摘要
目的旨在探讨老年人不同健康状况变化轨迹与认知障碍之间的关联,为认知障碍的早期筛查及预防提供科学依据。方法利用中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)的3轮全国数据(2011—2015年),纳入符合标准的3185名≥60岁成年人。通过潜类别轨迹模型识别认知功能得分和不同健康状况[握力、睡眠时长、基本日常生活活动(basic activities of daily living,BADLs)限制、抑郁症状]之间的纵向变化,采用Cox比例风险回归模型分析不同健康状况轨迹与认知障碍发生风险的关联,采用线性混合效应模型评估不同健康状况变化轨迹与认知功能得分之间的纵向关联。结果横断面分析显示,认知障碍者在基线时表现出低握力、短睡眠时长、BADLs限制和抑郁症状。在纵向队列研究中,Cox比例风险回归模型分析显示,抑郁症状高轨迹(HR=1.60,95%CI:1.31~1.96)、BADLs高限制轨迹(HR=1.39,95%CI:1.21~1.60)及短睡眠时长轨迹(HR=1.30,95%CI:1.13~1.49)增加认知障碍发生的风险,而握力高水平轨迹(HR=0.75,95%CI:0.63~0.90)可降低该风险。结论握力、睡眠时长、BADLs限制及抑郁症状的纵向变化轨迹可作为老年人认知障碍风险的早期识别指标,为针对性干预提供科学依据。
Objective This study aimed to investigate the association between the trajectory of changes in different health conditions and cognitive impairment in older adults,providing scientific evidence for the early screening and prevention of cognitive impairment.Methods Using data from 3 waves(2011-2015)of the China Health and Retirement Longitudinal Study(CHARLS),a total of 3185 participants aged 60 years and older who met the inclusion criteria were enrolled.Latent class trajectory models were employed to identify longitudinal changes in cognitive function scores and various health conditions[grip strength,sleep duration,limitations inbasic activities of daily living(BADLs),and depressive symptoms].Cox regression analysis was used to examine the association between health condition trajectories and the risk of cognitive impairment.Additionally,linear mixed-effects models were applied to assess the longitudinal relationship between the trajectories of health condition changes and cognitive function scores.Results Cross-sectional analysis showed that individuals with cognitive impairment at baseline exhibited lower grip strength,shorter sleep duration,limitations in BADLs,and depressive symptoms.In the longitudinal cohort study,Cox regression analysis revealed that high-level depressive symptom trajectories(HR=1.60,95%CI:1.31-1.96),high-level BADLs limitation trajectories(HR=1.39,95%CI:1.21-1.60),and short sleep duration trajectories(HR=1.30,95%CI:1.13-1.49)significantly increased the risk of cognitive impairment,whereas high-level grip strength trajectories(HR=0.75,95%CI:0.63-0.90)were associated with a reduced risk of cognitive impairment.Conclusions Longitudinal trajectories of grip strength,sleep duration,BADLs limitations,and depressive symptoms can serve as early indicators for identifying the risk of cognitive impairment in older adults,providing a scientific basis for targeted interventions.
作者
孙超凡
安川
令国兴
高慧娟
冯兴中
孙春全
SUN Chaofan;AN Chuan;LING Guoxing;GAO Huijuan;FENG Xingzhong;SUN Chunquan(Department of Endocrinology,Yuquan Hospital,Tsinghua University,Beijing 100040,China;Department of Endocrinology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;The First Clinical Medical College,Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《中华疾病控制杂志》
北大核心
2025年第10期1162-1170,共9页
Chinese Journal of Disease Control & Prevention
基金
首都卫生发展科研专项(CFH-2024-4-4135)。
关键词
认知障碍
中国健康与养老追踪调查
老年人
队列研究
Cognitive impairment
China Health and Retirement Longitudinal Study
Elderly adults
Cohort study
