Path Analysis Of Motor Cognitive Risk Syndrome Status And Influencing Factors In Community Older Adults

Research Background:Dementia has become a significant health crisis for the aging population worldwide.In the absence of appropriate treatment,attention has been focused on the preclinical stages of dementia."Motoric Cognitive Risk Syndrome,MCR" as a new pre-dementia clinical stage has attracted more and more attention.Currently,most studies are still in the initial stage.The relationship between the overall attribution and attribution factors of MCR in community older adults still needs further research.Research Purpose:Based on the previous conceptual model of MCR influencing factors,this study formed the theoretical framework of the MCR attribution from four aspects: social demography,psychology,physical function,lifestyle and behavior factors,and then explored the influencing factors and intrinsic path of MCR.Research Methods:The research was a cross-sectional study design and used the method of combining multi-stage random and convenient sampling.520 older adults from eight communities in Huzhou City were selected from March 2021 to January 2022.The MCR was screened using a set of neuropsychological tests and gait speed measurements.The related influencing factors were evaluated using the basic information questionnaire,the Purpose in Life Test,Pittsburgh Sleep Quality Index,Physical Activity Scale for the Elderly,and Chinese Big Five Personality Inventory Brief Version.SPSS 25.0 software was used for statistical analysis and inference of data to clarify the potential influencing factors of MCR.Mplus 7.0 software was used for path analysis to construct and verify each factor’s effect size and potential path on MCR.Research Results:1.520 older adults were enrolled in this study,with an average age of 73.25 ± 9.00 years,and most of them were women.A total of 72 participants were diagnosed with MCR,and the MCR incidence was 13.85%.2.Univariate analysis showed statistically significant differences between MCR and non-MCR older adults in education level,age,chronic diseases,depression,apathy,purpose in life,physical activity,grip strength,and personality characteristics（P<0.05）.3.Logistic regression analysis showed that older age（OR=3.064,95%CI=1.237-7.591,P=0.016）,more than 2 chronic disease（OR=2.214,95%CI=1.057-4.637,P=0.035）and depressive symptoms（OR=2.338,95%CI=1.159-4.716,P=0.018）were risk factors for MCR.More physical activity（OR=0.280,95%CI=0.121-0.650,P=0.003）,higher purpose in life（OR=0.288,95%CI=0.109-0.766,P=0.013）and agreeable personality traits（OR=0.946,95%CI=0.909-0.985,P=0.007）were protective factors for MCR.4.Path analysis shows that age,chronic disease,depressive symptoms,physical activity,and agreeable personality traits can directly affect MCR.And it can indirectly predict MCR through four mediating paths: age → physical activity →MCR;agreeableness → depressive symptoms →MCR;agreeableness→physical activity→MCR;chronic disease→depressive symptoms→MCR.The direct effect of the purpose in life on MCR was not noticeable.Two complete mediation pathways were used to predict MCR: the purpose in life → depressive symptoms → MCR;the purpose in life→ physical activity→MCR.Research Conclusion:1.The incidence of MCR in community older adults was 13.85%.The screening and management of MCR in community older adults should be strengthened to promote the process of dementia "ultra-early prevention and treatment" in the community.2.The occurrence of MCR in community older adults was affected by multiple variables.Particular attention should be paid to the older adults with advanced age,chronic disease,depressive symptoms,low physical activity and purpose in life,and agreeable personality characteristics.3.Age can directly affect MCR and affect MCR through physical activity level.Agreeable personality and purpose in life can affect MCR through the mediating effect of depressive symptoms and physical activity level.There is a partial mediating effect of depressive symptoms between chronic diseases and MCR.4.Medical staff should build a path-oriented MCR management program according to the MCR attribution path model,take the factors affecting MCR as the starting point of intervention,and carry out health management practice for the community MCR population by optimizing personalized intervention.