A Study On The Risk Factors Of Anemia,Its Relationship With Mild Cognitive Impairment And The Effect Of Education Intervention In The Community Elderly

Objective: To investigate the prevalence and distribution of anemia in the elderly in urban of Tianjin, and explore the risk factors for anemia and explore the relationship of anemia with cognitive function.Methods: Cross-sectional study, case control study and intervention study.1)Cross-sectional study: total of 14707 subjects who took physical examination during Jan to Dec in 2015 in a community health center in Tianjin. 2) Case-control Study on the risk factor of anemia: according to the WHO diagnosis criterion of anemia, 200 patients with anemia and 200 normal controls without anemia were randomly selected for the case-control study. Date, collected from self-designed questionnaire,laboratory testing and physical examination, logistic regression was used to analyze the factors associated with anemia.3) Intervention study:200 patients with anemia in the Case-control Study received intervention.The intervention by community health education about anemia was carried out for 150 patients. APP health education was carried out for 50 patients. After two months, 200 patients would receive the same questionnaire about awareness of anemia. 4). Effects of anemia on cognitive function in the elderly: strict accordance with the new inclusion criteria and exclusion criteria,exclude a variety of chronic diseases and mental illness which may affect cognitive function, two-hundred patients with anemia were selected as anemia group in a community of Tianjin, two-hundred patients without anemia as control group, MOCA was used to assess the cognition, compare the incidence of cognitive dysfunction and the score of Mo CA in the two groups.Results: 1. The prevalence of anemia in the elderly in the community was 11.33%(10.46% for male, 12.01% for female). The prevalence of anemia was rising with age.2. Results from logistic regression analysis showed that risk factors for anemia were drinking tea(OR=3.586,95%CI:2.050~6.274) and hyperlipidemia(OR=3.251,95%CI:1.412~7.256). Protective factors included: physical exercise(OR=0.387,95%CI:0.208~0.721), regular diet(OR=0.238,95%CI:0.123~0.461), collocationof meat and vegetables(OR=0.397,95%CI:0.273~0.578), collocation of coarse and refined grains(OR=0.473,95%CI:0.359~0.740), eating more red meat(OR=0.673,95%CI:0.426~0.913),more vegetable intake(OR=0.198,95%CI:0.073~0.539),eating more meat(OR=0.271,95%CI:0.147~0.500), eating animal liver(OR=0.198,95%CI : 0.073 ~ 0.539). 3.The results of iron indicators: ferritin(female), iron saturation and serum iron levels in anemia group was significantly lower than the control group, UIBC level was higher significantly than the control group. The rate of ferritin below normal was 3.75%(15/400), the rate of serum iron below normal was1.75%(7/400).4. The average awareness rate of the related knowledge about anemia was 42.33%. After the education, the awareness rates were 83.67%(?2=339.252,p<0.01) for those with community health education and 93.00%(?2=165.121,p<0.01)for those with APP health education.(?2=339.252,p<0.01)(?2=165.121,p<0.01).The effect of APP health education was superior to community health education(?2=16.279,p<0.01). 5.The incidence of cognitive dysfunction in anemia group was significantly higher than control group(48 % vs 12.5%, ?2=59.729,p<0.05),the score of Mo CA was significantly lower than control group(23.78 vs 27.12, p<0.05).Correlation analysis indicated that anemia was correlated to MCI(r=0.869, p<0.01).Conclusion: 1.The prevalence of anemia in the elderly was high, which was closely related to diet, lifestyle and underlying diseases.The rate of iron deficiency was low,iron deficiency anemia might not be the main kind of anemia in community. 2.Awareness rate of anemia was low in the elderly in Tianjin, health education was an effective measure to reduce anemia,the effect of We Chat APP educationt was superior to the traditional way, the way of modern education was worth of promotion. 3.Anemia is associated with cognitive impairment in the elderly, the elderly with anemia need early prevention and active treatment measures.