| Along with the aging of population, the number of patients with Alzheimer’s disease (AD) has increased year by year. As we all know, AD, the most serious problem of the ageing society, is a cognitive impairment mainly caused by brain structure changes. Currently, there are quite a number of epidemiological investigations and studies on the cognitive impairment of the AD patients, but research on the cognitive impairment of the elderly is insufficient. Our study is an epidemiological investigation based on the spectrum of diseases and quality of life of retired cadres over 80 years of age in one army sanatorium in Beijing. It is focused on the distribution patterns and influence factors of their cognitive impairment and is of great value for improving the quality of life for the aged and strengthening the treatment and care of AD-related diseases.Part Ⅰ Investigation of the current cognitive functions of 111 aged peopleObjective:To study the distribution patterns and influence factors of cognitive dysfunction for the elderlyMethods:MMSE and ADL scale and general information questionnaire prepared by ourselves were used, along with interviews and clinical data collection, to learn about the general information and spectrum of diseases of the retired cadres in a Beijing army sanatorium. Scale rating results were collected.Results:1. The morbidity rate of cognitive dysfunction for the elderly was positively correlated with age. The old people in this group, with an average age of 85 (80-97), had an AD morbidity rate of 21.6%. Cochran-Armitage trend test found that the number of AD patients rose linearly with increasing age. MMSE scores and single factor statistical analysis of their demographic information showed that MMSE scores were independent of gender and educational level, but were negatively correlated with age. Those more than 90 years old had even lower MMSE ratings (p<0.05).2. Investigation on the spectrum of diseases found that with lower MMSE scores, there is a growing trend of comorbid diseases related to cognitive impairment. The urinary system diseases also increased, and there was a significant difference in the morbidity of urinary system diseases between genders (p<0.05).3. The quality of daily life and the ADL ratings, sleep disorder problems, and the need for care among the aged with various cognitive levels were significantly different (p<0.05).Part II Investigation of old people’s sleep qualityObjective:To investigate the sleep quality of 111 old people in in one army sanatorium in Beijing.Methods:PSQI scale and general information questionnaire prepared were used, along with interviews and clinical data collection, to assess their sleep quality.Results:The overall prevalence of poor quality of sleep was 47.7%, but was 75.0% for AD patients. (/<0.01). PSQI of AD patients averaged 10.58±3.51, while PSQI of non-AD patients averaged 7.36±3.32. The poor sleep quality in AD patients was mainly seen in sleep timing, sleep length, sleep efficiency, sleep medication and effects on daytime functions(p<0.01). Conclusion:Multiple linear regression analysis showed that age, cognitive level, and the level of need for care can be potential predictors of sleep quality for the aged.Part III A comparative study of the clinical efficacy of donepezil in the treatment of mild cognitive impairment (MCI)Objective:To learn about the medications used by the elderly in the treatment of cognitive impairment and evaluate the clinical efficacy of donepezil in improving the cognitive function of the aged with MCIMethods:By collecting information on the medical records of the aged, their past history of diseases, and current medication to treat cognitive impairment, we learned about the medications of the aged people at various cognitive levels.Results:1. Our survey found that of the 111 cases,1) medication is common, with nearly half of them taking the drugs for improving cognitive functions; 2) a wide variety of drugs are used:Ginkgo, Nicergoline, oxiracetam, hydergine, donepezil, Butylphthalide, and memantine; 3) combination medication is common:in general AD patients combine 3-4 drugs.2. A comparative study of the clinical efficacy of donepezil in the treatment of MCI showed that 1) donepezil may improve cognitive function, and increase MMSE scores; 2) after taking donepezil for eight weeks,76.6% of patients found it significantly effective or effective; 3) Donepezil has little effect on daily activities. ADL scale scores before and after medication did not differ significantly.Conclusion:This research found that of the 111 cases, AD prevalence was 21.6%, lower than their counterparts in the country. It may be associated with the good medical conditions and health awareness. The old people diagnosed with AD suffer a variety of comorbidity, having poor quality of life and greater need for quality care. Old people generally have poor sleep quality, those diagnosed with AD are even worse (p<0.01). The survey found that the elderly often take the initiative to take drugs for improving cognitive functions. They may take a variety of medications, and combine different drugs. AD group may combine 3-4 drugs, suggesting that further study needs to be conducted in terms of standard treatment and drug administration. The control study of 60 cases taking donepezil for 8 weeks found that donepezil had little effect on the daily activities of the aged, but had a significant effect in improving MCI. Therefore it is worth our further efforts to explore whether early administration can delay the progression of the disease. |
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