基于蒙特利尔认知评估量表的上海市45~65岁社区女性认知水平及轻度认知障碍分布特征的横断面研究

黄雨; 陈红; 金晨阳; 张雨格; 蒋伟利; 赵琦; 朱丽萍; 徐飚

doi:10.16462/j.cnki.zhjbkz.2024.09.006

基于蒙特利尔认知评估量表的上海市45~65岁社区女性认知水平及轻度认知障碍分布特征的横断面研究

doi: 10.16462/j.cnki.zhjbkz.2024.09.006

黄雨^{1, 2},
陈红³,
金晨阳^{1, 2},
张雨格^{1, 2},
蒋伟利^{1, 2},
赵琦^{1, 2},
朱丽萍⁴,
徐飚^{1, 2, ,}

1.
复旦大学公共卫生学院流行病学教研室, 上海 200032
2.
复旦大学国家卫生健康委员会卫生技术评估重点实验室, 上海 200032
3.
上海市奉贤区妇幼保健所妇女保健科, 上海 201400
4.
上海市健康促进中心, 上海 200040

黄雨和陈红为共同第一作者

基金项目:

上海市公共卫生体系建设三年行动计划(2020-2022)妇幼整链式全生命周期健康管理服务模式优化 GWV-9.4

详细信息

通讯作者:
徐飚，E-mail：bxu@shmu.edu.cn

中图分类号: R749.1
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- 文章访问数: 43
- HTML全文浏览量: 10
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- 被引次数: 0
出版历程
- 收稿日期: 2024-01-04
- 修回日期: 2024-05-15
- 网络出版日期: 2024-10-24
- 刊出日期: 2024-09-10

Cognitive health and distribution of mild cognitive impairment of women aged 45-65 in communities of Shanghai: a cross-sectional study based on Montreal cognitive assessment

HUANG Yu^{1, 2},
CHEN Hong³,
JIN Chenyang^{1, 2},
ZHANG Yuge^{1, 2},
JIANG Weili^{1, 2},
ZHAO Qi^{1, 2},
ZHU Liping⁴,
XU Biao^{1, 2
, ,}

1.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
2.
Key Lab of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
3.
Department of Health Care for Women, Shanghai Fengxian Center for Women and Children′s Health, Shanghai 201400, China
4.
Shanghai Municipal Center for Health Promotion, Shanghai 200040, China

HUANG Yu and CHEN Hong contributed equally to this article

Funds:

Three-year Action Plan of Shanghai Public Health System Construction (2020-2022) Optimization of MCH Whole Life Cycle Health Management Service Model GWV-9.4

More Information

Corresponding author: XU Biao, E-mail: bxu@shmu.edu.cn

摘要

摘要: 目的了解上海市45~65岁社区女性的认知水平，掌握该人群的轻度认知障碍(mild cognitive impairment, MCI)分布特征及其影响因素。方法以上海市8个区自愿参加骨健康队列的45~65岁社区女性为对象，使用一般情况调查表收集人口社会学特征、生活方式、绝经状态、生育史和慢性病患病等信息；使用蒙特利尔认识评估量表(Montreal cognitive assessment, MoCA)测量研究对象的认知功能并筛选MCI患者，采用多因素logistic回归分析模型分析MCI患病的影响因素。结果本研究共完成2 205名45~65岁社区女性的问卷调查和MoCA评分，MoCA平均得分为(26.47±3.14)分，MCI患病率为10.25%。多元logistic回归分析模型分析结果显示，MCI患病风险与年龄呈正相关(OR=2.393, 95% CI: 1.345~4.256)；相较于小学及以下受教育水平，初中(OR=0.375, 95% CI: 0.240~0.585)、高中或中专(OR=0.185, 95% CI: 0.115~0.298)和大专及以上(OR=0.067, 95% CI: 0.033~0.135)学历女性的MCI患病风险下降；居住在市区(OR=0.563, 95% CI: 0.405~0.785)、饮食荤素均衡(OR=0.678, 95% CI: 0.466~0.986)的45~65岁社区女性的MCI患病风险低于居住在郊区和饮食以素食为主的女性。结论上海市45~65岁社区女性MCI的患病率为10.25%。年龄、文化程度、居住区和饮食习惯与45~65岁社区女性MCI患病风险有关。社区开展围绝经期和绝经早期女性人群认知功能评价，可为探讨早期干预策略，延缓MCI进程提供基础依据。
- 轻度认知障碍 /
- 蒙特利尔认知评估量表 /
- 社区女性 /
- 绝经
Abstract: Objective To investigate the cognitive level of women aged 45-65 in the community in Shanghai, and to describe the distribution of mild cognitive impairment (MCI) and its influencing factors. Methods The study subjects were women aged 45-65 in communities of 8 districts in Shanghai who volunteered to participate in the "bone health cohort". General information questionnaire was used to collect demographic information, lifestyle, menopausal status, reproductive history and chronic disease. Montreal cognitive assessment (MoCA) was used to measure cognitive function and screen for patients with MCI. Multivariate Logistic regression was used to analyze the influencing factors of MCI. Results A total of 2 205 women aged 45-65 in communities completed the questionnaire interview and MoCA-B assessment. The average score of MoCA-B was (26.47±3.14), points and the prevalence of mild cognitive impairment (MCI) was 10.25%. The results of the multivariate Logistic regression showed that the incidence of MCI was positively correlated with age (OR=2.393, 95% CI: 1.345-4.256). Compared to those with the education level of primary school or below, women completed junior high school (OR=0.375, 95% CI: 0.240-0.585), senior high school or technical school (OR=0.185, 95%CI: 0.115-0.298) and college or above (OR=0.067, 95% CI: 0.033-0.135) had a reduced risk ofMCI. The risk ofMCI in participating women living in urban areas (OR=0.563, 95% CI: 0.405-0.785) was significantly lower than those living in rural areas, and women having a balanced diet (OR=0.678, 95% CI: 0.466-0.986) also had a significantly lower risk of MCI than those having a vegetarian diet. Conclusions The prevalence of MCI among women aged 45-65 in communities of Shanghai was 10.25%. Age, education, living area and dietary habit were associated with MCI prevalence. Cognitive function assessment on women at peri-menopausal and early menopausal stage in community could provide basic evidences for developing early intervention strategies to prevent MCI and its progression.
- Mild cognitive impairment /
- Montreal cognitive assessment /
- Women in communities /
- Menopause

