MCI检出率为23.00%(95% CI: 22.07%~23.93%);低SES组MCI检出率(44.65%)高于中SES组MCI检出率(16.89%)和高SES组MCI检出率(9.18%);女性高于男性;农村高于城市。分层分析发现:城市男性低SES组MCI患病风险为高SES组的6.276倍(OR=6.276, 95% CI: 4.017~9.805),城市女性低SES组MCI患病风险为高SES组的3.978倍(OR=3.978, 95% CI: 2.943~5.376);依据现有SES标准,农村女性老年人SES分布不均匀。  结论  低SES组老年人MCI检出率较高,认知功能障碍的防控要密切关注低SES组老年人,特别是社区低收入、低教育程度的老年人。
  • 表  1  调查人群的基本情况

    Table  1.   Basic information of the participants

    变量 Variable SES[人数(占比/%)]
    SES [Number of people (proportion /%)]
    低 Low
    (n=2 383)
    中 Middle
    (n=3 173)
    高 High
    (n=2 331)
    χ2/Z
    value
    P
    value
    性别 Gender 52.104 < 0.001
      男 Male 994(41.71) 1 466(46.20) 1 216(52.17)
      女 Female 1 389(58.29) 1 707(54.80) 1 115(47.83)
    年龄/岁, (x±s)  Age /years, (x±s) 72.02±5.43 71.17±5.48 72.22±5.81 87.907 < 0.001
    居住地 Region 3 131.978 < 0.001
      城市 Urban 679(28.49) 2 609(82.23) 2 297(98.54)
      农村 Rural 1 704(71.51) 564(17.77) 34(1.46)
    婚姻状况 Marital status 629.937 < 0.001
      有配偶 Married 1 264(53.04) 2 119(66.78) 2 023(86.79)
      无配偶 Mateless 1 119(46.96) 1 054(33.22) 308(13.21)
    吸烟 Smoking 5.586 0.061
      是 Yes 753(31.60) 955(30.10) 663(28.44)
      否 No 1 630(68.40) 2 218(69.90) 1 668(71.56)
    饮酒 Drinking 261.413 < 0.001
      是 Yes 1 021(42.85) 811(25.56) 550(23.60)
      否 No 1 362(57.15) 2 362(74.44) 1 781(76.40)
    体育锻炼 Physical activity 502.804 < 0.001
      是 Yes 1 566(66.10) 2 726(85.94) 2 087(89.53)
      否 No 803(33.90) 446(14.06) 244(10.47)
    智力活动 Intellectual activity 1 019.457 < 0.001
      是 Yes 901(37.90) 2 140(68.28) 1 894(81.46)
      否 No 1 476(62.10) 994(31.72) 431(18.54)
    高血压 Hypertension 4.754 0.093
      是 Yes 1 431(60.05) 1 973(62.18) 1 469(63.02)
      否 No 952(39.95) 1 200(37.82) 862(36.98)
    糖尿病 Diabetes 38.418 < 0.001
      是 Yes 307(12.88) 557(17.55) 451(19.35)
      否 No 2 076(87.12) 2 616(82.45) 1 880(80.65)
    冠心病 Coronary heart disease 6.989 0.030
      是 Yes 385(16.16) 447(14.09) 382(16.39)
      否 No 1 988(83.84) 2 726(85.91) 1 949(83.61)
    脑血管病 Cerebral vascular disease 6.273 0.043
      是 Yes 459(19.26) 565(17.81) 477(20.46)
      否 No 1 924(80.74) 2 608(82.19) 1 854(79.54)
    向心性肥胖 Central obesity 40.458 < 0.001
      是 Yes 1 729(72.56) 2 106(66.37) 1 499(64.31)
      否 No 654(27.44) 1 067(33.63) 832(35.69)
    抑郁 Depressed 10.890 0.004
      是 Yes 115(4.83) 105(3.31) 76(3.26)
      否 No 2 268(95.17) 3 068(96.69) 2 255(96.74)
    失眠 Insomnia 205.092 < 0.001
      是 Yes 1 550(65.04) 1 627(51.28) 1 044(44.79)
      否 No 833(34.96) 1 546(48.72) 1 287(55.21)
    MCI 948.872 < 0.001
      是 Yes 1 064(44.65) 536(16.89) 214(9.18)
      否 No 1 319(55.35) 2 637(83.11) 2 117(90.82)
    注: 1. 15人在体育锻炼方面信息缺失,51人在智力活动习惯方面信息缺失。
    2. MCI, 轻度认知功能障碍; SES, 社会经济地位。
    Notes: 1. Fifteen people lacked information on physical exercise and 51 people lacked information on intellectual activity habits.
    2. MCI, mild cognitive impairment; SES, socioeconomic status.
    下载: 导出CSV

