老年人高血压住院患者合并认知障碍的现状及其危险因素
| 作者: |
1汤华萍
1 马鞍山市人民医院老年医学科，安徽 马鞍山 243000 |
| 通讯: | |
| DOI: | 10.3978/j.issn.2095-6959.2023.222286 |
摘要
目的：探讨老年人高血压住院患者合并认知障碍的现状及其危险因素分析。方法：收集2022年3至9月在马鞍山市人民医院老年医学科住院的161例老年人高血压住院患者资料，对其个人基本信息问卷、蒙特利尔认知评估量表(Montreal Cognitive Assessment，MoCA)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index，PSQI)、老年抑郁量表(Geriatric Depression Scale，GDS)及日常生活能力量表(Activity of Daily Living Scale，ADL)进行调查。根据MoCA评分结果将患者分为认知正常组(n=56)与认知障碍组(n=105)，比较2组患者精神生活状态的差异，并采用多因素logistic回归和多元线性回归分析影响老年人高血压患者发生认知障碍的危险因素。结果：在161例老年人高血压住院患者中，伴发认知障碍的患者有105例(65.22%)，认知正常的患者有56例(34.78%)。2组患者在是否患有糖尿病、是否有运动习惯、高血压分级、年龄、病程和PSQI评分方面差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示：患有糖尿病、没有运动习惯均是影响老年人高血压住院患者发生认知障碍的独立影响因素。多元线性回归分析显示：年龄、病程和PSQI评分均可显著影响患者MoCA评分结果(均P<0.001)。结论：患有糖尿病、没有运动习惯、年龄、病程和睡眠障碍均是老年人高血压住院患者发生认知障碍的危险因素，加强对老年人高血压住院患者合并症的管理、心理干预和日常生活不良习惯的纠正可能有助于降低其认知障碍的发生率。
关键词：
老年人高血压；认知障碍；危险因素；问卷调查
Current status and risk factors of mild cognitive impairment in elderly hypertension inpatients
DOI: 10.3978/j.issn.2095-6959.2023.222286
Abstract
Objective: To investigate the status and risk factors of cognitive impairment in elderly hospitalized patients with hypertension.
Methods: From March 2022 to September 2022, 161 elderly inpatients with hypertension who were hospitalized in the Department of Geriatric， Ma’anshan People’s Hospital from March 2022 to September 2022 were collected. They were investigated with the basic personal information questionnaire, Montreal Cognitive Assessment (MoCA), Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS), and Activity of Daily Living Scale (ADL). According to the MoCA score, the patients were divided into a cognitive normal group (n=56) and a cognitive impairement group (n=105). The difference of mental life status between the 2 groups was compared, and multivariate logistic regression and multiple linear regression were used to analyze the risk factors of cognitive impairment in elderly hypertensive patients.
Results: Among the 161 elderly inpatients with hypertension, 105 patients had cognitive impairment, and 56 patients had normal cognition. The 2 groups differed significantly in the presence or absence of diabetes, exercise habits, hypertension grade, age, disease duration, and score of PSQI (all P<0.05). Multivariate logistic regression analysis showed that diabetes and without exercise habits were independent influencing factors of cognitive impairment in elderly hypertensive inpatients. Multiple linear regression analysis showed that age, course of disease, and score of PSQI could significantly affect the MoCA score of patients (all P<0.001).
Conclusion: Diabetes mellitus, without exercise habits, age, disease duration, and sleep disorders are risk factors for cognitive impairment in elderly hypertensive patients. It may be beneficial to reduce the incidence of cognitive impairment to strengthen the management of complications, psychological intervention and correction of bad habits of daily life in elderly patients with hypertension.
Keywords：
senile hypertension; cognitive impairment; risk factors; questionnaire survey
Methods: From March 2022 to September 2022, 161 elderly inpatients with hypertension who were hospitalized in the Department of Geriatric， Ma’anshan People’s Hospital from March 2022 to September 2022 were collected. They were investigated with the basic personal information questionnaire, Montreal Cognitive Assessment (MoCA), Pittsburgh Sleep Quality Index (PSQI), Geriatric Depression Scale (GDS), and Activity of Daily Living Scale (ADL). According to the MoCA score, the patients were divided into a cognitive normal group (n=56) and a cognitive impairement group (n=105). The difference of mental life status between the 2 groups was compared, and multivariate logistic regression and multiple linear regression were used to analyze the risk factors of cognitive impairment in elderly hypertensive patients.
Results: Among the 161 elderly inpatients with hypertension, 105 patients had cognitive impairment, and 56 patients had normal cognition. The 2 groups differed significantly in the presence or absence of diabetes, exercise habits, hypertension grade, age, disease duration, and score of PSQI (all P<0.05). Multivariate logistic regression analysis showed that diabetes and without exercise habits were independent influencing factors of cognitive impairment in elderly hypertensive inpatients. Multiple linear regression analysis showed that age, course of disease, and score of PSQI could significantly affect the MoCA score of patients (all P<0.001).
Conclusion: Diabetes mellitus, without exercise habits, age, disease duration, and sleep disorders are risk factors for cognitive impairment in elderly hypertensive patients. It may be beneficial to reduce the incidence of cognitive impairment to strengthen the management of complications, psychological intervention and correction of bad habits of daily life in elderly patients with hypertension.