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表 1 上海市45~65岁社区女性蒙特利尔量表总分情况

Table 1. Total score of Montreal cognitive assessment for women aged 45-65 in community in Shanghai

特征Characteristic	合计Total ^① (n=2 205)	总分 Total score ^②	t/F值 value	P值 value
年龄/岁Age/years			15.825	< 0.001
45~55	1 104(50.1)	27.47±2.35
>55~65	1 101(49.9)	25.47±3.48
居住区Residential area			6.965	< 0.001
市区Urban	1 030(46.7)	26.69±2.82
郊区Rural	1 175(53.3)	26.04±3.33
文化程度Education level			151.261	< 0.001
大专及以上Junior college or above	794(36.0)	27.87±2.01
高中或中专Senior high school or technical school	693(31.4)	26.52±2.95
初中Junior high school	581(26.4)	25.23±3.33
小学Primary school or below	137(6.2)	23.44±4.12
工作状态Work status			65.544	< 0.001
在职Incumbented	1 142(51.8)	27.20±2.64
离退休Retired	917(41.6)	25.73±3.38
全职在家Housewife	146(6.6)	25.46±3.70
家庭人均月收入/元Monthly income per capita/yuan			40.017	< 0.001
< 5 000	832(37.7)	25.56±3.36
5 000~ < 10 000	730(33.1)	26.98±2.63
10 000~ < 15 000	337(15.3)	27.13±2.94
≥15 000	306(13.9)	27.02±3.25
婚姻状况Marital status			2.067	0.103
已婚Married	1 989(90.2)	26.48±3.16
未婚Unmarried	20(0.9)	27.45±1.91
丧偶Widowed	66(3.0)	25.71±3.67
离异/分居Divorced/separated	130(5.9)	26.64±2.53
生育史Reproductive history			12.933	< 0.001
有Yes	2 156(97.8)	26.44±3.15
无No	49(2.2)	28.06±2.03
绝经状态Menopause status			221.122	< 0.001
是Yes	1 219(55.3)	25.62±3.41
否No	986(44.7)	27.53±2.38
吸烟状况Smoking status			2.148	0.143
是Yes	26(1.2)	25.58±3.88
否No	2 179(98.8)	26.48±3.13
饮酒状况Drinking status			14.250	< 0.001
是Yes	450(20.4)	26.97±2.55
否No	1 755(79.6)	26.35±3.26
饮食习惯Eating habit			38.948	< 0.001
荤素均衡Balanced diet	1 921(87.1)	26.63±3.07
素食为主Vegetarian diet	284(12.9)	25.40±3.39
糖尿病Diabetes			15.841	< 0.001
有Yes	125(5.7)	25.39±3.69
无No	2 080(94.3)	26.54±3.09
高血压Hypertension			8.459	0.004
有Yes	461(20.9)	26.10±3.38
无No	1 744(79.1)	26.57±3.06
骨质疏松症Osteoporosis			1.051	0.305
有Yes	178(8.1)	26.24±3.10
无No	2 027(91.9)	26.49±3.14
恶性肿瘤Malignancy			2.414	0.120
有Yes	846(38.4)	26.60±3.19
无No	1 359(61.6)	26.39±3.10
其他慢性病Other chronic disease			0.165	0.685
有Yes	110(5.0)	26.59±2.84
无No	2 095(95.0)	26.47±3.15
注：①以人数(占比/%)表示；②以x±s表示。 Note: ① Number of people (proportion/%); ② x±s.

