本文選題：老年人 + 輕度認(rèn)知功能障礙　； 參考：《泰山醫(yī)學(xué)院》2013年碩士論文

【摘要】：目的 本研究旨在探討泰安市農(nóng)村老年人輕度認(rèn)知功能障礙(MCI)患病現(xiàn)況,調(diào)查其患病率、檢出率及其影響因素,為臨床觀察和治療提供參考數(shù)據(jù)。同時(shí)分析蒙特利爾認(rèn)知功能檢查量表(MoCA)在本市農(nóng)村老年人中進(jìn)行MCI篩查的效果,評(píng)定其信度、效度、對(duì)MCI的敏感性和特異性,探討最佳分界值,用以協(xié)助提早發(fā)現(xiàn)老年人MCI患者并進(jìn)行早期干預(yù)。 方法 采用隨機(jī)分層整群抽樣的方法,運(yùn)用MMSE和MoCA對(duì)泰安市農(nóng)村老年人進(jìn)行MCI篩查,計(jì)算調(diào)查人群MCI患病率、檢出率；采用老年人身心健康一般狀況調(diào)查表、老年抑郁量表(GDS)、焦慮自評(píng)量表(SAS)社會(huì)支持評(píng)定量表(SSRS)、5個(gè)條目的生活滿意度量表進(jìn)行調(diào)查,分析MCI的影響因素。其次,對(duì)MoCA進(jìn)行探討,計(jì)算其信度、效度、敏感性、特異性和Youden旨數(shù),評(píng)價(jià)MoCA對(duì)泰安市農(nóng)村老年人MCI篩查的應(yīng)用價(jià)值,并計(jì)算適合我市農(nóng)村老年人MCI患者的劃界分。 結(jié)果 1、參與此次社區(qū)調(diào)查人數(shù)2150人,完整有效問(wèn)卷1971人次,有效率91.67%。615人可能存在抑郁情緒,267人可能存在焦慮情緒,675人患高血壓,222人患高血脂,365人患冠心病,108人患腦血栓,273人有失眠史,315人吸煙,648飲酒。 2、其中,651人臨床初步診斷為MCI,總體檢出率為33.03%,患病率為17.78%,135人臨床診斷為癡呆,總體檢出率為6.85%,患病率3.56%。 3、年齡、文化程度、職業(yè)、不同居住情況、自認(rèn)為身體狀況、記憶力、聽(tīng)力、體重(BMI異常)、血脂、腦血栓、飲酒、是否做家務(wù)、睡眠情況、抑郁情緒、社會(huì)支持狀況等對(duì)MCI患病有顯著影響。 4、年齡、婚姻(離婚)、自認(rèn)為身體狀況差、參加活動(dòng)少、高血脂、抑郁為MCI的危險(xiǎn)因素；常做家務(wù)為保護(hù)因素。 5、MoCA量表的Cronbach's a為0.777,具有較好的信度；其總分與MMSE比較,相關(guān)系數(shù)為0.737,校標(biāo)效度良好；除連線、復(fù)制立方體、動(dòng)物命名、數(shù)字計(jì)算外,其余各項(xiàng)相關(guān)系數(shù)均與MoCA總分顯著相關(guān),內(nèi)容效度良好。 6、MoCA以原版推薦26分為界,對(duì)MCI篩查的敏感性和特異性分別為98.85%和14.72%,Youden指數(shù)為0.1358。 結(jié)論 1、泰安市農(nóng)村人口以農(nóng)民為主,平均受教育年限低,高齡老人所占比重大,患基礎(chǔ)疾病者較多,抑郁、焦慮患病率高,身心健康狀況不容樂(lè)觀。 2、泰安市農(nóng)村老人MCI患病率較高,應(yīng)加強(qiáng)宣傳教育及篩查力度。 3、年齡、婚姻(離婚)、自認(rèn)為身體狀況差、參加活動(dòng)少、高血脂、抑郁為MCI的危險(xiǎn)因素；常做家務(wù)為保護(hù)因素。 4、MoCA量表對(duì)農(nóng)村老年人認(rèn)知功能的篩查簡(jiǎn)便可行,具有良好的信度和效度敏感高,但以26分為分界其診斷價(jià)值較低,推薦以15分作為我市農(nóng)村老年人的MCl分界值。 5、MoCA量表部分題目與我市農(nóng)村文化傳統(tǒng)存在一定差異,在農(nóng)村老年人認(rèn)知功能篩查中應(yīng)做適當(dāng)修改。
[Abstract]:Objective to explore the prevalence of mild cognitive impairment (MCI) in the elderly in rural areas of Taian City and to investigate its prevalence, detection rate and its influencing factors, so as to provide reference data for clinical observation and treatment. At the same time, we analyzed the effect of MCI screening by Montreal Cognitive function Checklist (MoCA) in the rural elderly in this city, evaluated its reliability, validity, sensitivity and specificity to MCI, and discussed the best demarcation value. Methods the method of random stratified cluster sampling and MMSE and MoCA were used to screen the MCI of the rural elderly in Taian city, and the prevalence rate and the detection rate of MCI were calculated. The general physical and mental health of the elderly was investigated with the Social support scale (SSRS), the elderly Depression scale (GDSs) and the Self-Rating anxiety scale (SAS). The influential factors of MCI were analyzed by the life satisfaction scale of 5 items. Secondly, the reliability, validity, sensitivity, specificity and Youden number of MoCA were calculated. Results 1. 2150 people participated in the community survey and 1971 valid questionnaires were completed. The effective rate is 91.67. 