摘要
目的了解氟中毒地区老年人轻度认知功能障碍(mild cognitive impairment,MCI)情况,并分析其潜在影响因素。方法2020年4—10月,采用整群随机抽样方法,在天津市饮水型地方性氟中毒地区抽取当地60岁及以上老年人,通过面对面调查收集其一般资料;采集调查对象饮用水末梢水水样,采用离子选择电极法测定水氟浓度;简易精神状态量表(Mini-Mental State Examination,MMSE)评估认知功能,并根据MMSE评分将调查对象划分为MCI组和对照组;构建logistic回归模型和卡方自动交互检测分类树模型分析MCI的影响因素。结果共纳入调查对象677例,其中MCI组160例、对照组517例,MCI检出率为23.63%;高氟暴露组和非高氟暴露组MCI检出率分别为30.82%(94/305)、17.74%(66/372),组间比较差异有统计学意义(χ^(2)=15.88,P<0.001)。单因素分析结果显示,MCI与是否高氟暴露、年龄、家庭人均年收入、睡眠时间、性格、人际关系均有关(χ^(2)=15.88、16.17、12.32、8.91、14.03、9.81,均P<0.05);多因素logistic回归分析结果显示,人际关系一般(OR=2.13,95%CI:1.08,4.20)和高氟暴露(OR=1.91,95%CI:1.03,3.54)均为MCI的危险因素(均P<0.05)。分类树模型分析结果显示,是否高氟暴露是影响氟中毒地区老年人MCI的首要因素,其次为家庭人均年收入、性格、年龄。结论氟中毒地区的高氟暴露组老年人MCI检出率高于非高氟暴露组,是否高氟暴露、人际关系、家庭人均年收入、性格及年龄均为氟中毒地区老年人MCI的影响因素。
Objective To investigate the situation of mild cognitive impairment(MCI)in elderly people in fluorosis areas,and analyze its potential influencing factors.Methods From April to October 2020,a cluster random sampling method was used to select local elderly people aged 60 and older in areas of drinking-water-borne endemic fluorosis in Tianjin,and their general information was collected through face-to-face surveys.Terminal drinking water samples were collected from survey subjects.Water fluoride concentration was measured using ion-selective electrode method.Cognitive function was evaluated using the Mini-Mental State Examination(MMSE),and survey subjects were categorized into MCI group and control group based on MMSE scores.Logistic regression and Chi-squared automatic interaction detection classification tree models were constructed to analyze the influencing factors of MCI.Results A total of 677 subjects were included,including 160 cases in the MCI group and 517 cases in the control group,with a MCI detection rate of 23.63%.The detection rates of MCI in the high fluoride exposure group and non high fluoride exposure group were 30.82%(94/305)and 17.74%(66/372),respectively,with a statistically significant difference between the groups(χ^(2)=15.88,P<0.001).The results of univariate analysis showed that MCI was associated with high fluoride exposure,age,per capita annual household income,sleep duration,personality,and interpersonal relationships(χ^(2)=15.88,16.17,12.32,8.91,14.03,9.81,P<0.05).The results of multiple logistic regression analysis showed that moderate interpersonal relationships(OR=2.13,95%CI:1.08,4.20)and high fluoride exposure(OR=1.91,95%CI:1.03,3.54)were both risk factors for MCI(P<0.05).The classification tree model analysis result showed that high fluoride exposure was the primary factor affecting MCI in elderly people in fluorosis areas,followed by per capita annual household income,personality,and age.Conclusions The detection rate of MCI in the high fluoride exposure group of elderly people in fluorosis areas is higher than that in the non high fluoride exposure group.High fluoride exposure,interpersonal relationships,per capita annual household income,personality,and age are all influencing factors of MCI in elderly people in fluorosis areas.
作者
李芳
王洋
段雅妮
李文凤
张丹丹
Li Fang;Wang Yang;Duan Yani;Li Wenfeng;Zhang Dandan(Institute of Environmental and Public Health,Tianjin Center for Diseases Control and Prevention,Tianjin 300011,China)
出处
《中华地方病学杂志》
北大核心
2025年第7期543-549,共7页
Chinese Journal of Endemiology
基金
天津市卫生健康科技项目(TJWJ2023QN090)
天津市医学重点学科(专科)建设项目(TJYXZDXK-051A)。
