基于中国老年人队列的认知障碍、教育程度与死亡风险的关联研究

doi:10.3969/j.issn.1006-5253.2023.03.002

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摘要目的在中国老年人群中探究认知障碍和教育程度与死亡的关联，为中国老年人的认知功能管理提供建议。方法研究人群来自2005年和2008年中国老年健康调查（Chinese longitudinal healthy longevity survey， CLHLS）中年龄在65岁及以上的老年人群。传统的Cox比例风险模型和可加Cox比例风险模型被用于估计认知障碍和教育程度与全死因死亡之间的关联。数据分析包括单暴露分析，分层分析及交互作用分析。其中可加Cox比例风险模型的结果通过图像的形式呈现。结果 15 860名满足条件的参与者被纳入研究,其中11 044名参与者在随访过程中死亡。研究发现，患有认知障碍会导致老年人死亡风险的增加（HR=1.32，95%CI：1.26~1.39），且在按教育程度分层后，这种有害作用随着教育程度的下降而减弱(受教育年限>6年 HR=1.47，95%CI：1.08~2.00；受教育年限1~6年 HR=1.44，95%CI：1.26~1.63；受教育年限0年 HR=1.32，95%CI1.25~1.39)。此外，教育程度与死亡的关联在不同认知功能的人群中不一致，在认知功能正常的人群中观察到教育程度对于死亡的保护作用（HR=0.83，95%CI：0.77~0.91），未在患有认知障碍人群中观察到这种保护作用（HR=1.09，95%CI：0.81~1.47）。结论建议社区卫生中心根据老年人的受教育程度来对他们的认知功能状况进行管理。

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	吴菁祎
	邓伟
	余勇夫

关键词 ：认知障碍, 教育程度, 老年人队列, 死亡

Abstract：Objective To explore the association of cognition impairment with education status and mortality among the Chinese elderly and to provide recommendations for cognitive management of the Chinese elderly.Methods The study population was from the elderly aged 65 and above in the Chinese longitudinal healthy longevity survey (CLHLS) in 2005 and 2008. The traditional Cox proportional hazard model and additive Cox proportional hazard model were used to estimate the associations of cognitive impairment with education status and all-cause mortality. Data analysis included univariable analysis, stratified analysis and interaction analysis. The additive Cox proportional hazard model results were presented in the form of images.Results Among 15 860 eligible participants included in the study, 11 044 died during follow-up. The results showed that cognitive impairment would increase the mortality risk of the elderly (HR=1.32, 95%CI:1.26-1.39). And after stratified by education status, the hazardous effects diminished as education status decreased (years of schooling >6 years HR=1.47, 95%CI: 1.08-2.00; years of schooling 1-6 years HR=1.44, 95%CI: 1.26-1.63; years of schooling 0 year HR=1.32, 95%CI:1.25-1.39). In addition, the association of education status and mortality was inconsistent across cognitively diverse populations. The protective effect of education status on mortality was observed among the people with normal cognitive function (HR=0.83, 95%CI: 0.77-0.91) but not observed among the people with cognitive impairment (HR=1.09, 95%CI: 0.81-1.47).Conclusion It is suggested that the community health centers should manage the cognitive function of the elderly according to their education status.

Key words： cognitive impairment education status elderly cohort mortality

收稿日期: 2023-02-16

PACS:

基金资助:国家自然科学基金（82273730）；
上海市青年科技启明星计划（21QA1401300）；

上海市自然科学基金（22ZR1414900）

通讯作者: 余勇夫，Email：yu@fudan.edu.cn

引用本文:

吴菁祎，邓伟，余勇夫. 基于中国老年人队列的认知障碍、教育程度与死亡风险的关联研究[J]. 中国医院统计, 2023, 30(3): 166-172.
Wu Jingyi，Deng Wei， Yu Yongfu.

Associations of cognitive impairment with education status and mortality risk based on a Chinese elderly cohort

. journal1, 2023, 30(3): 166-172.

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