社区主观认知下降老年人日常生活活动能力现状及影响因素分析

doi:10.3969/j.issn.1003-9198.2024.11.007

Abstract

Abstract: Objective To investigate the activities of daily living (ADL) of the community elderly with subjective cognitive decline (SCD) and to analyze the influencing factors. Methods Convenient sampling method was used to enroll a total of 459 elderly people in a community in Beijing from January 2019 to January 2022 in this study. The patients’ demographic data, anxiety and depression status, lifestyle, exercise style, nutrition, disease history and medication history were collected by self-designed questionnaire; And barthel index rating scale was used to evaluate the level of basic activities of daily living (BADL), Lawton instrumental activities of daily living (IADL) scale was used to evaluate the level of IADL. Univariate analysis and multivariate Logistic regression analysis were used to explore the influencing factors of ADL. Results A total of 209 cases (45.5%) presented with dependence on BADL, with a higher frequency of functional decline in ascending and descending stairs and urination; 256 cases (55.8%) presented with dependence on IADL; The frequency of functional decline is higher when going out, shopping and taking medication. Logistic regression analysis showed that age, decreased vision, BMI and physical activity time were the independent influencing factors of BADL dependence; Gender, hearing loss, anxiety, alcohol consumption, and nutrition were independent influencing factors of IADL dependence (P<0.05). Conclusions The incidence of ADL dependence in the elderly with SCD in community is high, but the degree is light; Community healthcare workers should focus on the elderly people being elderly, male, obesity, anxious, having decreased vision and hearing, having low physical activity, drinking alcohol, and having a risk of malnutrition, and should assist the elderly in establishing a healthy lifestyle to improve or delay their cognitive impairment.

Key words: subjective cognitive decline, aged, activities of daily living

CLC Number:

R 749.13

YANG Cunmei, HU Yixin, LIU Cuie, MA Hongying, YAN Jin, XU Qiuli, XING Dan, ZHANG Tianyi. Analysis of current situation and influencing factors of activities of daily living in the elderly with decreased subjective cognition in community[J]. Practical Geriatrics, 2024, 38(11): 1110-1115.

