轻度认知障碍高危老年人认知水平下降的影响因素及预测:基于上海市静安区的纵向随访研究OA北大核心CSTPCD

Objective To explore the influencing factors of cognitive decline and risk prediction of community elderly people exposed to high-risk factors of Mild Cognitive Impairment(MCI)and to provide a theoretical basis for key population screening and individual prevention and treatment.Methods Firstly,the high-risk factors for MCI were identified by literature review.Then,based on the annual longitudinal follow-up cohort of community elderly in the Monitoring and Implementation of Basic Data of Elderly Care Needs Assessment Criteria Project conducted from 2014 to 2022,multi-stage sampling was carried out to include the elderly with at least one high risk factor exposed to MCI.And these elderly were divided into MCI and non-MCI groups based on whether their MCI outcomes occurred in the follow-ups.Their demographic characteristics and other relevant variables were collected using The Unified Needs Assessment Questionnaire for Elderly Care.Their cognitive function was evaluated using the Montreal Cognitive Assessment(MoCA).Multivariate linear regression model and Cox regression model were utilized to analyze the influencing factors of cognitive decline and the risk prediction of MCI.Results A total of 1 141 high-risk elderly from a community in Jing'an District were included in this study,with 363(31.81%)developing MCI during the follow-ups.There were notable differences(P＜0.05)in age,education,money management,family support,ADL,care needs,self-rated health status,interest maintenance,sleep status,and history of diabetes between the MCI and non-MCI groups among them(exposed at least one high-risk factor).Stratified analysis showed that advanced age(≥80 years old)was a risk factor for cognitive decline between MCI and non-MCI groups(β=0.51 and 4.28,P＜0.05).Besides,no control over money and decreased activity of daily living(ADL)were two risk factors for cognitive decline in the MCI group(β=9.52 and 2.68,P＜0.05).Interest maintenance was a protective factor for cognitive decline(β=-3.97,P＜0.05),education(≥13 years)was a protective factor for the non-MCI group(β=-0.55,P＜0.05).Conclusions Advanced age,decreased money management ability and impaired ADL play key roles in MCI disease among the elderly.Maintaining interest is instrumental in preserving cognitive function.At the community level,more attention should be paid on the elderly with related risk factors with early intervention mechanism improvement.