老年慢性病患者认知衰弱的危险因素分析及风险模型构建

doi:10.13481/j.1671-587X.20230525

Abstract

Abstract:

Objective To discuss the risk factors for cognitive frailty in the elderly patients with chronic diseases，and to construct the corresponding risk model. Methods The general clinical data of 207 elderly patients with chronic diseases were collected.The FRAIL Scale and the Montreal Cognitive Assessment Questionnaire（MoCA） were used to detect the status of cognitive frailty of the patients， and the patients were divided into cognitive frailty group （n=75） and non-cognitive frailty group （n=132）. Univariate and binary Logistic regression analysis were used to identify the risk factors associated with cognitive frailty in the elderly patients. Results Among the 207 elderly patients， a total of 75 cases （36.23%） had cognitive frailty. There were significant differences in age， body mass index （BMI）， physical exercise， job category， social activity， night sleep time， daytime mental status， and number of chronic diseases of the patients between two groups（P<0.05）. After propensity score matching for age， the binary Logistic regression analysis results showed that low BMI， physically labour， night sleep time≤5 h， poor daytime mental status， and more than two chronic diseases were the risk factors for the cognitive frailty. The receiver operating characteristic curve （ROC） analysis results showed the area under curve（AUC） was 0.87 for the risk model constructed in this study to distinguish the patients’ cognitive frailty. Conclusion The risk model constructed based on the risk factors in this study has good predictive efficacy for cognitive frailty in the elderly patients，and its has potential clinical application prospects.

Key words: Risk model, Elderly, Cognitive frailty, Risk factor, Chronic disease

CLC Number:

R473

Tong SHEN,Yang WANG,Wei JIN,Zhihui LIN,Li YAN. Risk factors analysis and risk model construction of cognitive frailty in elderly patients with chronic diseases[J].Journal of Jilin University(Medicine Edition), 2023, 49(5): 1304-1309.

Figures/Tables 4

Tab.1

Tab.2

Tab.3

Fig. 1

References 22

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Clincal characteristic	Cognitive frailty group (n=75)	Non-cognitive frailty group (n=132)	t/χ²	P
Age(year)[n(η/%)]
60－75	21(28.00)	83(62.88)	23.27	<0.001
>75	54(72.00)	49(37.12)	23.27	<0.001
Gender(male)	34(45.33)	60(45.45)	0	>0.05
BMI(kg·m^－2)	21.63±1.66	22.43±1.77	－3.21	<0.01
Educational level[n(η/%)]
Primary and below	35(46.67)	46(34.85)
Middle school to high school	32(42.67)	68(51.52)	2.82	0.24
College degree and above	8(10.67)	18(13.63)
Marital status[n(η/%)]
Married	51(68.00)	105(79.55)	3.43	0.06
Divorced or widowed	24(32.00)	27(20.45)	3.43	0.06
Physical exercise[n(η/%)]
<2 times/week	32(42.67)	35(26.52)	5.70	0.02
≥2 times/week	43(57.33)	97(73.48)	5.70	0.02
Job category[n(η/%)]
Mental labour	22(29.33)	88(66.67)	26.77	<0.001
Physical labour	53(70.67)	44(33.33)	26.77	<0.001
Social activity[n(η/%)]
Yes	28(37.33)	88(66.67)	16.70	<0.001
No	47(62.67)	44(33.33)	16.70	<0.001
Night sleep time[n(η/%)]
≤5 h	19(25.33)	14(10.61)	7.74	<0.01
>5 h	56(74.67)	118(89.39)	7.74	<0.01
Daytime mental state[n(η/%)]
Poor	27(36.00)	16(12.12)	16.57	<0.001
Good	48(64.00)	116(87.88)	16.57	<0.001
Medical payment[n(η/%)]
Medical insurance	64(85.33)	110(83.33)	0.14	0.71
Self-paying	11(14.67)	22(16.67)	0.14	0.71
Smoking[n(η/%)]	11(14.67)	20(15.15)	0.009	0.92
Drinking[n(η/%)]	15(20.00)	26(19.70)	0.003	0.96
Number of chronic diseases[n(η/%)]
≤2	37（49.33）	120（90.91）	45.13	<0.001
>2	38（50.67）	12（9.09）	45.13	<0.001
Family support[n(η/%)]
Good	58(77.33)	115(87.12)	3.34	0.07
Poor	17(22.67)	17(12.88)	3.34	0.07

Variable	Assignment method
Age	0=60－75, 1=>75
Marital status	0=Married, 1=Divorced or widowed
Physical exercise	0=≥2 times/week, 1=<2 times/week
Job category	0=Mental labour, 1=Physical labour
Social activities	0=Yes, 1=No
Night sleep time	0=>5 h, 1=≤5 h
Daytime mental state	0=Good, 1 =Poor
Number of chronic diseases	0=≤2, 1=>2
Family support	0=Good, 1 =Poor

Variable	Model 1			Model 2
Variable	B	OR(95%CI)	P	B	OR(95%CI)	P
Age	1.365	3.916(1.708,8.975)	0.001	0.414	1.513(0.604,3.789)	0.376
BMI(kg·m^－2)	－0.295	0.745(0.588,0.942)	0.014	－0.333	0.717(0.553,0.930)	0.012
Marital status	0.220	1.246(0.487,3.186)	0.646	0.096	1.101(0.411,2.951)	0.848
Physical exercise	1.096	2.992(1.232,7.268)	0.015	0.796	2.216(0.885,5.544)	0.089
Job category	1.204	3.332(1.499,7.406)	0.003	1.208	3.348(1.449,7.737)	0.005
Social activity	0.883	2.418(1.081,5.408)	0.032	0.689	1.992(0.844,4.704)	0.116
Night sleep time	1.255	3.506(1.227,10.023)	0.019	1.389	4.012(1.257,12.804)	0.019
Daytime mental state	1.278	3.591(1.402,9.199)	0.008	1.143	3.138(1.178,8.358)	0.022
Number of chronic diseases	2.324	10.215(3.762,27.731)	<0.01	2.248	9.469(3.222,27.830)	<0.01
Family support	0.285	1.330(0.449,3.945)	0.607	0.245	1.278(0.415,3.931)	0.669

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Risk factors analysis and risk model construction of cognitive frailty in elderly patients with chronic diseases

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