昆明市官渡区老年人体重指数对认知障碍的影响

易庆华; 徐娟; 李爱莲; 田林云; 桑东丽; 熊静; 邓昌

昆明市官渡区老年人体重指数对认知障碍的影响

1.
昆明市官渡区人民医院内分泌科，云南昆明　650200
2.
昆明市官渡区关上街道社区卫生服务中心内科，云南昆明　650200
3.
昆明医科大学第二附属医院神经内科，云南昆明　650330

基金项目: 昆明市卫生健康委员会卫生科研课题项目（2022-03-07-002）；云南省科技厅科技计划项目（202201AY070001-131）

详细信息

作者简介:
易庆华（1968～），女，云南昆明人，硕士研究生，主任医师，主要从事慢性病管理工作

通讯作者:
邓昌，E-mail：yiqinghua1968@126.com

中图分类号: R589.2
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- 文章访问数: 31
- HTML全文浏览量: 52
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- 被引次数: 0
出版历程
- 收稿日期: 2024-07-10

Association between Body Mass Index and Cognitive Impairment in the Elderly in Guandu District of Kunming City

1.
Dept. of Endocrinology，Guandu District People’s Hospital，Kunming Yunnan 650200
2.
Department of Internal Medicine，Community Health Service Center of Guanshang Street，Guandu District，Kunming Yunnan 650200
3.
The Second Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650330，China

摘要

摘要: 目的探讨云南省官渡区社区老年人体重指数与认知功能障碍之间关联。方法数据来自云南省官渡区2021－2023年社区老年人体检，通过简易精神状态检查（MMSE表）和体格检查的横断面数据（≥ 65，n = 17352）收集分析。结果在17352名参与者中，本地区老年人受教育程度低，认知障碍的发生率22.31%，女性高于男性，教育程度越高发生率越低，基线时体重过轻、正常、超重和肥胖的比例分别为2.5%、41.9%、40.7%和14.9%，与正常基线 BMI 组相比，排外年龄、性别、教育程度、吸烟、糖尿病、高血压及中风等因素的影响，BMI 25 –27.9 kg/m²认知障碍风险最低SSME值最高、和BMI正常的人群相比风险下降11%、而BMI < 18.5 kg/m²和BMI ≥ 28 kg/m²的参与者认知障碍风险增加50%及60%，老年女性BMI > 25 kg/m²认知功能障碍的发病率高于同体重男性12%、BMI ≥ 28 kg/m²人群高于同体重男性42%。结论本研究提示昆明市官渡区接受调查的老年人认知功能障碍发病率不低，体重过轻和肥胖人群认知功能障碍的风险高，保持适当的体重特别是BMI在25-27是本地区老年人认知功能障碍的保护因素特别是女性。
- 老年人 /
- 体重指数 /
- 认知功能障碍
Abstract: Objective To explore the association between body mass index （BMI） and cognitive impairment in the elderly in Guandu district of Yunnan province. Methods The data were collected from the community health check-ups for elderly individuals in Guandu District, Yunnan Province, from 2021 to 2023. It includes cross-sectional data from the Mini-Mental State Examination （MMSE） and physical examinations for those over 65 years （n = 17, 352）. Results Among 17, 352 participants, elderly individuals in this region had a low level of education, with a prevalence of cognitive impairment at 22.31%. Women had higher rates than men, and the higher the education level, the lower the prevalence. At baseline, the proportions of underweight, normal weight, overweight, and obese individuals were 2.5%, 41.9%, 40.7%, and 14.9% respectively. When controlling for factors like age, gender, education level, smoking, diabetes, hypertension, and stroke, those with a BMI of 25-27.9 kg/m² had the lowest risk of cognitive impairment and the highest SSME value. Compared to those with a normal BMI, their risk decreased by 11%. In contrast, participants with a BMI less than 18.5 kg/m² or greater than or equal to 28 kg/m² had a 50% and 60% increase in the risk of cognitive impairment, respectively. Elderly women with a BMI greater than 25 kg/m² had a 12% higher incidence of cognitive dysfunction compared to similarly weighted men, and those with a BMI greater than or equal to 28 kg/m² had a 42% higher rate compared to men of the same weight. Conclusion This study suggests that the prevalence of cognitive impairment among the elderly surveyed in Guandu District, Kunming, is not low. Those who are underweight or obese have a higher risk of cognitive impairment. Maintaining an appropriate weight, especially a BMI between 25 and 27, is a protective factor against cognitive impairment for the elderly in this region, particularly for women.
- Elderly people /
- Body mass index /
- Cognitive impairment

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图 1 8组人群MMSE值比较

Figure 1. Comparison of MMSE values among 8 groups of population

下载: 全尺寸图片幻灯片

图 2 8组之间两两比较

Figure 2. Pairwise comparison between 8 groups

下载: 全尺寸图片幻灯片

表 1 体检人群一般情况（n）

Table 1. General Information

指标	分组	数字	比率（%）	MMSE值	F/t	P
性别	男	7318	42.20%	24.42 ± 4.23	16.234	<0.001^*
	女	10034	57.80%	23.30 ± 4.71
学历	文盲	3055	18.03%	20.33 ± 5.05	1229.522	<0.001^*
	小学	6773	37.85%	23.31 ± 4.25a
	中学	5415	36.83%	25.40 ± 3.68ab
	大学	2109	7.44%	26.05 ± 3.26abc
^*P < 0.05。

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表 2 多变量调整模型

Table 2. Multivariate Adjustment Model

变量	认知障碍
变量	Odds Ratio	95%CI	P
Model
BMI
体重过轻	1.50	1.34–1.67	< 0.001
正常	1 （Ref）
超重	0.89	0.77–1.09	< 0.001
肥胖	1.60	1.43–1.78	< 0.001

