Analysis On Influencing Factors Of Cognitive Impairment Of The Elderly In Community And Research On Whole Process Hierarchical Health Management Based On TCM Constitution Differentiation

First part:Objective:This study analyzed the clinical data of the elderly population over 60 years old and the population with mild cognitive impairment in the community of Xicheng District,Beijing,discussed the prevalence and influencing factors of cognitive impairment in the elderly population in the community,and analyzed the prevalence and influencing factors of mild cognitive impairment in the elderly population in the community.Methods:the subjects of this study in the Xicheng District of Beijing were the elderly over 60 years old in 8 communities including Guangnei,Guangwai,Niujie,Baizhifang,Shichahai Street,Baiguang Road,Honglian,and Huguosi in Xicheng District,Beijing.Combined with the corresponding incidence rate and sample size,the total number of survey was calculated by combining various statistical analysis.Combined with the calculation,it is determined that the sample size is 4000 and the actual sample size is 4268.516 patients with mild cognitive impairment were selected from the population,and143 persons of the patients were randomly selected as the case group by simulation software.Collect the medical history and other information of all enrolled patients,and analyze the current situation and inducement of the subjects.Results:this part of the study investigated and analyzed the elderly over 60 years old in the community of Xicheng District,Beijing.The prevalence of mild cognitive impairment in the community was more than 10%.At the same time,it is found that the elderly,low education level,low income and gender are closely related to mild cognitive impairment.The patients with mild cognitive impairment are worse than the normal group in listening,reading memory,episodic memory,mapping and picture arrangement.By comparing the frequency of age and gender,the univariate analysis found that the level of education is also an important factor affecting mild cognitive impairment.The level of education is closely related to a person’s health awareness and behavior,and the health effects brought by different health awareness and behavior are also significantly different.Mild cognitive impairment is closely related to blood glucose,blood lipid and blood pressure.Univariate analysis showed that triglycerides and low-density lipoprotein had significant effects on mild cognitive impairment,but there was no statistical significance in multivariate analysis.In addition,the results of this survey show that smoking and drinking are not shown to be risk factors for mild cognitive impairment.Further,in the analysis of the injury mechanism of mild cognitive impairment,studies have analyzed the transmembrane proteins expressed in the central nervous system,most of which are amyloid precursor proteins.Studies show that the increase of amyloid precursor proteins will lead to the direct increase of amyloid proteins,which will lead to Alzheimer’s disease.Conclusion:there is a significant mild cognitive impairment in the elderly over 60 years old.The prevalence rate of female is higher than that of men.With the increase of age,the incidence rate of disease is obviously increasing and it is high in the low income group.Therefore,gender,age and occupation are important factors that harm the population.We should pay enough attention and strengthen prevention.The analysis of mild cognitive impairment of the elderly in the community found that their abilities in calculation and memory decreased significantly.At the same time,the tests of multiple cognitive function areas showed that knowledge,arithmetic,mapping,picture arrangement,spatial reasoning,listening and reading were closely related to the occurrence of mild cognitive impairment of the elderly.Second part:Objective:by analyzing the clinical data of AD patients,this study discusses the whole process hierarchical health management of elderly patients with cognitive impairment based on TCM Constitution Differentiation.According to the characteristics of TCM Constitution,syndrome elements and syndrome characteristics in the elderly,through modern information and artificial intelligence technology,the whole process hierarchical management of elderly MCI and mild,moderate and severe AD is formed to form a combination of man-machine and A health management platform based on the whole process management of doctor-patient interaction,the combination of stage and target,and hierarchical management.Methods:according to the diagnostic criteria of cognitive impairment in the elderly,the diagnostic criteria of TCM syndromes and the classification and judgment of TCM Constitution,and the course of disease is more than 3 months.100 cases with normal cognition,200 patients with mild cognitive impairment and 108 patients with AD were enrolled in this research.Their clinical data were collected,and the internal and external information of Chinese and western hospitals were comprehensively collected.The information in the hospital includes:basic information of patients,four diagnostic information of TCM(including constitution judgment and syndrome differentiation information)Cognitive impairment evaluation related scale information,test information,outpatient diagnosis and treatment information and inpatient diagnosis and treatment information.The out of hospital information includes daily medication information,diet and daily life information,psychological state information,health care and rehabilitation information,etc.intervention treatment is carried out according to the patient’s physique,and a hierarchical management system is established.Results:the results showed that there was no significant difference in the basic data of all patients with cognitive impairment before and after hierarchical management.After clinical intervention and hierarchical management,the cognitive function of patients in hierarchical management group and control group was significantly improved.At the same time,the improvement of some cognitive functions of patients in hierarchical management group was significantly better than that in control group.At the same time,the corresponding indexes of basic biochemical indexes were compared.The results showed that the indexes of systolic blood pressure,blood glucose,triglyceride and low-density lipoprotein were significantly improved,The improvement of blood glucose,blood pressure,low density lipoprotein and triglyceride in stratified management group was significantly better than that in unmanaged group.Conclusion:for patients with early cognitive impairment,we mainly carry out publicity and education on population cognitive impairment,do a good job in the health management of mild cognitive impairment,and build a hierarchical management comprehensive system for the prevention mechanism of cognitive impairment.