615 people may have depression. 267 people may have anxiety. 675 people may have high blood pressure, 222 people have high blood lipid, 365 people have coronary heart disease, 108 cases have cerebral thrombosis, 273 people have insomnia, 315 people smoke and drink alcohol. 22Of them, 651 cases are clinically diagnosed. The total detection rate of MCI was 33.03 and the prevalence rate was 17.780.135 people were clinically diagnosed with dementia. The overall detection rate was 6.85. The prevalence rate was 3.56.3, age, education, occupation, different living conditions, self-perceived physical condition, memory, hearing, body weight and BMI abnormality, blood lipid, cerebral thrombosis, alcohol consumption, household chores, sleep, depression, etc. Social support status had a significant impact on MCI prevalence. 4. Age, marriage (divorce, self-perceived poor physical condition, less participation in activities, hyperlipidemia, depression) were the risk factors of MCI. 5The Cronbachsa of the MoCA scale was 0.777, which had good reliability, the correlation coefficient was 0.737 and the calibration validity was good compared with MMSE, except for wired, duplicated cubes, animal nomenclature and numerical calculation, the total score of Cronbachsa was better than that of MMSE, and the correlation coefficient was 0.737, and the validity of calibration was good, except for connection, replication cubes, animal nomenclature and numerical calculation. The other correlation coefficients were significantly correlated with the total score of MoCA, and the content validity of MoCA was good. 6MoCA was classified by original recommendation 26, the sensitivity and specificity of MCI screening were 98.85% and 14.72% respectively, Youden index was 0.1358.Conclusion 1.The rural population of Tai'an is mainly peasant. The average number of years of education is low, the proportion of the elderly is large, the number of people suffering from basic diseases is more, the prevalence rate of depression, anxiety is high, the state of physical and mental health is not optimistic. 2, the prevalence rate of MCI of the rural elderly in Tai'an City is higher. We should strengthen propaganda, education and screening. 3, age, marriage (divorce, self-perceived poor physical condition, less participation in activities, hyperlipidemia, depression are the risk factors of MCI; 4MoCA scale was simple and feasible for the screening of cognitive function of the elderly in rural areas, and had good reliability and sensitivity, but its diagnostic value was low according to the dividing line of 26. It is recommended that 15 points be taken as the MCL boundary value of the rural elderly in our city. 5. Some items of the MoCA scale are different from those of the rural cultural tradition in our city, which should be properly modified in the screening of the cognitive function of the rural elderly.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.16

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本文編號(hào)：1997984