农村老年人运动认知功能减退综合征风险预测模型的构建及验证

doi:10.3969/j.issn.1003-9198.2024.04.007

摘要/Abstract

摘要： 目的探讨农村老年人运动认知功能减退综合征(MCRS)的影响因素,并构建列线图预测模型。方法于2022年10月至2023年5月,采用一般资料问卷、匹兹堡睡眠质量指数量表、社会支持量表、简版老年抑郁量表、简易精神状态检查量表、4 m步行测试法对752例农村老年人进行调查评估。根据是否发生MCRS将其分为MCRS组和非MCRS组,通过Lasso回归筛选相关变量,采用多因素Logistic回归构建农村老年人MCRS列线图预测模型,绘制ROC曲线和校准曲线评价模型的区分度和校准度,运用Bootstrap法对模型进行内部验证。结果 752例农村老年人MCRS的发生率为14.89%(112/752)。年龄、久坐行为、多重用药、睡眠质量较差、社会支持、抑郁是农村老年人发生MCRS的影响因素(P＜0.05)。列线图预测模型ROC曲线下面积为0.844(95%CI:0.804~0.883),Bootstrap内部验证结果显示:平均绝对误差为0.009,模型表现与理想模型具有较好的一致性。结论本研究构建的农村老年人MCRS列线图模型预测效果较好,可为早期识别MCRS高风险人群提供参考。

关键词: 农村, 老年人, 运动认知功能减退综合征, 影响因素, 列线图

Abstract: Objective To construct and validate a risk prediction model for motoric cognitive risk syndrome (MCRS) in the elderly in rural areas. Methods From October 2022 to May 2023, 752 rural elderly people were surveyed using General Information Questionnaire, Pittsburgh Sleep Quality Index Scale, Social Support Rating Scale, Simplified Geriatric Depression Scale-15(GDS-15), Mini-Mental State Examination(MMSE) and 4-meter walk test. According to the occurrence of MCRS, they were divided into MCRS group and non-MCRS group. The relevant variables of MCRS were screened by Lasso regression, and then the nomogram prediction model of MCRS in the elderly in rural areas was constructed by multi-factor Logistic regression. The ROC curve and calibration curve were drawn to evaluate the model's discrimination and calibration,and a bootstrap was further conducted to internally validate the model. Results The incidence rate of MCRS in 752 rural elderly people was 14.89% (112/752). Age, sedentary behavior, polypharmacy, poor sleep quality, social support and depression were the influencing factors of MCRS in the elderly in rural areas (P＜0.05). The area under the ROC curve of the nomogram prediction model was 0.844 (95%CI: 0.804-0.883). Bootstrap internal verification results showed that the average absolute error was 0.009, and the model performance was in good agreement with the ideal model. Conclusions The nomogram model of MCRS constructed in this study has a good predictive effect, which provides a reference for early identification of high-risk groups of MCRS.

Key words: rural, aged, motoric cognitive risk syndrome, influencing factor, nomogram

中图分类号:

R 749.1

高娜, 许梦茹, 张利, 刘玉文, 魏星. 农村老年人运动认知功能减退综合征风险预测模型的构建及验证[J]. 实用老年医学, 2024, 38(4): 353-357.

GAO Na, XU Mengru, ZHANG Li, LIU Yuwen, WEI Xing. Construction and validation of a risk prediction model for motoric cognitive risk syndrome in the elderly in rural areas[J]. Practical Geriatrics, 2024, 38(4): 353-357.

