| Research background and purpose:Chronic disease patients account for a large proportion of the elderly population in China.In order to cope with aging actively,this study by understanding the cognitive function status of the elderly with chronic diseases as well as individual differences and trends,master the rule of cognitive function change in the elderly with chronic diseases.Through cross-sectional and longitudinal studies,the factors influencing cognitive function of the chronically ill elderly were found out for comprehensive comparative analysis,which provided empirical data support for the prevention of cognitive function decline of the chronically ill elderly and the formulation of intervention measures.Data and Methods:The data came from the Chinese Longitudinal Healthy Longevity Survey.The spss13.0 software was used to make a single factor analysis of the CLHLS cross-sectional data in 2018,and the binary logistics regression was adopted to analyze the risk factors and protective factors of cognitive function of the chronically ill elderly from the aspects of social demography,lifestyle behavior habits,eating habits,physical and mental health,intergenerational support,etc.According to the 2008-2018 longitudinal data of the 2018 data backtracking sample,the latent variable growth curve model is built to understand the individual initial differences and changes in cognitive function of the chronically ill elderly.Moreover,the multi-level model is adopted to further analyze the influencing factors of cognitive function of the chronically ill elderly under the longitudinal tracking data.Both the latent variable growth curve model and the multilevel model were constructed using Mplus15.0.Result:1.The results of cross-sectional study showed that the elderly with chronic diseases suffered most from hypertension,followed by heart disease cataract.There were 4453 elderly with only one chronic disease,accounting for 46.47%,and 5130 elderly with more than two chronic diseases,accounting for 53.53%.2.Among 9583 patients with senile chronic disease,the detection rate of cognitive dysfunction was 12.74%.3.Binary logistics regression shows that educational experience in primary school or below and above is a protective factor for cognitive impairment in the elderly with chronic diseases,compared with illiteracy.Living in nursing home,exercising regularly,doing housework,outdoor activities,visiting with friends,reading books and newspapers,playing cards or mahjong,watching TV or listening to radio,eating fresh vegetables,eating nuts,eating meat,self-rated good health,parents giving their children economic support were also protective factors for whether the elderly with chronic disease had cognitive impairment(P<0.05).Older age,living alone,disability and more severe depression were risk factors for cognitive impairment in the elderly with chronic disease(P<0.05).4.In the ranking of the importance of factors affecting cognitive function in chronically ill elderly,age has the greatest influence,followed by depression.5.The latent variable growth curve model of cognitive function of chronically ill elderly people shows that the cognitive function of this population is in curve decline,and the rate of decline is gradually accelerated.There is individual difference in the first measured value,but there is no individual difference in the rate of decline.6.The results of longitudinal multi-level model showed that age,living alone,frequent consumption of white sugar or candy,disability and cognitive function were negatively correlated(P<0.05).Male cognitive function was better than female(P<0.05),education experience,family income level,doing housework,outdoor activities,reading books and newspapers,raising poultry and livestock,playing cards or mahjong,watching TV and listening to radio,eating fresh fruit,fresh vegetables,eating fish and other aquatic products,eating salted vegetables and pickles,drinking tea,timely treatment of illness,self-rated good health.Children’s economic support was positively correlated with cognitive function(P<0.05).Conclusions:1.The number of chronic disease elderly population is large,and hypertension patients are the most.Attention should be paid to the cognitive function of this population.2.The cognitive function of the elderly with chronic disease is characterized by accelerated decline,and the decline rate is faster with age and there are individual differences.3.The cognitive function of chronically ill elderly people is influenced by individual physiology,psychology and society.It is important to focus on elderly,poorly educated with disabilities who live alone.On the whole,men have better cognitive function than women,so women should pay more attention to the monitoring of cognitive function.Good physical and mental health,healthy lifestyle and diet habits have positive effects on cognitive function of the elderly with chronic disease.Intervention and prevention measures can reduce the influence of uncontrollable factors,increase the self-management of controllable factors,and actively mobilize the forces of family,society and self.To improve cognitive function in chronically ill elderly. |