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表 2 上海市45~65岁社区女性蒙特利尔量表各认知模块得分情况

Table 2. Scores of cognitive modules of MoCA-B for women aged 45-65 in community in Shanghai

特征Characteristic	执行功能 Perform function ^①	流畅性 Fluency ^①	定向 Orientation ^①	计算 Calculation ^①	抽象 Abstract thinking ^①
合计Total (n=2 205)	0.73±0.44	1.64±0.52	5.93±0.35	2.79±0.57	2.66±0.72
年龄/岁Age/years
45~55	0.80±0.40 ^②	1.74±0.46^②	5.97±0.18^②	2.87±0.44^②	2.84±0.48^②
>55~65	0.66±0.47	1.54±0.55	5.89±0.46	2.70±0.66	2.48±0.86
居住区Residential area
市区Urban	0.78±0.42^②	1.67±0.50^②	5.89±0.42^②	2.78±0.56	2.80±0.50^②
郊区Rural	0.69±0.46	1.61±0.53	5.96±0.28	2.80±0.58	2.53±0.85
文化程度Education level
大专及以上Junior college or above	0.85±0.36^②	1.79±0.42^②	5.96±0.30^②	2.93±0.29^②	2.91±0.32^②
高中或中专Senior high school or technical school	0.74±0.44	1.66±0.49	5.92±0.41	2.80±0.56	2.72±0.62
初中Junior high school	0.62±0.49	1.52±0.56	5.93±0.30	2.67±0.70	2.42±0.87
小学Primary school or below	0.45±0.50	1.23±0.62	5.82±0.48	2.44±0.91	1.92±1.20
工作状态Work status
在职Incumbented	0.77±0.42^②	1.72±0.48^②	5.95±0.31^②	2.85±0.46^②	2.80±0.55^②
离退休Retired	0.69±0.46	1.55±0.54	5.91±0.39	2.73±0.64	2.52±0.83
全职在家Housewife	0.65±0.48	1.62±0.53	5.88±0.36	2.68±0.78	2.42±0.90
家庭人均月收入/元Monthly income per capita/yuan
< 5 000	0.65±0.48^②	1.55±0.56^②	5.91±0.39^②	2.71±0.66^②	2.45±0.88^②
5 000~ < 10 000	0.75±0.43	1.68±0.49	5.94±0.34	2.83±0.51	2.77±0.59
10 000~ < 15 000	0.82±0.39	1.73±0.46	5.93±0.36	2.85±0.44	2.85±0.46
≥15 000	0.79±0.41	1.71±0.48	5.96±0.26	2.83±0.56	2.76±0.60

