老年脑卒中患者发生运动认知风险综合征的影响因素分析

doi:10.19854/j.cnki.1008-2425.2026.03.0003

摘要/Abstract

摘要： 目的分析老年脑卒中患者发生运动认知风险综合征(MCR)的影响因素。方法选取2021年6月~2024年5月110例伴随MCR的老年脑卒中患者,同期选择45例不伴随MCR的老年脑卒中患者作为本次研究对象。收集所有患者基线资料,Logistic多因素分析老年脑卒中患者发生MCR的危险因素,并采用ROC曲线分析预测价值。结果经比对,两组患者年龄、体质指数、共病数量、久坐行为、多重用药、体育锻炼时间、睡眠质量、营养状态及衰弱水平存在差异(P＜0.05);Logistic分析得出,年龄(OR=2.048,95% CI:1.118~3.750)、多重用药(OR=7.241,95% CI:3.506~14.958)、体育锻炼时间(OR=0.994,95% CI:0.988~0.999)、睡眠质量(OR=3.909,95% CI:1.263~12.102)、营养状态(OR=0.020,95% CI:0.001~0.464)、衰弱(OR=15.381,95% CI:7.580~31.200)是老年脑卒中患者发生MCR的影响因素(P均<0.05);利用ROC曲线评估发现,六者联合预测的AUC为0.891,敏感度、特异度为89.1%、87.7%,Hosmer-Lemeshow结果:χ²=6.877,P=0.526,模型效能较高。结论高龄、存在多重用药、体育锻炼时间过短、睡眠质量以及营养状态不佳与衰弱可作为预测老年脑卒中患者发生MCR的指标。

关键词: 脑卒中, 运动认知风险综合征, 老年, 因素分析

Abstract: Objective To analyze the influencing factors of motoric cognitive risk syndrome (MCR) in elderly stroke patients. Methods A total of 110 elderly stroke patients with MCR were selected from June 2021 to May 2024,and 45 elderly stroke patients without MCR were selected as the objects of this study.Baseline data of all patients were collected,the risk factors of MCR in elderly stroke patients were analyzed by Logistic multivariate analysis,and the predictive value was analyzed by ROC curve. Results After comparison,there were differences in age,body mass index,number of comorbidity,sedentary behavior,multiple drug use,time of physical exercise,sleep quality,nutritional status and frailty level between the two groups (P＜0.05);Logistic analysis showed that age (OR=2.048,95% CI:1.118~3.750),polypharmacy (OR=7.241,95% CI:3.506~14.958),physical exercise duration (OR=0.994,95% CI:0.988~0.999),sleep quality (OR=3.909,95% CI:1.263-12.102),nutritional status (OR=0.020,95% CI:0.001~0.464),frailty (OR=15.381,95% CI:7.580~31.200) were the influencing factors of MCR in elderly stroke patients (P<0.05);The ROC curve evaluation showed that the AUC predicted by the six parties was 0.891,the sensitivity and specificity were 89.1% and 87.7%,and the Hosmer-Lemeshow result was χ²=6.877,P=0.526,indicating high efficiency of the model. Conclusion Old age,multiple drug use,short time of physical exercise,sleep quality and poor and weak nutritional status can be used as indicators to predict the occurrence of MCR in elderly stroke patients.

Key words: Stroke, Motoric cognitive risk syndrome, Agedness, Factor analysis

中图分类号:

R743.9

陈园园, 董书宇, 徐海清, 周生奎, 孙嫄. 老年脑卒中患者发生运动认知风险综合征的影响因素分析[J]. 立体定向和功能性神经外科杂志, 2026, 39(3): 145-151.

Chen Yuanyuan, Dong Shuyu, Xu Haiqing, Zhou Shengkui, Sun Yuan. Analysis of influencing factors of the occurrence of motoric cognitive risk syndrome in elderly stroke patients[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2026, 39(3): 145-151.

