| Objective:1.To explore the effect of Memory and Executive Screening(MES)in screening elderly people with mild cognitive impairment(MCI)in community.2.To construct a cognitive intervention model using structural equation model.3.To explore the effect of simple finger exercise on improving cognitive function,frailty and health outcomes of elderly people with MCI in community.Methods:1.A total of 252 elderly people who met the inclusion criteria in two communities of Yangzhou were enrolled in by random sampling.The cognitive function of them was assessed by MoCA,MMSE,MES and GDS.ROC curve was used to determine the cut-off values of MCI screened by MES scale,and was compared with MMSE and MoCA to understand the screening effect.2.The cognitive function,frailty and health status of 252 elderly people involved in the study were evaluated.Exploratory factor analysis and confirmatory factor analysis were used to construct the cognitive intervention model of MCI in community.3.80 elderly patients with MCI were divided into control group and intervention group,with 40 cases in the control group and 40 cases in the intervention group.The cognitive function,frailty and health outcomes of the two groups were compared through finger exercise intervention.Results:1.Compared with MMSE and MoCA,MES is not affected by education level and can better screen MCI.When MMSE<26 was classified as screening criteria for diagnosis,the cut-off value for screening MCI was 81,AUC was 0.787,95%CI was 0.733?0.840,sensitivity was 0.68,and specificity was 0.66.When MoCA<26 was classified as screening criteria for diagnosis,the cut-off value for screening MCI was 81,AUC was 0.632,95%CI was 0.564?0.699,sensitivity was 0.57,and specificity was 0.59.When MMSE?26 and MoCA<26 were classified as screening criteria for diagnosis,the cut-off value for screening MCI was 80,AUC was 0.816,95%CI was 0.762?0.870,sensitivity was 0.67,and specificity was 0.722.Cognitive function and frailty interacted with each other directly,and the path coefficient was-0.521.There were direct and indirect influence path from cognitive function to health outcome:the path coefficient was-0.728 of a direct influence path,the path coefficient was-0.031 of indirect influence path,the total effects were-0.759.There were direct and indirect influence path from frailty to health outcomes:the path coefficient was 0.060 of a direct influence path,the path coefficient was 0.380 of indirect influence path,the total effects were 0.4403.Significant inter-group effects were observed in MMSE,MoCA and MES scores(P<0.05),suggesting that finger exercise can improve cognitive function of MCI in the elderly.There were significant inter-group effects on daily living ability,social activity ability and quality of life(P<0.05),suggesting that finger exercise could improve health outcomes.Significant inter-group effect was observed in fatigue condition(P<0.05),indicating that finger exercise could improve fatigue condition.There was no significant inter-group effect on grip strength(P>0.05),suggesting that finger exercise could not improve grip strengthConclusion:1.MES can effectively screen MCI for the elderly,which is short-time and easy to operate without any auxiliary tools.It can be widely used for screening MCI in the community,which is worthy of promotion and application2.The cognitive intervention model has a good fitting degree and can be applied to the intervention of the elderly with MCI in community.Through the effects of cognitive function,frailty and health outcomes,it can provide guidance for the formulation of practical intervention in the later stage.3.The finger exercises can improve the cognitive ability,health outcomes and fatigue status of the elderly.It is simple,easy to operate and implement without the need for any place and facilities,can be widely promoted in the community. |
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