特征Characteristic	延迟回忆 Delayed recall ^①	视知觉 Visual perception ^①	命名 Naming ^①	注意力Attention ^①
特征Characteristic	延迟回忆 Delayed recall ^①	视知觉 Visual perception ^①	命名 Naming ^①	Ⅰ	Ⅱ
合计Total (n=2 205)	3.44±1.31	2.51±0.71	3.84±0.47	0.96±0.21	1.90±0.35
年龄/岁Age/years
45~55	3.65±1.23^②	2.71±0.54^②	3.93±0.30^②	0.98±0.13^②	1.95±0.24^②
>55~65	3.23±1.35	2.31±0.80	3.76±0.58	0.93±0.26	1.86±0.42
居住区Residential area
市区Urban	3.66±1.18^②	2.60±0.61^②	3.89±0.38^②	0.95±0.22^②	1.86±0.40^②
郊区Rural	3.25±1.39	2.43±0.78	3.81±0.54	0.96±0.19	1.94±0.29
文化程度Education level
大专及以上Junior college or above	3.76±1.17^②	2.78±0.43^②	3.94±0.27^②	0.97±0.16^②	1.94±0.26^②
高中或中专Senior high school or technical school	3.42±1.31	2.49±0.71	3.85±0.45	0.96±0.20	1.91±0.34
初中Junior high school	3.11±1.38	2.28±0.80	3.76±0.62	0.94±0.23	1.87±0.41
小学Primary school or below	3.05±1.31	2.02±0.94	3.66±0.62	0.88±0.32	1.80±0.50
工作状态Work status
在职Incumbented	3.62±1.25^②	2.65±0.59^②	3.89±0.39^②	0.96±0.18	1.93±0.30^②
离退休Retired	3.24±1.34	2.36±0.78	3.81±0.52	0.94±0.23	1.89±0.39
全职在家Housewife	3.32±1.40	2.32±0.85	3.69±0.65	0.95±0.21	1.84±0.44
家庭人均月收入/元Monthly income per capita/yuan
< 5 000	3.23±1.39^②	2.33±0.80^②	3.76±0.58^②	0.94±0.23	1.90±0.37
5 000~ < 10 000	3.55±1.25	2.62±0.61	3.91±0.33	0.96±0.19	1.91±0.33
10 000~ < 15 000	3.59±1.25	2.66±0.59	3.89±0.37	0.96±0.19	1.91±0.32
≥15 000	3.59±1.23	2.58±0.67	3.87±0.47	0.96±0.20	1.91±0.35
注：①以x±s表示; ② P＜0.05。 Note: ① x±s; ② P＜0.05.

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表 3 不同特征上海市45~65岁社区女性MCI情况比较

Table 3. Comparison of MCI among women aged 45-65 in community in Shanghai with different characteristics

特征Characteristic	单因素分析Univariate analysis		多因素分析Multivariate analysis
特征Characteristic	OR值value (95% CI)	P值value	OR值value (95% CI)	P值value
年龄/岁Age/years
45~55	1.000		1.000
>55~65	5.587(3.913~7.977)	< 0.001	2.393(1.345~4.256)	0.003
居住区Residential area
郊区Rural	1.000		1.000
市区Urban	0.466(0.346~0.626)	< 0.001	0.563(0.405~0.785)	0.001
文化程度Education level
小学Primary school or below	1.000		1.000
初中Junior high school	0.441(0.292~0.667)	< 0.001	0.375(0.240~0.585)	< 0.0001
高中或中专Senior high school or technical school	0.191(0.123~0.297)	< 0.001	0.185(0.115~0.298)	< 0.0001
大专及以上Junior college or above	0.033(0.017~0.063)	< 0.001	0.067(0.033~0.135)	< 0.0001
工作状态Work status
在职Incumbented	1.000		1.000
离退休Retired	3.034(2.221~4.145)	< 0.001	1.065(0.726~1.562)	0.749
全职在家Housewife	3.539(2.146~5.834)	< 0.001	1.116(0.645~1.932)	0.694
婚姻状况Marital status
已婚Married	1.000		1.000
未婚Unmarried	0.000(0.000)	0.998	0.000(0.000)	0.998
丧偶Widowed	1.913(0.007~3.635)	0.048	1.688(0.830~3.435)	0.148
离异/分居Divorced/separated	0.490(0.226~1.063)	0.071	0.480(0.212~1.085)	0.078
家庭人均月收入/元Monthly income per capita/yuan
< 5 000	1.000		1.000
5 000~ < 10 000	0.322(0.226~0.458)	< 0.001	0.733(0.494~1.088)	0.123
10 000~ < 15 000	0.277(0.166~0.460)	< 0.001	0.931(0.531~1.635)	0.805
≥15 000	0.380(0.237~0.607)	< 0.001	0.851(0.507~1.428)	0.541
绝经状态Menopause status
否No	1.000		1.000
是Yes	5.643(3.842~8.286)	< 0.001	1.655(0.898~3.048)	0.106
吸烟状况Smoking status
否No	1.000
是Yes	1.603(0.547~4.693)	0.389
饮酒状况Drinking status
否No	1.000		1.000
是Yes	0.499(0.329~0.757)	0.001	0.849(0.540~1.334)	0.477
饮食习惯Eating habit
素食为主Vegetarian diet	1.000		1.000
荤素均衡Balanced diet	0.444(0.317~0.623)	< 0.001	0.678(0.466~0.986)	0.042
糖尿病Diabetes
无No	1.000		1.000
有Yes	2.085(1.297~3.353)	0.002	1.349(0.807~2.254)	0.253
高血压Hypertension
无No	1.000
有Yes	1.315(0.955~1.810)	0.093
骨质疏松症Osteoporosis
无No	1.000
有Yes	1.484(0.949~2.321)	0.083
恶性肿瘤Malignancy
无No	1.000
有Yes	0.813(0.609~1.086)	0.161
其他慢性病Other chronic disease
无No	1.000
有Yes	1.076(0.581~1.993)	0.815

