The Follow-up Study Of Assessment,classification And Intervention Of The Cognitive Impairment In The Elderly In The Changchun South-lake Community

Background and purpose:Cognitive impairment(Cognitive impairment,CI),is refers to the various reasons lead to different degrees of Cognitive impairment,.Alzheimer's disease(AD)and vascular dementia(VD)and mild cognitive impairment(MCI)are the common types of cognitive impairment in the elderly.With the rapid development of aging population,dementia and MCI will certainly become a health and social problem which could not be ignored.The study by examming the cognitive function in the south-lake community elderly residents over the age of 60 to understand the CI prevalence,distribution characteristics and influence factors of stratification and the CI for the elderly in the community elderly,judge the cognitive impairment elderly at which stage,MCI or dementia,identify the main characteristics,and give the intervention treatment.We hope to prove the degree of understanding of cognitive impairment in the elderly and to give the help to control and protect the prevelence of MCI and dementia in the community elderly.Methods:The fellowship into the standard of the elderly as the researchobject which form the the south-lake community,Located in near the south-lake campus of Ji Lin university hospital.895 elderly people were exammed,recorded the basic information,and used MMSE scale for cognitive examing.For the people less than normal points would be ordered to our memory disorders clinic,then testing the Mo CA scale,geriatric depression scale(GDS),clinical dementia rating scale(CDR),ha kinski ischemia index scale(HIS),daily life ability scale(ADL),and the head imaging examination.Based on the above results,the layered diagnosis to patients with CI and compared the scale features.MCI patients are divided into donepezil joint cognitive training intervention group and pure cognitive intervention group.Dementia patients are divided into donepezil together joint cognitive training intervention group and pure donepezil intervention group.After 3 months,observing the cognitive function and ADL scores points.Using the SPSS17.0 statistical software for statistical analysis.With poor,composition ratio,average standard for some general information,the prevalence is used by chi-square test and the logistic analysis.the scores before and after the intervention using t-test,P < 0.05 standard for the difference is statistically significant.Results:(1)The prevalence of CI was 12.96%(2)The factors that age,the educational level the smoking,hypertension,diabetes were associatedwith CI disease;(3)After classified diagnosis,in the 116 CI patients,48 cases were the mild cognitive impairment(MCI),the prevalence rate of5.36%.There were 61 cases of dementia patients,the prevalence rate of6.83%.,and 29 cases of AD type dementia,the prevalence rate was 3.24%;VD 32 cases,the prevalence rate of 3.58%;Of which 7 were accompanied by hypothyroidism,Parkinson's disease grouping for other reasons.(P <0.05).(4)The total score of MMSE and each item score of the directional force,attention,memory and language ability of the in the MCI group were significantly higher than those in the VD group and the AD group(P <0.05).AD group had a significantly higher concentration score than VD group,the recall force score of AD group was significantly lower than VD group(P<0.05).(5)after 3 months,compared the MMSE scores and ADL scores with the scores of the same group before the treatment,the cognitive function and daily life ability in the elderly are improved,the combined score in treatment group is better than that of single scheme,intervention group(P ?0.05).Conclusion:(1)The prevalence of cognitive dysfunction is high in the South Lake community in Changchun City,and the prevalence of vascular dementia is greater than that of AD.(2)The elderly in the lower education group and the smoking,and with high blood pressure and diabetes should be focus on screeningcognitive function.(3)Different subtypes of cognitive impairment have the different characteristics,neuropsychological scale could help to distinguish the type of cognitive impairment.(4)Drugs combined with the and cognitive training treatment could be better improve the CI patients' cognitive situation and the daily living ability of the dementia elder.