长期照护机构中老年人运动认知风险综合征的患病率及影响因素

文献信息

中文摘要

背景/目的： 探讨长期照护机构中老年人运动认知风险（MCR）综合征的患病率及其相关危险因素。方法：2024年1月至12月，通过便利抽样从中国西南地区五家长期照护机构招募老年人。所有参与者接受了一系列标准化评估，包括自行设计的人口学问卷、15项老年抑郁量表（GDS-15）、计时起立-行走测试（TUG）、Fried衰弱表型量表、基于SARC-F肌少症筛查量表的肌少症评估、基础日常生活活动能力（BADL）量表、Lawton工具性日常生活活动能力（IADL，Lawton）量表以及简易精神状态检查（MMSE）。进行4米步行测试以测量参与者的步速。本横断面研究旨在探讨机构养老老年人中MCR综合征的患病率及其相关影响因素。结果：总体MCR患病率为8.6%。单因素检验发现组间在BMI、抑郁症状、听力损失、多重共病、活动能力受损、衰弱及若干慢性疾病方面存在差异（均p < 0.05）。多因素logistic回归分析进一步表明，在调整混杂因素后，较高的抑郁症状评分（OR = 1.169，95% CI：1.079-1.265，p < 0.001）、轻度活动能力受损（OR = 4.725，95% CI：1.340-16.663，p = 0.016）、中度活动能力受损（OR = 3.921，95% CI：1.146-13.420，p = 0.029）以及超过三种慢性共病是长期照护机构中机构养老老年人MCR的独立危险因素（OR = 2.789，95% CI：1.465-5.309，p = 0.002）。结论：抑郁症状、轻至中度活动能力受损及多重共病是机构养老老年人MCR的独立相关因素。SG与SCCs存在不同的危险因素模式，凸显了运动维度与主观认知维度可分离的性质。有必要对长期照护机构居民进行情绪、躯体及慢性疾病风险的综合筛查，并实施个体化活动干预。

英文摘要

Background/Objectives: To investigate the prevalence of the Motoric Cognitive Risk (MCR) Syndrome among older adults in long-term care facilities and its associated risk factors. Methods: From January to December 2024, older adults were recruited from five long-term care facilities in Southwest China via convenience sampling. All participants underwent a series of standardized assessments, including a self-designed demographic questionnaire, the 15-item Geriatric Depression Scale (GDS-15), the Timed Up and Go (TUG) test, the Fried frailty phenotype scale, sarcopenia assessment based on the SARC-F sarcopenia screening scale, the Basic Activities of Daily Living (BADL) scale, the Lawton Instrumental Activities of Daily Living (IADL, Lawton) scale, and the Mini-Mental State Examination (MMSE). The 4 m walk test was performed to measure participants' gait speed. This cross-sectional study aimed to explore the prevalence of MCR syndrome and its associated influencing factors among institutionalized older adults. Results: The overall MCR prevalence was 8.6%. Univariate tests detected intergroup differences in BMI, depressive symptoms, hearing loss, multimorbidity, mobility impairment, frailty and several chronic diseases (all p < 0.05). Multivariate logistic regression analysis further demonstrated that, after adjustment for confounders, higher depressive symptom scores (OR = 1.169, 95% CI: 1.079-1.265, p < 0.001), mild mobility impairment (OR = 4.725, 95% CI: 1.340-16.663, p = 0.016), moderate mobility impairment (OR = 3.921, 95% CI: 1.146-13.420, p = 0.029), and more than three chronic comorbidities were independent risk factors for MCR among institutional older adults residing in long-term care facilities (OR = 2.789, 95% CI: 1.465-5.309, p = 0.002). Conclusions: Depressive symptoms, mild-to-moderate mobility impairment and multimorbidity were independent correlates of MCR among institutional older adults. Distinct risk-factor patterns existed for SG and SCCs, highlighting the separable nature of motor and subjective-cognitive dimensions. Integrated screening for emotional, physical and chronic disease risk and personalized activity interventions are warranted for long-term care residents.