参考文献

[1] Potter TBH,Tannous J,Vahidy FS.A contemporary review of epidemiology,risk factors,etiology,and outcomes of premature stroke[J].Curr Atheroscler Rep,2022,24(12):939-948.
[2] 《中国脑卒中防治报告2021》编写组,王陇德.《中国脑卒中防治报告2021》概要[J].中国脑血管病杂志,2023,20(11):783-792.
[3] Xie HY,Zhang N,Xia CQ,et al.The clinical characteristics of cerebral small vessel disease patients with motoric cognitive risk syndrome during single- and dual-task walking[J].Heliyon,2024,10(9):e30007.
[4] Wen ZF,Peng SH,Wang JL,et al.Prevalence of motoric cognitive risk syndrome among older adults:a systematic review and meta-analysis[J].Aging Ment Health,2023,27(8):1443-1455.
[5] Mullin DS,Gadd D,Russ TC,et al.Motoric cognitive risk syndrome trajectories and incident dementia over 10 years[J].Cereb Circ Cogn Behav,2023,5:100178.
[6] 黄馨仪,耿桂灵,韩悦.运动认知功能减退综合征与轻度认知障碍关系的研究进展[J].中风与神经疾病杂志,2020,37(10):952-954.
[7] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国各类主要脑血管病诊断要点2019[J].中华神经科杂志,2019,52(9):710-715.
[8] 张海洪,杨阳,丛亚丽.世界医学会《赫尔辛基宣言》[J].医学与社会,2025,38(1):141-144.
[9] 柴依依,叶青芳,林平,等.寒地城市冠心病患者运动认知风险综合征发生现状及影响因素研究[J].中国全科医学,2025,28(14):1730-1736.
[10] Allahyari E.Differential item functioning analysis on the Geriatric Depression Scale-15:An iterative hybrid ordinal logistic regression[J].Biomedicine (Taipei),2021,11(4):23-34.
[11] Passler JS,Kennedy RE,Crowe M,et al.The relationship of cognitive change over time to the self-reported Ascertain Dementia 8-item Questionnaire in a general population[J].Arch Clin Neuropsychol,2021,36(2):243-252.
[12] Benats F,Vaes B,Hegendörfer E,et al.A standardised physical performance test versus the frailty phenotype as predictors of adverse events in octogenarians[J].Geriatr Psychol Neuropsychiatr Vieil,2022,20(4):439-456.
[13] Nagaratnam JM,Sharmin S,Diker A,et al.Trajectories of mini-mental state examination scores over the lifespan in general populations:a systematic review and meta-regression analysis[J].Clin Gerontol,2022,45(3):467-476.
[14] 樊萌语,吕筠,何平平.国际体力活动问卷中体力活动水平的计算方法[J].中华流行病学杂志,2014,35(8):961-964.
[15] 路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014(3):260-263.
[16] 何夏阳,刘雪琴.微型营养评估表和营养筛查表的信度和效度评价[J].解放军护理杂志,2010,27(12):894-896.
[17] Fried LP,Tangen CM,Walston J,et al.Frailty in older adults:evidence for a phenotype[J].J Gerontol A Biol Sci Med Sci,2001,56(3):M146-M156.
[18] Xiang K,Liu Y,Sun L.Motoric cognitive risk syndrome:symptoms,pathology,diagnosis,and recovery[J].Front Aging Neurosci,2022,13:728799.
[19] 李晓芳,李月美,赵生秀,等.青海省部分医院急性期脑卒中患者认知功能障碍的影响因素分析及预测模型构建[J].中华物理医学与康复杂志,2023,45(7):598-603.
[20] 杨存美,舒刚明,胡亦新,等.社区主观认知下降老年人的运动认知风险综合征发生情况及影响因素研究[J].中国全科医学,2022,25(34):4278-4285.
[21] 张丽,邢怡文,李静,等.北京市社区老年人运动认知功能减退综合征患病情况及影响因素分析[J].中国临床保健杂志,2024,27(5):607-611.
[22] Pazan F,Wehling M.Polypharmacy in older adults:a narrative review of definitions,epidemiology and consequences[J].Eur Geriatr Med,2021,12(3):443-452.
[23] Iso-Markku P,Kujala UM,Knittle K,et al.Physical activity as a protective factor for dementia and Alzheimer's disease:systematic review,meta-analysis and quality assessment of cohort and case-control studies[J].Br J Sports Med,2022,56(12):701-709.
[24] Liao YY,Chen IH,Hsu WC,et al.Effect of exergaming versus combined exercise on cognitive function and brain activation in frail older adults:A randomised controlled trial[J].Ann Phys Rehabil Med,2021,64(5):101492.
[25] 邬馨益,徐林燕,陈卓琦,等.老年人运动认知功能减退综合征风险预测模型的构建与验证[J].护理学报,2024,31(10):73-78.
[26] Ma W,Wu B,Gao X,et al.Association between frailty and cognitive function in older Chinese people:A moderated mediation of social relationships and depressive symptoms[J].J Affect Disord,2022,316:223-232.
[27] Yuan Y,Peng C,Burr JA,et al.Frailty,cognitive impairment,and depressive symptoms in Chinese older adults:an eight-year multi-trajectory analysis[J].BMC Geriatr,2023,23(1):843.