References

[1] 世界卫生组织.痴呆症[EB/OL].[2020-10-31] (2023-12-01).https://www.whoi.nt/zh/newsGroom/factGshets/detail/dementia.
[2] LIN Y, SHAN P Y, JIANG W J, et al. Subjective cognitive decline:preclinical manifestation of Alzheimer’s disease[J].Neurol Sci, 2019, 40(1):41-49.
[3] 杨清,王雨欣,田翀,等.主观认知减退问卷汉化及信效度研究[J].护理学杂志, 2021, 36(2):68-71.
[4] DESAI A K, GROSSBERG G T, SHETH D N. Activities of daily living in patients with dementia: clinical relevance, methods of assessment and effects of treatment[J].CNS Drugs, 2004, 18(13): 853-875.
[5] 易雅研.长期护理机构老年痴呆患者基础性日常生活活动能力及其影响因素[D].广州:南方医科大学, 2020.
[6] 马新成.老年人生活自理能力评估方法研究[D].北京:北京理工大学,2016.
[7] 周滢,甘珊,李峥.社区老年人主观认知下降现状及影响因素分析[J].解放军护理杂志, 2021, 38(4):21-24.
[8] 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(Suppl 4):462.
[9] 中国痴呆与认知障碍指南写作组,中国医师协会神经内科医师分会认知障碍疾病专业委员会.2018中国痴呆与认知障碍诊治指南(一):痴呆及其分类诊断标准[J].中华医学杂志, 2018, 98(13):965-970.
[10] 中国痴呆与认知障碍诊治指南写作组,中国医师协会神经内科医师分会认知障碍疾病专业委员会. 2018中国痴呆与认知障碍诊治指南(五):轻度认知障碍的诊断与治疗[J].中华医学杂志, 2018, 98(17):1294-1301.
[11] 郭飏,王丽娟,付雪连,等.社区失能老人健康管理现状调查[J].护理学杂志, 2014, 29(7):73-75.
[12] BIER N, BELCHIOR PDA, PAQUETTE G, et al. The instrumental activity of daily living profile in aging: a feasibility study[J]. J Alzheimers Dis, 2016, 52(4): 1361-1371.
[13] 刘硕,朱鸣雷,刘晓红. 老年住院患者衰弱和抑郁的相关性[J]. 中华老年多器官疾病杂志,2020,19(6):419-423.
[14] SPITZER R L,KROENKE K,WILLIAMS J B. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire[J].JAMA,1999,282(18):1737-1744.
[15] 仇军.中国体育人口的理论探索与实证研究[D].北京:北京体育大学,1999.
[16] 董杰,董群,张保国.山东省不同体育参与水平老年人的体质状况[J].中国老年学杂志, 2014,34(8):2216-2218.
[17] 中华医学会老年医学分会. 老年患者衰弱评估与干预中国专家共识[J]. 中华老年医学杂志,2017,36(3): 251-256.
[18] RUBENSTEIN L Z,HARKEI J O,SALVA A,et al. Screening for under nutrition in geritric practice: developing the Short-Form Mini Nutritional Assessment(MNA-SF)[J].J Gerontol A Biol Sci Med Sci,2001,56(6): M366-M372.
[19] 王佳,贾音,王慧丽.老年慢性病患者多重用药及用药安全性的研究现状[J].继续医学教育,2021,35(11):157-159.
[20] FERRUCCI L, GURALNIK J M, CECCHI F, et al. Constant hierarchic patterns of physical functioning across seven populations in five countries[J]. Gerontologist, 1998, 38(3): 286-294.
[21] 彭陪陪.失能老人照批需求及质量评价体系构建研究[D].北京:解放军医学院,2015.
[22] 张晗,王志会,王丽敏,等.中国社区老年居民日常生活活动能力失能状况调查[J].中华流行病学杂志,2019,40(3):266-271.
[23] 钱佳慧,吴侃,罗会强,等.中国老年人日常生活活动能力损失现况及影响因素分析[J].中华流行病学杂志,2016, 37(9): 1272-1276.
[24] 党俊武.中国城乡老年人生活状况调查报告-2018[M].北京:社会科学文献出版社,2018:144.
[25] ĆWÍRLEJ-SOZAŃSKA A, WIŚNIOWSKA-SZURLEJ A,WILMOWSKA-PIETRUSZYŃSKA A,et al. Determinants of ADL and IADL disability in older adults in southeastern Poland[J]. BMC Geriatr, 2019, 19(1): 297.
[27] CREWS J E, CHOU C F, SEKAR S, et al. The prevalence of chronic conditions and poor health among people with and without vision impairment,aged ≥65 years,2010—2014[J]. Am J Ophthalmol, 2017,182:18-30.
[28] 于普林,高超,雷平,等. 预防老年人失能核心信息中国专家共识 (2019)[J].中华老年医学杂志,2019,38(10):1073-1074.
[29] 蔡敏, 张耀光, 谢学勤,等. 我国 60 岁及以上居家老年人失能情况及影响因素分析[J].中国医院统计,2021,28(5):389-394,400.
[30] TSAI H J, CHANG F K. Associations between body mass index, mid-arm circumference, calf circumference, and functional ability over time in an elderly Taiwanese population[J]. PLoS One, 2017, 12(4): e0175062.
[31] KERAMAT S A, ALAM K, SATHI N J, et al. Self-reported disability and its association with obesity and physical activity in Australian adults: results from a longitudinal study[J]. SSM Popul Health, 2021, 14: 100765.
[32] CHENG I F, KUO L C, TSAI Y J, et al. The comparisons of physical functional performances between older adults with and without regular physical activity in two different living settings[J]. Int J Environ Res Public Health, 2021, 18(7):3561.
[33] KRAMER A F, COLCOMBE S J, MCAULEY E, et al. Fitness, aging and neurocognitive function[J]. Neurobiol Aging, 2005, 26 (Suppl 1): 124-127.
[34] 龙敏.中国老年人日常生活自理能力的影响因素研究[D].上海:华东师范大学,2013.
[35] 王嘉慧.中国老年人膳食多样性评分变化与认知功能受损及日常生活自理能力失能的队列研究[D].广州:南方医科大学,2022.
[36] GALLACHER J, BAYER A, FISH M, et al. Does anxiety afect risk of dementia?Findings from the Caerphily prospective study[J].Psychosom Med,2009,71(6):659-666.