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特征Characteristic	合计Total ^① (n=2 205)	总分 Total score ^②	t/F值 value	P值 value
年龄/岁Age/years			15.825	< 0.001
45~55	1 104(50.1)	27.47±2.35
>55~65	1 101(49.9)	25.47±3.48
居住区Residential area			6.965	< 0.001
市区Urban	1 030(46.7)	26.69±2.82
郊区Rural	1 175(53.3)	26.04±3.33
文化程度Education level			151.261	< 0.001
大专及以上Junior college or above	794(36.0)	27.87±2.01
高中或中专Senior high school or technical school	693(31.4)	26.52±2.95
初中Junior high school	581(26.4)	25.23±3.33
小学Primary school or below	137(6.2)	23.44±4.12
工作状态Work status			65.544	< 0.001
在职Incumbented	1 142(51.8)	27.20±2.64
离退休Retired	917(41.6)	25.73±3.38
全职在家Housewife	146(6.6)	25.46±3.70
家庭人均月收入/元Monthly income per capita/yuan			40.017	< 0.001
< 5 000	832(37.7)	25.56±3.36
5 000~ < 10 000	730(33.1)	26.98±2.63
10 000~ < 15 000	337(15.3)	27.13±2.94
≥15 000	306(13.9)	27.02±3.25
婚姻状况Marital status			2.067	0.103
已婚Married	1 989(90.2)	26.48±3.16
未婚Unmarried	20(0.9)	27.45±1.91
丧偶Widowed	66(3.0)	25.71±3.67
离异/分居Divorced/separated	130(5.9)	26.64±2.53
生育史Reproductive history			12.933	< 0.001
有Yes	2 156(97.8)	26.44±3.15
无No	49(2.2)	28.06±2.03
绝经状态Menopause status			221.122	< 0.001
是Yes	1 219(55.3)	25.62±3.41
否No	986(44.7)	27.53±2.38
吸烟状况Smoking status			2.148	0.143
是Yes	26(1.2)	25.58±3.88
否No	2 179(98.8)	26.48±3.13
饮酒状况Drinking status			14.250	< 0.001
是Yes	450(20.4)	26.97±2.55
否No	1 755(79.6)	26.35±3.26
饮食习惯Eating habit			38.948	< 0.001
荤素均衡Balanced diet	1 921(87.1)	26.63±3.07
素食为主Vegetarian diet	284(12.9)	25.40±3.39
糖尿病Diabetes			15.841	< 0.001
有Yes	125(5.7)	25.39±3.69
无No	2 080(94.3)	26.54±3.09
高血压Hypertension			8.459	0.004
有Yes	461(20.9)	26.10±3.38
无No	1 744(79.1)	26.57±3.06
骨质疏松症Osteoporosis			1.051	0.305
有Yes	178(8.1)	26.24±3.10
无No	2 027(91.9)	26.49±3.14
恶性肿瘤Malignancy			2.414	0.120
有Yes	846(38.4)	26.60±3.19
无No	1 359(61.6)	26.39±3.10
其他慢性病Other chronic disease			0.165	0.685
有Yes	110(5.0)	26.59±2.84
无No	2 095(95.0)	26.47±3.15
注：①以人数(占比/%)表示；②以x±s表示。 Note: ① Number of people (proportion/%); ② x±s.

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基于蒙特利尔认知评估量表的上海市45~65岁社区女性认知水平及轻度认知障碍分布特征的横断面研究

doi: 10.16462/j.cnki.zhjbkz.2024.09.006

通讯作者:
徐飚，E-mail：bxu@shmu.edu.cn

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Cognitive health and distribution of mild cognitive impairment of women aged 45-65 in communities of Shanghai: a cross-sectional study based on Montreal cognitive assessment

Corresponding author: XU Biao, E-mail: bxu@shmu.edu.cn

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基于蒙特利尔认知评估量表的上海市45~65岁社区女性认知水平及轻度认知障碍分布特征的横断面研究

doi: 10.16462/j.cnki.zhjbkz.2024.09.006

通讯作者: 徐飚，E-mail：bxu@shmu.edu.cn

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Cognitive health and distribution of mild cognitive impairment of women aged 45-65 in communities of Shanghai: a cross-sectional study based on Montreal cognitive assessment

Corresponding author: XU Biao, E-mail: bxu@shmu.edu.cn

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出版历程

目录

通讯作者:
徐飚，E-mail：bxu@shmu.edu.cn