    表  2  不同SES组老年人MCI检出率的城乡、性别差异

    Table  2.   Differences in the prevalence of MCI among older adults in different SES groups with regard to urban-rural and gender disparities

    变量  Variable MCI
    男  Male 女  Female
    患病率/%
    Prevalence/%
    患病率(95% CI)/%
    Prevalence(95% CI)/%
    χ2
    value
    P
    value
    患病率/%
    Prevalence/%
    患病率(95% CI)/%
    Prevalence(95% CI)/%
    χ2
    value
    P
    value
    农村 SES Rural SES
      低  Low 41.26 37.79~44.73 / / 54.54 51.32~57.75 / /
      中 Middle 31.88 27.09~36.67 9.288 0.002 42.64 35.67~49.61 9.217 0.002
      高 High 18.52 2.86~34.18 7.386 0.007 // // // //
    城市 SES Urban SES
      低  Low 34.72 28.32~41.12 / / 35.21 30.84~39.57 / /
      中 Middle 11.28 9.41~13.16 77.223 < 0.001 13.97 12.22~15.75 103.976 < 0.001
      高  High 7.99 6.45~9.53 486.356 < 0.001 10.11 8.33~11.89 142.429 < 0.001
    注:1. “/”表示该组作为参考组; “//”表示农村女性高SES组7人,不满足分析条件。
    2. SES, 社会经济地位; MCI, 轻度认知功能障碍。
    Notes: 1. "/" indicates that the group serves as a reference group; "//" indicates that there are 7 rural women in the high SES group, which do not meet the analysis conditions.
    2. SES, socioeconomic status; MCI, mild cognitive impairment.
    下载: 导出CSV

    表  3  不同地区及性别老年人SES与MCI患病的关联性

    Table  3.   Relationship between SES and MCI in older adults of different regions and gender

    变量  Variable 男  Male 女  Female
    P值  value OR值  value 95% CI P值  value OR值 value 95% CI
    农村 SES Rural SES
      高  High 1.000 //
      中 Middle 0.047 2.862 1.013~8.089 1.000
      低  Low 0.026 3.208 1.150~8.951 0.002 1.468 1.146~1.880
    城市 SES Urban SES
      高  High 1.000
      中  Middle 0.021 1.425 1.054~1.927 0.003 1.463 1.136~1.885
      低  Low < 0.001 6.276 4.017~9.805 < 0.001 3.978 2.943~5.376
    注:1. 模型控制了年龄、婚姻状况、饮酒、向心性肥胖、抑郁、失眠、体育锻炼以及智力活动习惯。
    2. “//”表示农村女性高SES组7人,不满足分析条件。
    3. SES, 社会经济地位; MCI, 轻度认知功能障碍。
    Notes: 1. The model adjusting for age, marital status, alcohol consumption, centripetal obesity, depression, insomnia, physical activity, and intellectual activity habits.
    2. "//" indicates that there were 7 rural women in the high SES group who did not meet the analysis conditions.
    3. SES, socioeconomic status; MCI, mild cognitive impairment.
    下载: 导出CSV
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  • 收稿日期:  2022-09-19
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  • 刊出日期:  2023-08-10

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