Analysis of current situation and influencing factors of activities of daily living in the elderly with decreased subjective cognition in community

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Recommended 10

[1]	LI Jiang, QIU Yan, WANG Ting, WANG Dan, YU Yifan, PU Lingli, BU Ling. Correlation between preoperative SII/ALB and clinicopathologic features in elderly patients with lung adenocarcinoma [J]. Practical Geriatrics, 2024, 38(9): 893-896.
[2]	DAI Jing, CUI Yan. Correlation between glycosylated hemoglobin variability and cognitive dysfunction in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(9): 931-935.
[3]	ZHENG Hong, QI Zhenbo, XU Peng, XU Jie, YU Xinyu, ZANG Yanan, ZHANG Zhaoyan. Effects of hypnotics on cognition function and daytime sleepiness in the elderly [J]. Practical Geriatrics, 2024, 38(9): 936-939.
[4]	ZHANG Xingxing, ZHANG Haiyang, HE Xiaojing, LU Xiang. Investigation on the relationship between different physical indexes and the risk of diabetes mellitus in the elderly [J]. Practical Geriatrics, 2024, 38(9): 940-943.
[5]	NI Hongyan, CHEN Yun, ZHANG Qibing, MA Yiming, XIE Chenglan. Effects of electroacupuncture on cognitive function and inflammatory factors in elderly patients undergoing lower limb orthopedic surgery during the perioperative period [J]. Practical Geriatrics, 2024, 38(9): 944-947.
[6]	LI Xiaomin, LI Xiaolin, LI Jie, WU Lei, HAO Ranran. Efficiency influencing factors of transanal double-balloon enteroscopy in elderly patients [J]. Practical Geriatrics, 2024, 38(9): 958-961.
[7]	CAI Huicui, CHEN Yan, WANG Yan, YE Jinjun, ZHU Yuying. Effects of diversified health education model with simple respiratory function exercise on cancer-related fatigue and compliance behavior in elderly patients with lung cancer receiving radiotherapy [J]. Practical Geriatrics, 2024, 38(9): 968-972.
[8]	WANG Xiaojiao, WANG Ning, CUI Hong, YE Tong, WANG Xiaoming. Influence of exercise rehabilitation in elderly patients with mild to moderate chronic heart failure [J]. Practical Geriatrics, 2024, 38(8): 775-778.
[9]	SHEN Chenjun, WANG Xiaoqing, TANG Degang, NING Ping. Correlation between standardized uric acid and renal function in elderly patients with chronic kidney disease aged 90 and over [J]. Practical Geriatrics, 2024, 38(8): 779-782.
[10]	HAO Shijie, ZOU Jianpeng, WEI Chen, LIU Qingjiang. Effect of comprehensive respiratory training on hypokinetic dysarthria in elderly patients with Parkinson’s disease [J]. Practical Geriatrics, 2024, 38(8): 783-787.
[11]	XIANG Chao, LUO Caidong. Analysis of the diagnostic value of T wave change of avL lead for the degree of coronary artery stenosis in elderly patients with coronary heart disease [J]. Practical Geriatrics, 2024, 38(8): 788-791.
[12]	LI Huiying, CAI Lili, ZHU Qiwei. Predictive value of plasma N-terminal pro-brain natriuretic peptide for prognosis in patients aged ≥80 years old with left ventricular hypertrophy [J]. Practical Geriatrics, 2024, 38(8): 797-801.
[13]	WANG Xinping, XIE Baimei, WEI Guo, YE Xiaoli, ZHAO Yayun, TAN Xiaotian. Expression levels and clinical significance of serum S100A9 and sCD163 in elderly patients with idiopathic interstitial pneumonia [J]. Practical Geriatrics, 2024, 38(8): 802-807.
[14]	LIU Meijuan, WANG Ning, WANG Dong, LU Fangzhou, LIU Juan. Effect of low-dose lidocaine combined with propofol on motor evoked potential in elderly patients undergoing intracranial tumor resection [J]. Practical Geriatrics, 2024, 38(8): 808-811.
[15]	LI Jingbing, WANG Huijun, WANG Shaoying, ZHAO Can, WANG Lidi, CAO Yujiao. Impacts of pentoxifylline combined with lipoic acid intervention on physical function and quality of life in elderly patients with frailty syndrome [J]. Practical Geriatrics, 2024, 38(8): 812-815.