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表 3 8组人群及相应的MMSE值

Table 3. 8 groups of population and their corresponding MMSE values

指标	分组	数字	MMSE	F/t	P
BMI分组
<18.5	1	637	23.30 ± 4.74	6.712	<0.001
18.5-21	2	1616	23.69 ± 4.76
21-24	3	3438	23.66 ± 4.69
23-25	4	4169	23.95 ± 4.44abc
25-27	5	3699	23.98 ± 4.37abc
27-29	6	2102	23.85 ± 4.49a
29-31	7	1008	23.33 ± 4.67cdef
≥31	8	683	23.14 ± 4.54bcdef
注：a 表明P < 0.05与组1比较差异有统计学意义；b 表明P < 0.05与组2比较差异有统计学意义；c表明P < 0.05与组3比较差异有统计学意义；d表明P < 0.05与组4比较差异有统计学意义；e表明P < 0.05与组5比较差异有统计学意义；f表明P < 0.05与组6比较差异有统计学意义。

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表 4 组之间两两比较

Table 4. Pairwise comparison between groups

（I） BMI分组		平均差（I-J）	标准错误	P	95% 置信区间
（I） BMI分组		平均差（I-J）	标准错误	P	下限值	上限
1	2	−0.384	0.213	0.071	−0.8	0.033
	3	−0.356	0.196	0.07	−0.74	0.028
	4	−0.6492^*	0.193	0.001	−10.028	−0.27
	5	−0.6783^*	0.195	0.001	−10.06	−0.296
	6	−0.5497^*	0.205	0.007	−0.952	−0.147
	7	−0.033	0.23	0.886	−0.484	0.418
	8	0.161	0.25	0.52	−0.33	0.651
2	1	0.384	0.213	0.071	−0.033	0.8
	3	0.028	0.137	0.838	−0.241	0.297
	4	−0.2656^*	0.133	0.046	−0.527	−0.005
	5	−0.2947^*	0.135	0.03	−0.56	−0.029
	6	−0.166	0.15	0.269	−0.461	0.129
	7	0.351	0.182	0.054	−0.007	0.708
	8	0.5445^*	0.207	0.009	0.138	0.951
3	1	0.356	0.196	0.07	−0.028	0.74
	2	−0.028	0.137	0.838	−0.297	0.241
	4	−0.2935^*	0.105	0.005	−0.499	−0.088
	5	−0.3227^*	0.108	0.003	−0.534	−0.112
	6	−0.194	0.126	0.123	−0.441	0.053
	7	0.3227^*	0.163	0.047	0.004	0.642
	8	0.5165^*	0.19	0.007	0.143	0.89
4	1	0.6492^*	0.193	0.001	0.27	10.028
	2	0.2656^*	0.133	0.046	0.005	0.527
	3	0.2935^*	0.105	0.005	0.088	0.499
	5	−0.029	0.103	0.776	−0.23	0.172
	6	0.099	0.122	0.413	−0.139	0.338
	7	0.6163^*	0.159	0	0.304	0.929
	8	0.8100^*	0.188	0	0.442	10.178
5	1	0.6783^*	0.195	0.001	0.296	10.06
	2	0.2947^*	0.135	0.03	0.029	0.56
	3	0.3227^*	0.108	0.003	0.112	0.534
	4	0.029	0.103	0.776	−0.172	0.23
	6	0.129	0.124	0.3	−0.115	0.372
	7	0.6454^*	0.161	0	0.329	0.962
	8	0.8392^*	0.189	0	0.468	10.21
6	1	0.5497^*	0.205	0.007	0.147	0.952
	2	0.166	0.15	0.269	−0.129	0.461
	3	0.194	0.126	0.123	−0.053	0.441
	4	−0.099	0.122	0.413	−0.338	0.139
	5	−0.129	0.124	0.3	−0.372	0.115
	7	0.5168^*	0.174	0.003	0.176	0.858
	8	0.7105^*	0.2	0	0.318	10.103
7	1	0.033	0.23	0.886	−0.418	0.484
	2	−0.351	0.182	0.054	−0.708	0.007
	3	−0.3227^*	0.163	0.047	−0.642	−0.004
	4	−0.6163^*	0.159	0	−0.929	−0.304
	5	−0.6454^*	0.161	0	−0.962	−0.329
	6	−0.5168^*	0.174	0.003	−0.858	−0.176
	8	0.194	0.225	0.389	−0.248	0.635
8	1	−0.161	0.25	0.52	−0.651	0.33
	2	−0.5445^*	0.207	0.009	−0.951	−0.138
	3	−0.5165^*	0.19	0.007	−0.89	−0.143
	4	−0.8100^*	0.188	0	−10.178	−0.442
	5	−0.8392^*	0.189	0	−10.21	−0.468
	6	−0.7105^*	0.2	0	−10.103	−0.318
	7	−0.194	0.225	0.389	−0.635	0.248

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表 5 不同BMI分性别比较

Table 5. Comparison of different BMI by gender

组别	变量	认知障碍
		Odds Ratio	95%CI	P
体重正常组	性别
	女	1.06	0.94–1.18	0.301
	男	1 （Ref）
体重过轻组	性别
	女	0.82	0.53–1.25	0.362
	男	1 （Ref）
体重超重组	性别
	女	1.22	1.09–1.38	0.001
	男	1 （Ref）
体重肥胖组	性别
	女	1.42	1.17–1.74	< 0.001
	男	1 （Ref）

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