【摘要】：目的通過隨訪研究了解太原市阿爾茨海默病患者的認知、抑郁、日常行為能力及生命質(zhì)量現(xiàn)狀、隨時間的變化趨勢以及其影響因素。探討AD患者認知與抑郁,日常行為能力與生命質(zhì)量之間的相關(guān)關(guān)系,為制訂科學(xué)合理疾病防治策略提供依據(jù)。 方法基于對AD患者首次隨訪資料,對患者的認知功能、抑郁狀態(tài)、日常行為能力及生命質(zhì)量進行單因素分析并以它們?yōu)榉磻?yīng)變量進行多重線性回歸分析,初步探討各個反應(yīng)變量的影響因素,進一步采用多元多水平模型探討患者認知功能與抑郁狀態(tài)的相關(guān)關(guān)系、隨時間的變化趨勢及影響因素,探討患者日常行為能力及生命質(zhì)量的相關(guān)關(guān)系、隨時間的變化趨勢及影響因索,同時探討認知功能與抑郁狀態(tài)對日常行為能力及生命質(zhì)量的影響。 結(jié)果 1、多無多水平模型擬合效果較好。 2、AD患者認知功能、抑郁狀態(tài)、日常行為能力及生命質(zhì)量影響因素的多元多水平結(jié)果顯示,以AD患者認知功能及抑郁狀態(tài)同為反應(yīng)變量時,影響AD患者認知功能的因素為受教育程度、性格、、業(yè)余愛好、體育活動、讀書看報、鋁制炊具、限制飲食和高血壓8個因素,影響AD患者抑郁狀態(tài)的因素有婚姻狀況、退休前職業(yè)、經(jīng)常做家務(wù)、讀書看報、鋁制炊具、限制飲食及高血壓7個因素,其中讀書看報、鋁制炊具、限制飲食和高血壓為AD患者認知功能及抑郁狀態(tài)的共同影響因素。教育水平高、性格外向者、具有業(yè)余愛好、經(jīng)常參加體育活動經(jīng)常讀書看報、不常用鋁制炊具、小限制飲食及不患有高血壓的患者認知功能得分較高,具有較好的認知功能,獨身、退休前從事體力勞動、不經(jīng)常做家務(wù)、不讀書看報、經(jīng)常使用鋁制炊具、限制飲食及患有高血壓的患者抑郁狀態(tài)得分較高，抑郁程度更強。并且有個體和測量時點水平上,AD患者認知功能及抑郁狀態(tài)具有相關(guān)性且為負相關(guān)，相關(guān)系數(shù)分別為-0.685和-0.354。 3、以AD患者的日常行為能力及生命質(zhì)量得分同為反應(yīng)變量時,影響AD患者日常行為能力的因素有受教育程度、經(jīng)常做家務(wù)、患者認知功能及抑郁狀態(tài)4個因素，影響AD患者生命質(zhì)量的因素有婚姻狀況、體育活動、讀書看報、飲酒及患者的認知功能和抑郁狀態(tài)6個因素，其中AD患者認知功能及抑郁狀態(tài)對患者的日常行為能力和生命質(zhì)量都有影響,受教育程度低、不經(jīng)常做家務(wù)、認知功能得分低及抑郁狀態(tài)得分高的患者日常行為能力得分高，日常行為能力差，獨身、不經(jīng)常參加體育活動、不經(jīng)常讀書看報、不飲酒、認知功能得分低及抑郁狀態(tài)得分高的患者生命質(zhì)量得分低,生命質(zhì)準差。在個體和測量時點水平上,AD患者日常行為能力及生命質(zhì)量具有相關(guān)性,且為負相關(guān)，相關(guān)系數(shù)分別為-0.379和-0.238。 結(jié)論AD患者的認知功能、抑郁狀態(tài)、日常行為能力及生命質(zhì)量與多種因素有關(guān)，需要注重AD患者對阿爾茨海默病的預(yù)防及治療。此外，，相比于傳統(tǒng)的縱向數(shù)據(jù)的分析方法多元多水平模型具有其優(yōu)勢，不僅能夠分析其影響因素還能分析各反應(yīng)變量隨時間的變化趨勢及兩個反應(yīng)變量之間的相關(guān)關(guān)系。
[Abstract]:Objective to investigate the cognition, depression, daily behavior ability and quality of life in patients with Alzheimer's disease in Taiyuan, and to explore the relationship between cognition and depression, daily behavior and quality of life in the patients with Alzheimer's disease in Taiyuan, and to provide a basis for the formulation of a scientific and rational disease control strategy. According to it.
Methods based on the first follow-up data of AD patients, the patients' cognitive function, depressive state, daily behavior ability and quality of life were analyzed by single factor analysis and multiple linear regression analysis was carried out with them as response variables. The factors affecting the response variables were preliminarily discussed, and the cognitive function of patients was studied by multiple multilevel models. The relationship with depression, the change trend and the influencing factors of time, the relationship between the daily behavior ability and the quality of life, the change trend and the influence of time, and the influence of cognitive function and depression on the daily behavior and quality of life.
Result
1, the multiple no multi level model has better fitting effect.
2, the multiple levels of cognitive function, depression, daily behavior and quality of life in AD patients showed that the factors affecting the cognitive function of AD patients were education, personality, hobbies, sports, reading, reading, cooking utensils, restricted diet when the cognitive function and depressive state of the AD patients were the reacting variables. And hypertension 8 factors, the factors affecting the depression of AD patients are marital status, pre retirement occupation, regular housework, reading and reading, aluminum cookers, diet and hypertension 7 factors, including reading and reading, aluminum cooking utensils, restriction diet and hypertension as the common influence factors of recognition and depression of AD patients. Education level is high, Extroverts, with hobbies, often participate in sports activities, often read and read newspapers, do not often use aluminum cooking utensils, small restricted diet and hypertension patients have higher cognitive function score, have better cognitive function, single, before retiring to engage in manual labor, do not do housework often, do not read newspapers, often use aluminum cookers, restrict the use of aluminum cookers, LIMITED Patients with diet and hypertension had a higher score of depression and a greater degree of depression. There was a correlation and negative correlation between the cognitive function and depression status of AD patients, and the correlation coefficient was -0.685 and -0.354., respectively.
3, when the daily behavior ability and quality of life score of AD patients were the reacting variables, the factors affecting the daily behavior of AD patients were education, housework, cognitive function and depression. The factors affecting the quality of life of AD patients were marital status, physical activity, reading and reading, drinking and cognition of patients. There are 6 factors of function and depression, of which the cognitive function and depression of AD patients have an impact on the patient's daily behavior and quality of life, low education, not often doing housework, low score of cognitive function and high score of depression, the higher scores of daily behavior ability, poor daily behavior, single, and unfrequent participation in the patients. At the level of individual and measuring time, the daily behavior ability and quality of life of AD patients were correlated and negatively correlated, and the correlation coefficient was -0.379 and -0.238., respectively.
Conclusion the cognitive function, depressive state, daily behavior ability and quality of life of AD patients are related to a variety of factors. It is necessary to pay attention to the prevention and treatment of Alzheimer's disease in AD patients. In addition, the multivariate and multilevel model of the traditional longitudinal data analysis method has its advantages, not only can analyze its influencing factors but also analyze the various kinds of anti Alzheimer's disease. The variation trend of strain with time and the correlation between the two reaction variables.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R749.16

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