老年慢性病住院患者认知障碍现状及风险预测模型的构建研究

陈勇; 周志庆

文章摘要

老年慢性病住院患者认知障碍现状及风险预测模型的构建研究

Study on the current status of cognitive impairment and construction of a risk prediction model in hospitalized elderly patients with chronic diseases

投稿时间：2026-03-14 修订日期：2026-06-29

DOI：

中文关键词: 老年人慢性病认知障碍影响因素风险预测模型

英文关键词: Elderly Chronic Diseases Cognitive Impairment Influencing Factors Risk Prediction Mode

基金项目:安徽省教育厅重大课题项目（2024AH040381）、安徽省高等学校省级质量工程项目（2020xsxxkc457）、皖南医学院校级科研项目（2020kcbz06）、中华医学会杂志社护理科研课题（CMAPH-NRD 2025044）

作者	单位	邮编
陈勇	皖南医学院研究生院	241002
周志庆^*	皖南医学院第一附属医院（弋矶山医院）护理部	241001

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中文摘要:

摘要目的探讨老年慢性病住院患者认知障碍现状及影响因素，构建并验证风险预测模型，为降低老年慢性病住院患者认知障碍提供借鉴。方法采用简单随机抽样法，对2025年3月—2025年8月对广西医科大学第一附属医院、皖南医学院第一附属医院和芜湖市第二人民医院共752例老年慢性病住院患者采用一般资料调查问卷?认知障碍量表（AD8）、口腔衰弱量表（OFI-8）、临床生理弹性评估量表（CHEES）进行问卷调查。采用Spearman相关性和二元Logistic回归分析老年慢性病住院患者认知障碍影响因素。结果 752例老年慢性病住院患者（AD8）量表得分2.00（1.00，5.00）、（OFI-8）量表得分5.00（2.00，8.00）、（CHEES）量表得分47.00（41.00，54.00），认知障碍发生率49.9%。老年慢性病住院患者认知障碍与口腔衰弱呈正相关（r=0.584，P<0.001），与临床生理弹性呈负相关（r=-0.529，P<0.001）?分析结果显示：年龄、慢性病病程、口腔衰弱是患者发生认知障碍的危险因素；婚姻状况、文化程度高、临床生理弹性好是保护因素（均P<0.05）。基于以上回归分析结果构建的预测模型校准曲线拟合度良好；ROC曲线下面积为0.857（95%CI：0.826-0.887），灵敏度为0.906，特异度为0.627；显示该模型具有良好的临床适用性和实用性。结论老年慢性病住院患者认知障碍发生率较高。医护工作者可针对其影响因素采取相应的干预措施，以期提高老年慢性病住院患者的认知功能。

英文摘要:

Abstract:Objective To investigate the prevalence and influencing factors of cognitive impairment in hospitalized elderly patients with chronic diseases,and to establish and validate a risk prediction model,so as to provide a reference for reducing cognitive impairment in this population.Methods From March 2025 to August 2025,a total of 752 elderly inpatients with chronic diseases were enrolled from the First Affiliated Hospital of Guangxi Medical University,the First Affiliated Hospital of Wannan Medical College,and Wuhu Second People’s Hospital using a simple random sampling method.All participants completed a set of questionnaires,including a general demographic questionnaire,the Ascertain Dementia 8 (AD8) for cognitive impairment,the Oral Frailty Index8 (OFI8),and the Clinical Health Evaluation and Scoring Scale (CHEES).Spearman correlation analysis and binary logistic regression were performed to explore the correlates and influencing factors of cognitive impairment in elderly inpatients with chronic diseases.Results Among the 752 patients,the median (interquartile range) scores were 2.00(1.00,5.00) for AD8,5.00 (2.00,8.00) for OFI-8,and 47.00 (41.00,54.00) for CHEES.The prevalence of cognitive impairment was 49.9%.Cognitive impairment was positively correlated with oral frailty (r=0.584,P<0.001) and negatively correlated with clinical physiological resilience (r=-0.529,P<0.001).Logistic regression showed that age,duration of chronic diseases,and oral frailty were risk factors; while marital status,high education level,and good clinical physiological resilience were protective factors (all P<0.05).The prediction model showed good calibration.The area under the ROC curve was 0.857 (95%CI:0.826–0.887),with a sensitivity of 0.906 and specificity of 0.627,indicating favorable clinical applicability and practicability.Conclusion The prevalence of cognitive impairment is high in hospitalized elderly patients with chronic diseases.Medical staff can implement targeted interventions according to the influencing factors to improve cognitive function in these patients.

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