Evidence-based Study On Risk Prediction Of Mild Cognitive Impairment In The Elderly In Community

ObjectiveMild cognitive impairment(MCI)is a transitional state of cognitive function between normal aging and dementia.It is an important stage of early intervention to prevent dementia.In this study,the main risk factors of MCI in Chinese community were analyzed to provide reference for its prevention and treatment.The evaluation model of MCI risk was constructed to lay the foundation for predicting the risk of individual MCI,and the established prediction model was applied to the community elderly population in Shanghai in order to explore the practical application value of the model.MethodsIn Baoshan District of Shanghai,1826 elderly people over 60 years old from four community health service centers were selected by cluster random sampling to carry out demographic information,past disease history,lifestyle and other data questionnaire survey and physiological index data collection.According to the Univariate analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of MCI in this area.Through literature retrieval,case-control studies and cohort studies on risk factors of MCI in China from 2006 to 2018 were collected.The risk factors of MCI patients and the corresponding comprehensive risk values were obtained by Meta analysis,and the Rothman-Keller model for predicting the risk of MCI in the elderly in China was established.Then the model was applied to 1826 elderly people in Baoshan District of Shanghai,and the performance of the MCI risk prediction model was evaluated by ROC curve.ResultsA total of 1826 elderly people over 60 years old were included in this study,including 798 males(43.70%)and 1028 females(56.30%).There are 430 MCI patients.The prevalence rate of MCI was 23.55%.There was no significant difference in gender between the two groups(P > 0.05).The average age of MCI group was significantly older than that of the normal control group(P < 0.001).Multivariate Logistic regression analysis showed that hypertension,stroke,low educational level,insomnia,less housework and rarely reading newspapers were independent risk factors for MCI(P < 0.05).A total of 38 articles on MCI risk factors in the elderly in China were included in this study for Meta analysis.The results showed that hypertension,diabetes,educational level,hyperlipidemia,smoking,physical exercise,living alone,stroke,drinking,heart disease could be used as risk factors for predicting MCI in elderly Chinese population.The Rothman-Keller model includes several risk factors for hypertension,diabetes,education,hyperlipidemia,smoking,physical exercise,marriage,stroke,drinking and heart disease.The area(AUC)under the curve of Rothman-Keller model is 0.726(95% CI: 0.705 ? 0.746),the sensitivity and specificity were 73.30% and 61.85%,respectively.ConclusionOn the basis of updating Meta analysis,this study researched the risk factors of MCI in the elderly in China,and compared it with the current situation of MCI in this area.At the same time,the risk assessment model of MCI in the elderly in China was constructed,and the model was used to effectively predict the MCI patients in this area,which provides a reference for the primary prevention of MCI in the elderly in China,promotes the in-depth development of high-risk population screening in community health services,helps to reduce the risk of MCI,and also provides a useful reference for the evaluation of other disease risk factors.