摘要
背景国内外研究证据显示慢性病共病与老年人群脑健康有密切联系。目前很少有文献关注躯体和精神疾病同时对认知障碍的影响。目的探索中国、印度和印度尼西亚中老年人群身心共病与认知功能下降的关联。方法本研究基于中国健康与养老追踪调查(CHARLS,2015年)、印度纵向老龄化研究(LASI,2017—2018年)和印度尼西亚家庭生活调查(IFLS,2014—2015年)具有全国代表性的调查数据库,共纳入73119名受访者。从3个维度——时间定向、词语回忆和计算能力评估认知功能。根据报告的慢性病数量和存在抑郁症状情况构建了5类身心共病情况。采用多元线性回归模型探究身心共病与认知功能下降的关系。结果中国中老年受访者9951例,平均认知功能评分为(54.7±19.9)分;印度中老年受访者54802例,平均认知功能评分为(51.1±20.0)分;印度尼西亚中老年受访者8446例,平均认知功能评分为(50.7±18.4)分。多元线性回归分析结果显示,在调整了社会人口和生活行为方式等因素后,中国(β=-6.99,95%CI=-8.26~-5.71)、印度(β=-2.76,95%CI=-3.41~-2.11)、印度尼西亚(β=-2.75,95%CI=-4.10~-1.41)存在身心共病的中老年受访者认知功能低于无慢性病者(P<0.05)。结论身心共病与中国、印度和印度尼西亚中老年人认知功能下降有关,且在女性中较明显。关注和积极应对共病患者的心理健康问题可能会减少老年人群发生认知障碍的风险。
Background There is evidence showing that multimorbidity is associated with brain health among the elderly.Limited studies examined the combined impacts of physical and mental diseases on cognition performance.Objective This study aims to explore the relationship between mental-physical multimorbidity and cognitive decline in middle-aged and elderly people in China,India and Indonesia.Methods This study based on three national-representative data from China(China Health and Retirement Longitudinal Study),India(Longitudinal Aging Study in India),and Indonesia(Indonesian Family Life Survey),with a total sample of 73119 respondents.Three domains of cognitive function were considered in the analysis,including time orientation,word recall,and numeracy.Five categories of mental-physical multimorbidity were constructed according to the number of non-communicable diseases and the existence of depressive symptoms,reported by participants.Multivariable linear regression models were applied to examine the association of physical and mental multimorbidity with cognitive decline.Results The mean cognitive function score was(54.7±19.9)among 9951 participants in China,(51.1±20.0)among 54802 participants in India,and(50.7±18.4)among 8446 participants in Indonesia.The cognitive score was significantly lower in those middle-aged and elderly people with mental-physical multimorbidity in China(β=-6.99,95%CI=-8.26 to-5.71),India(β=-2.76,95%CI=-3.41 to-2.11)and Indonesia(β=-2.75,95%CI=-4.10 to-1.41)than in those individuals without any non-communicable disease(P<0.05),after adjusting for socio-demographic and lifestyle behavioral covariates.Conclusion Cognitive decline is associated with mental-physical multimorbidity among middle-aged and elderly people in China,India and Indonesia,particularly in females.Paying attention to and actively addressing mental health problems among patients with multimorbidity may reduce the risk of cognitive impairment in the elderly.
作者
赵思琪
叶杏
赵洋
Kanya Anindya
Tiara Marthias
Mercian Daniel
赵天浩
韩莉
ZHAO Siqi;YE Xing;ZHAO Yang;Kanya Anindya;Tiara Marthias;Mercian Daniel;ZHAO Tianhao;HAN Li(Yantaishan Hospital,Yantai 264000,China;The George Institute for Global Health,University of New South Wales,Sydney 2050,Australia;Duke-NUS Medical School,National University of Singapore,Kent Ridge 169857,Singapore;School of Public Health and Community Medicine,University of Gothenburg,Gothenburg 40530,Sweden;Faculty of Medicine,Public Health&Nursing,Gadjah Mada University,Yogyakarta 55281,Indonesia;Nossal Institute for Global Health,the University of Melbourne,Melbourne 3010,Australia;The George Institute for Global Health(India),New Delhi 110025,India;School of Public Health,Shandong University,Jinan 250012,China)
出处
《中国全科医学》
北大核心
2025年第28期3532-3540,共9页
Chinese General Practice
基金
全球脑健康倡议基金项目(P01258)。
关键词
共病
中年人
老年人
身心共病
认知功能
中国
印度
印度尼西亚
Multimorbidity
Middle aged
Aged
Mental-physical multimorbidity
Cognition performance
China
India
Indonesia
