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目的 了解老年住院患者认知障碍的现况及其影响因素作用路径，为制定老年患者认知障碍早期预防与干预措施提供依据。方法 采用一般资料问卷、简易智能状态检查量表(MMSE)、老年抑郁量表(GDS)及营养风险筛查表(NRS-2002)对上海市第五人民医院1 986例60岁以上老年住院患者进行问卷调查，采用单因素和多因素logistic回归模型分析认知障碍的影响因素，采用路径分析法分析影响因素的作用路径。结果 老年住院患者认知功能MMSE得分为(25.6±4.6)分，认知障碍者1 087例(54.7%);年龄、文化程度、婚姻状况、职业、居住地、运动锻炼、睡眠、夜间睡眠时长、清淡饮食及抑郁是老年住院患者认知障碍的影响因素(均P<0.05);年龄(-0.324)、抑郁(-0.252)、文化程度(0.249)是总效应前3位的影响因素，睡眠、抑郁是路径中的中介因素。结论 老年住院患者认知障碍发生率高，其认知功能受多因素、多条路径影响，抑郁和睡眠对认知障碍具有双重中介作用。
Abstract：Objective To understand the influencing factors and its pathways of cognitive impairment among the elderly inpatients, so as to provide a basis for the development of early prevention and intervention measures for cognitive impairment in elderly patients. Methods The general information questionnaire, Mini-Mental State Examination(MMSE), Geriatric Depression Scale(GDS), and Nutritional Risk Screening-2002(NRS-2002) were used to investigate 1 986 elderly inpatients aged 60 and older from a tertiary hospital in Minhang district of Shanghai. The influencing factors of cognitive impairment were analyzed with univariate and multivariate logistic regression models, and path analysis was used to analyze the action path of the influencing factors.Results The MMSE score of cognitive function in elderly inpatients was(25.6±4.6)points, and there were 1 087(54.7%) people with cognitive impairment.Age, education level, marital status, occupation, residence, exercise, sleep, night sleep duration, light diet, and depression were the influencing factors of cognitive impairment in elderly inpatients(all P<0.05). Age(-0.324), depression(-0.252), and education level(0.249) were the top three influencing factors of the total effects, while sleep and depression were the mediating factors in the pathway. Conclusion The incidence of cognitive impairment is high in elderly inpatients, whose cognitive function is influenced by multiple factors and multiple pathways. Depression and sleep have dual mediating effects on cognitive impairment in elderly inpatients.
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基本信息:
DOI：10.16821/j.cnki.hsjx.2022.17.002
中图分类号:R473.74
引用信息:
[1]谢传桃,顾艳荭,汪亚男.老年住院患者认知障碍现况及影响因素路径分析[J].护士进修杂志,2022,37(17):1543-1548.DOI:10.16821/j.cnki.hsjx.2022.17.002.
基金信息:
上海市卫生健康委员会卫生行业临床研究专项(编号：201840195); 复旦大学-复星护理科研基金(编号：FNF201820); 复旦大学附属上海市第五人民医院院级医学重点专科(编号：2020WYZDZK10)