The Study Of The Risk Factors And Protective Factors Of Mild Cognitive Impairment In The Community Of Shijiazhuang

Objective:Mild cognitive impairment (MCI) ,a kind of syndrome happened in the elderly population is a stage between the normal aging and dementia .It is cognitive impairment state and a kind of unstable transitional state,which has transformed into higher risk of dementia. MCI is a high risk factor of the AD and 10% ~ 15% patients of MCI in elderly population change into alzheimer's disease (AD) every year. MCI which make the most burdensome for sufferers and their caregivers make the old people higher risk into medical institutions. This study aims to investigate the cognitive function and related factors of elderly in Shijiazhuang city and explore the risk factors and protective factors of elderly with MCI and provide the scientific basis from the Angle of group.Methods: The study investigated 1600 elderly people which older than 60 from December 2009 to December 2010 in Shijiazhuang community and made MCI diagnosis. It adopted the case-control study and 205 MCI patients were selected to be cases group(MCI group). Inclusion criteria:(1)Petersen etc with diagnostic criteria:①a cognitive complaint (self-reported and/or informant);②cognitive impairment (not normal for age and education) or decline in cognition evidenced by performance on objective cognitive tasks;③preserved general cognitive functioning;④preserved basic activities of daily living;⑤absence of dementia; (2)age≥60;(3)The elderly to cooperate Cognitive investigation;(4)Voluntary participation and follow the informed consent principle. Exclusion criteria:(1)The elderly Because of aphasia, deaf,blind or other body diseases cannot be tried with cognitive investigation;(2) The neurological diseases that can cause brain dysfunction such as stroke,Parkinson's disease, brain tumor,etc;(3)The elderly that had mental illness such as Heavy depression, schizophrenia or delirium,consciousness that have influence on cognitive function. The normal control group had 356 cases of normal cognitive function which from the investigation;Inclusion criteria:(1)age≥60;(2)no cognitive complaint;(3)According to education,the total points of MMSE should not be below the following delimitation:illiteracy(degree of education<1 year)shoude be 19 points,Elementary school(1~6years)22 points, High school and above(≥7years)26 points;the points of Moca≥26;ADL<26;(4)The elderly to cooperate cognitive investigation;(5)Voluntary participation and followed the informed consent principle. Exclusion criteria is similar to MCI group's. The 4 aspects such as general demographic characteristics, life style,life events and psysical diseases of two groups were analyzed. According to SPSS13.0 Software,the enumeration data were analyzed by Chi-square test and the ranked data were analyzed by nonparametric test. Finally,the related factors were analyzed by logistic regression.Results: (1)The analysis of single factor:①There were significant difference with age(Z=-7.597,p=0.000),education(Z=-13.489,p=0.000),marriage(χ2=9.556,p=0.008),occupation(χ2=66.672,p=0.000)between MCI group and normal group;gender(χ2=1.262,p=0.261)was no statistical different between two groups.②There were significant difference with drinking(χ2=12.969,p=0.005), leisure-time activitie(sχ2=46.654,p=0.000)between two groups;smoking(χ2=2.059,p=0.357), physical exercise(χ2=0.684,p=0.408)were no statistical different.③Only loss of spouse(χ2=10.011,p=0.002) was significant difference in life events between two groups. There were no significant difference with loss of parents and children (χ2=2.788,p=0.095),economic hardship(χ2=3.068 ,p=0.080), divorced(p=0.303), unemployed or laid-of(fχ2=0.004,p=0.948),the accidents such as fire or flooding(χ2= 3.335,p=0.068), criminal events such as robbed,kidnapped(χ2=1.958,p=0.162). Occurrence frequency of life events was no statistical different between two groups(Z=-1.334,p=0.182).④There were significant difference with coronary heart disease(χ2=4.074,p=0.044),hypertension(χ2=6.388,p=0.011),insomnia(χ2=6.349,p=0.012), hyperlipaemia(χ2=12.564,p=0.000),peptic ulcer (χ2=37.174,p=0.000),cataracta(χ2=5.015,p=0.025),hearing disorder(χ2=6.967,p=0.008)between two groups ;brain trauma(χ2=3.174,p=0.075)and diabetes(χ2=2.384,p= 0.123)were no statistical different.(2)Results of logistic regression analysis:the factors influence on MCI included age,education,drinking,leisure-time activities,hypertension,hyperlipaemia.The protective factors included age (60~69)(OR=0.058),high school/technical secondary school (10~12years)(OR=0.983),drinking occasionally (OR=0.746),no hypertension(OR=0.637),no hyperlipaemia(OR=0.565). And the risk factors of MCI included age(70~79) (OR=1.127),illiteracy(degree of education<1 year)(OR=93.943),elementary schoo(l1~6years)(OR=16.722),junior high school(7~9years)(OR=3.394),low leisure-time activities(OR=2.131),drinking more than 2 times a week(OR=3.008),give up drinking (OR=1.505).Conclusion: The protective factors of MCI include low age,high education,drinking occasionally,high leisure-time activities,no hypertension,no hyperlipaemia. According to the OR,the order of protective factors were age (60~69),no hyperlipaemia,no hypertension,drinking occasionally,high school/technical secondary school. And the risk factors include low culture,low leisure-time activities,drinking more than 2 times a week and give up drinking,the order of risk factors were illiteracy(degree of education<1 year),elementary schoo(l1~6years),junior high schoo(l7~9years),drinking more than 2 times a week,low leisure-time activities,give up drinking,age(70~79).Gender,physical exercise,life events,diabetes and other factors were no associated with MCI.