中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2020, Vol. 15 ›› Issue (6): 1111-1119.doi: 10.4103/1673-5374.266070

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

中国冀东认知障碍队列研究：目标，设计和基线筛选

  

  • 出版日期:2020-06-15 发布日期:2020-07-02
  • 基金资助:
    国家自然科学基金资助（91749205，81973112，81973138，81903401）；山东省泰山青年学者计划（tsqn20161046）

Jidong cognitive impairment cohort study: objectives, design, and baseline screening

Dai-Yu Song1, 2, Xian-Wei Wang2, Sa Wang5 , Si-Qi Ge3 , Guo-Yong Ding1 , Xue-Yu Chen1 , Yan-Ru Chen1 , Hua-Min Liu1 , Xiao-Mei Xie4 ,Wei-Jia Xing 1 , Dong Li 1, Yong Zhou2#br#   

  1. 1School of public health, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
    2 School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
    3 Department of Neuroepidemiology, Beijing Neurosurgical Institute; Capital Medical University, Beijing, China
    4 Staff hospital of jidong oilfield, Caofeidian district, Tangshan, Hebei Province, China
    5 Department of Neurology, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, Zhejiang Province, China
  • Online:2020-06-15 Published:2020-07-02
  • Contact: Yong Zhou, MD,yongzhou78214@163.com; Dong Li, MD,tsmcdongli@163.com; Wei-Jia Xing, MD,xingweijia@hotmail.com.
  • Supported by:
    This study was supported by the National Natural Science Foundation of China, No. 91749205 (to YZ), 81973112 (to YZ), 81973138 (to DL), 81903401 (to WJX); the Young Taishan Scholars Program of Shandong Province of China, No. tsqn20161046 (to WJX).

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摘要：

认知功能障碍患者患痴呆症的风险会增加，目前尚不清楚哪些因素可确切地影响认知障碍和痴呆的预后。为此，研究设计了一项冀东(中国河北省唐山市)认知障碍前瞻性队列研究，旨在调查该人群每5年认知障碍的患病率及影响认知障碍和痴呆预后的因素。于2012年4月至2015年8月建立冀东认知障碍队列，有痴呆病史的参与者被排除在外，共招募了来自中国河北省唐山市开滦和曹妃甸社区中国石油冀东油田职工医院的健康体检者5854名，年龄＞45岁，平均年龄57岁，男性占55.1%。研究收集了对象的基线资料和血样信息，所有受试者均进行了双侧颈动脉超声检查，采用简易精神状态量表(MMSE)对认知功能障碍进行评定(认知障碍的定义是MMSE评分＜24分)。采用美国精神病学协会《精神疾病诊断与统计手册》第四版标准和国际工作组标准及MMSE评分相结合进行痴呆的诊断。此队列研究从2012年4月到2015年8月开始收集基线资料，随访将一直持续到2024年12月，每年的随访期间将为痴呆评估工具建立一个预后模型。研究的主要结局事件是认知障碍和痴呆，次要结局事件是生活质量下降。基线筛查结果显示：(1)共有320名对象患有认知障碍，患病率为5.5%，此部分对象将被排除研究，剩余人群将进入进行队列研究随访；(2)320名认知障碍者相比其他各教育程度及文盲的认知障碍患病率(35.9%)明显升高（P < 0.05），年龄、高血压、饮酒、被动吸烟等认知障碍的预后因素在认知障碍组与正常认知功能组间存在显著差异（P < 0.05），多变量Logistic回归分析显示年龄（OR=1.059，95%CI：1.044-1.074）和动脉高血压（OR=1.665，95%CI：1.143-2.427）是轻度认知功能障碍的危险因素，随着教育程度的提高（文盲、小学、初中、高中、大学及以上），认知障碍对象数量逐渐减少(OR < 1，P < 0.05）；(3)此队列研究基线初步筛选了一些认知障碍的危险因素，随后的前瞻性数据将进一步描述和验证及评估这些危险因素对认知障碍和痴呆的影响，为认知障碍和痴呆的早期预防提供临床证据；（4）在后续队列研究中，随着随访时间的推进，痴呆和生活质量的结局随访数据结果将会陆续整理发表。研究于2013年7月12日获得中国河北省唐山市开滦总医院伦理委员会和中国石油冀东油田职工医院的批准(批准号：2013 YILUNZI 1)。

orcid:0000-0001-5221-8026 (Yong Zhou)

        0000-0002-7729-7151 (Dong Li)
        0000-0003-0252-6340 (Wei-Jia Xing)

关键词: 认知障碍, 预后因素, 老年痴呆症, 随访, 简易精神状态量表, 模型, 新的基础, 预防, 评估, 社区

Abstract: The risk of dementia increases in patients with cognitive impairment. However, it is not clear what factors contribute to the onset of de- mentia in those with cognitive impairment. In this prospective cohort study, we will investigate the every-five-year incidence of cognitive impairment and prognostic factors for cognitive impairment. The Jidong cognitive impairment cohort was established from April 2012 to August 2015, during which we recruited 5854 healthy participants (55.1% male) older than 45 years (mean, 57 years). Participants re- ceived a health examination in the Staff Hospital, Jidong Oilfield Branch, China National Petroleum Corporation. Baseline data and blood samples were collected. Cognitive impairment was evaluated using the Mini-Mental State Examination, and was defined as a Mini-Mental State Examination score of less than 24. Dementia was assessed using the criteria of Diagnostic and Statistical Manual of Mental Disorders (Fourth edition), the International Working Group criteria, and the Mini-Mental State Examination score. The follow-up will continue until December 2024, during which a prognostic model will be constructed. The primary outcome is the presence/absence of dementia and the secondary outcome is quality of life. Baseline screening results showed the following: (1) Cognitive impairment was apparent in 320 participants (5.5%). These participants will be excluded from the Jidong cohort study, and the remaining participants will be followed up. (2) Of the 320 participants with cognitive impairment, there was a significantly higher prevalence of illiteracy than other education levels (35.9%, P < 0.05). Age, arterial hypertension, alcohol consumption, and passive smoking differed significantly between the cognitive impairment and healthy groups (P < 0.05). Multivariate logistic regression models showed that age (odds ratio [OR] = 1.059, 95% confidence interval [CI]: 1.044–1.074) and arterial hypertension (OR = 1.665, 95% CI: 1.143–2.427) were risk factors for mild cognitive impairment. With the increase of educational level (illiteracy, primary school, junior high school, high school, university, and above), cognitive impairment gradually decreased (OR < 1, P < 0.05). (3) This cohort study has initially screened for several risk factors for cognitive impairment at base- line, and subsequent prospective data will further describe, validate, and evaluate the effects of these risk factors on cognitive impairment and dementia. These results can provide clinical evidence for the early prevention of cognitive impairment and dementia. The study was approved by the Ethics Committee of Kailuan General Hospital of Tangshan City and the Medical Ethics Committee, Staff Hospital, Jidong Oilfield Branch, China National Petroleum Corporation on July 12, 2013 (approval No. 2013 YILUNZI 1).

Key words: assessment, cognitive impairment, community, dementia, follow-up, Mini-Mental Status Examination Scale, model, new basis, prevention,  , prognostic factors