| Summary: | 博士 === 中山醫學大學 === 醫學研究所 === 98 === Objectives
The population of cognitive impairment increases rapidly because of fast growing elderly population. The importance is to explore and prevent the risk factors that affect the cognitive function. This study aims to explore the risk factors of cognitive impairment in elderly persons without dementia from a longitudinal study of “Survey of Health and Living Status of the Elderly in Taiwan”, during a 4-year period (1999~2003).
Methods
Data were derived from a population-based cohort study of 2,310 elderly Taiwanese that were collected in 1999. Cognitive function was measured by the Short Portable Mental Status Questionnaire (SPMSQ) both in 1999 and in 2003. Each item scored one point, and the scores ranged from 0 to 9. The nine item SPMSQ was adequate to assess cognitive function. To reconcile this inconsistency, we chose the nine items shared by the 1999 and 2003 SPMSQ. Using nine-item criterion, a score of 6–9 was intact cognition; accordingly, in the present study, normal cognitive function was defined as a score of six or greater. A total of 1,224 participants free of cognitive impairment at baseline were included in these analyses. Gender, age, race, marriage, chronic diseases, voluntary, BMI, dietary behavior (intake of vegetable, fruit and drinking tea), depression, ADL, IADL, physical activity, falls, religion, and self-perceived health status, has been admitted to a hospital, ER, or any hospitalization were independent variables and the cognitive function in 2003 was the dependent variable. A Chi-square test was used to analyze the relationships among dependent variable and independent variables first. Secondly, the stratum logistic regression was used to establish six models by using the significant variables based on the results of chi-square including (1). basic characteristics, (2). chronic diseases, (3). Physical activity, (4). Health behaviors, (5). Social participation, and (6). nutrition and then analyze the Odds Ratio and the 95％confidence interval.
Results
One hundred and fifty-five out of 1,224 elderly were diagnosed with cognitive impairment between 1999 and 2003. The accumulated prevalence rate was 31.1 persons/1,000 persons. Through the stratum logistic regression analysis, it’s found that the goodness of fit is adequate enough for the purpose to predict cognitive impairment among the elderly. In the logistic regression model adjusted for age, education, hypertension, cancer, heart disease, stroke and so on at baseline, persons who are 75 (Odds ratio = OR = 2.45; 95% CI = 1.59-3.76; p < 0.0001), those who had lower educational background (OR = 2.24, 95% CI = 1.05-4.76), those who were diagnosed with cancer (OR = 3.25, 95% CI = 1.26-8.38), those who has been admitted to hospital in the past year (OR = 1.96, 95% CI = 1.23-3.11), those who has IADL impairment (OR = 3.09, 95% CI = 1.98-4.83) were significantly to develop cognitive impairment. On the contrary, males has lower risk to develop cognitive impairment. (OR = 0.56, 95% CI = 0.35-0.87).
Conclusion
Aged 75 years old, females, lower educational background, who were diagnosed with cancer, has been admitted to hospital in the past year, has IADL deficit were found to be the risk factors of cognitive impairment in this study.
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