参考文献

[1] SUN X, HARRIS K E, HOU L, et al. The prevalence and associated factors of motoric cognitive risk syndrome in multiple ethnic middle-aged to older adults in west China: a cross-sectional study[J]. Eur J Neurol, 2022, 29(5):1354-1365.
[2] 曹汝汝,马秋平,黄秀丹,等.社区老年人运动认知风险综合征患病率及相关因素的系统评价和Meta分析[J]. 现代预防医学, 2023, 50(3):482-487, 494.
[3] DOI T, SHIMADA H, MAKIZAKO H, et al. Motoric cognitive risk syndrome: association with incident dementia and disability[J]. J Alzheimers Dis, 2017, 59(1):77-84.
[4] BORTONE I, ZUPO R, CASTELLANA F, et al. Motoric cognitive risk syndrome, subtypes and 8-year all-cause mortality in aging phenotypes: the Salus in Apulia Study[J]. Brain Sci, 2022, 12(7):861.
[5] LAU H, MAT LUDIN A F, SHAHAR S, et al. Factors associated with motoric cognitive risk syndrome among low-income older adults in Malaysia[J]. BMC Public Health, 2019, 19(4):1-7.
[6] 杨昌凤,何永琴,易德坤,等.老年髋部骨折患者术后1年内死亡的影响因素分析及列线图预测模型构建[J]. 陆军军医大学学报, 2023, 45(1):60-66.
[7] LEI Y, ZOU K, XIN J, et al. Sedentary behavior is associated with chronic obstructive pulmonary disease: a generalized propensity score-weighted analysis[J]. Medicine, 2021, 100(18): e25336.
[8] 蔡真真, 王晓霞, 骆钰婷, 等. 养老机构轻度认知障碍老年人睡眠质量及影响因素研究[J]. 护理学杂志,2022,37(7):79-81.
[9] 罗秋湖,陈务贤,王灿,等.D型人格对住院冠心病病人睡眠质量的影响[J]. 护理研究,2022,36(11):2058-2060.
[10]尹艳茹, 周洪昌, 刘梦如, 等.老年维持性血液透析患者社会隔离现状的调查研究[J]. 中华护理杂志,2023,58(7):822-829.
[11]杨存美, 舒刚明, 胡亦新, 等.社区主观认知下降老年人的运动认知风险综合征发生情况及影响因素研究[J]. 中国全科医学,2022,25(34):4278-4285.
[12]VERGHESE J, WANG C, BENNETT D A, et al. Motoric cognitive risk syndrome and predictors of transition to dementia: a multicenter study[J]. Alzheimers Dement, 2019, 15(7):870-877.
[13]韦萍萍,孙建萍,吴红霞,等.太原市社区老年人运动认知功能减退综合征发生现状及影响因素分析[J]. 中华现代护理杂志,2022,28(15):2036-2042.
[14]BEAUCHET O, ALLALI G, ANNWEILER C, et al. Association of motoric cognitive risk syndrome with brain volumes: results from the gait study[J]. J Gerontol A Biol Sci Med Sci, 2016, 71(8):1081-1088.
[15]MEINER Z, AYERS E, VERGHESE J. Motoric cognitive risk syndrome: a risk factor for cognitive impairment and dementia in different populations[J]. Ann Geriatr Med Res, 2020, 24(1):3-14.
[16]IQBAL K, HASANAIN M, AHMED J, et al. Association of motoric cognitive risk syndrome with cardiovascular and noncardiovascular factors: a systematic review and meta-analysis[J]. J Am Med Dir Assoc, 2022, 23(5):810-822.
[17]LIANG H, FANG Y. Association of polypharmacy and motoric cognitive risk syndrome in older adults: a 4-year longitudinal study in china[J]. Arch Gerontol Geriatr, 2023, 106:104896.
[18]XU W, BAI A, HUANG X, et al. Association between sleep and motoric cognitive risk syndrome among community-dwelling older adults: results from the China health and retirement longitudinal study[J]. Front Aging Neurosci, 2021, 13:774167.
[19]COTTON K, VERGHESE J, BLUMEN H M. Gray matter volume covariance networks, social support, and cognition in older adults[J]. J Gerontol B Psychol Sci Soc Sci, 2020, 75(6):1219-1229.
[20]XU W, BAI A, LIANG Y, et al. Association between depression and motoric cognitive risk syndrome among community-dwelling older adults in china: a 4-year prospective cohort study[J]. Eur J Neurol, 2022, 29(5):1377-1384.
[21]GROEGER J L, AYERS E, BARZILAI N, et al. Inflammatory biomarkers and motoric cognitive risk syndrome: multicohort survey[J]. Cereb Circ Cogn Behav, 2022, 3:100151.