蚌埠市蚌山区老年人群骨质疏...对跌倒风险和认知功能的影响_杨波.pdf

现代生物医学进展Progress in Modern Biomedicine Vol.23NO.1JAN.2023doi:10.13241/ki.pmb.2023.01.022蚌埠市蚌山区老年人群骨质疏松症流行病学调查及对跌倒风险和认知功能的影响*杨波1,2陈任1潘阳2沈雁2王祥2张威振2（1 安徽医科大学卫生管理学院 安徽 合肥 230032；2 蚌埠市疾病预防控制中心 安徽 蚌埠 233080）摘要 目的：对蚌埠市蚌山区老年人群骨质疏松症进行流行病学调查，并探讨骨质疏松症对跌倒风险和认知功能的影响。方法：于2019 年 11 月 2021 年 4 月采用多阶段分层随机抽样的方法，抽取蚌埠市蚌山区的常住居民，调查老年人群骨质疏松症发生率，共发放 960 份调查问卷，回收 941 份，回收率为 98.02%。根据有无骨质疏松症分为骨质疏松症组和无骨质疏松症组，观察两组跌倒风险和认知功能状况。应用多因素 logistic 回归分析老年人群发生骨质疏松症的危险因素和保护因素。结果：941 例研究对象中，检查出存在骨质疏松症者 325 人，发病率为 34.54%。根据有无骨质疏松症分为骨质疏松症组（n=325）和无骨质疏松症组（n=616）。单因素分析结果显示，老年人群发生骨质疏松症与乳制品和钙片摄入情况、年龄、连续服用类固醇激素超过 3 个月情况、骨折史、性别、其他慢性病患病情况、体质量指数、婚姻状况、饮茶情况、每天运动情况有关（P0.05）。多因素 logistic 回归性分析，结果显示：年龄70 岁、性别为女性、连续服用类固醇激素超过 3 个月情况是老年人群发生骨质疏松症的危险因素，而每天运动情况30 min、有乳制品和钙片摄入情况、体质量指数24 kg/m2是老年人群发生骨质疏松症的保护因素（P0.05）。骨质疏松症组的跌倒风险评估工具（FROP-Com）评分高于无骨质疏松症组，跌倒效能量表（MFES）评分低于无骨质疏松症组（P0.05）。骨质疏松症组的简明精神状态检查量表（MMSE）评分低于无骨质疏松症组，画钟试验（CDT）评分高于无骨质疏松症组（P0.05）。结论：蚌埠市蚌山区老年人群骨质疏松症患病率较高，且受到年龄、性别、连续服用类固醇激素超过 3 个月情况等因素的影响，而每天运动情况30 min、乳制品和钙片摄入情况、体质量指数24 kg/m2可减少骨质疏松症患病率，同时存在骨质疏松症的患者其跌倒风险升高，认知功能下降。关键词：蚌埠市；蚌山区；老年；骨质疏松症；流行病学；跌倒风险；认知功能中图分类号：R68；R181文献标识码：A文章编号：1673-6273（2023）01-113-05Epidemiological Investigation of Osteoporosis Among the Elderly Populationin Bengshan District of Bengbu City and its Influence on the Fall Riskand Cognitive Function*YANG Bo1,2,CHEN Ren1,PAN Yang2,SHEN Yan2,WANG Xiang2,ZHANG Wei-zhen2(1 School of Health Management,Anhui Medical University,Hefei,Anhui,230032,China;2 Bengbu Center for Disease Control and Prevention,Bengbu,Anhui,233080,China)ABSTRACT Objective:To investigate the prevalence of osteoporosis among the elderly population in bengshan district,Bengbucity,and to explore the impact of osteoporosis on the fall risk and cognitive function.Methods:From November 2019 to April 2021,amulti-stage stratified random sampling method was adopted to select the permanent residents of bengshan district,Bengbu city to investi-gate the incidence of osteoporosis among the elderly population.A total of 960 questionnaires were distributed,and 941 were recovered,with a recovery rate of 98.02%.According to the presence or absence of osteoporosis,they were divided into osteoporosis group and nonosteoporosis group.The fall risk and cognitive function status of the two groups were observed.Multivariate logistic regression was usedto analyze the risk factors and protective factors of osteoporosis in the elderly population.Results:Among the 941 subjects,325 werefound to have osteoporosis,and the incidence rate was 34.54%.They were divided into osteoporosis group(n=325)and non osteoporosisgroup(n=616)according to the presence or absence of osteoporosis.The results of univariate analysis showed that the incidence of osteo-porosis in the elderly population was related to the intake of dairy products and calcium tablets,age,continuous use of steroids for morethan 3 months,fracture history,gender,other chronic diseases,body mass index,marital status,tea drinking and daily exercise(P0.05).Multivariate logistic regression analysis showed that age greater than or equal to 70 years,gender with female and continuous use ofsteroids for more than 3 months were the risk factors for osteoporosis in the elderly population,while daily exercise greater than or equal*基金项目：安徽高校人文社会科学研究项目（SK2019A0166）作者简介：杨波（1991-），男，硕士研究生，从事流行病学调查方向的研究，E-mail:通讯作者：陈任（1980-），男，博士，教授，从事流行病学调查方向的研究，E-mail:（收稿日期：2022-04-10 接受日期：2022-04-30）113现代生物医学进展Progress in Modern Biomedicine Vol.23NO.1JAN.2023to 30 min,intake of dairy products and calcium tablets,and body mass index greater than or equal to 24 kg/m2were the protective factorsfor osteoporosis in the elderly population(P0.05).The falls risk for older people in the community(FROP-Com)score of osteoporosisgroup was higher than that of non osteoporosis group,and the Modified Falls Efficacy Scale(MFES)score was lower than that of nonosteoporosis group(P0.05).The MMSE score ofosteoporosis group was lower than that of non osteoporosis group,and the clock drawingtest(CDT)score was higher than that in non osteoporosis group(P0.05).Conclusion:The prevalence of osteoporosis among the elderlypopulation in bengshan district of Bengbu city is high,and it is affected by factors such as age,gender,and continuous use of steroids formore than 3 months.Daily exercise greater than or equal to 30min,intake of dairy products and calcium tablets,and body mass indexgreater than or equal to 24 kg/m2can reduce the prevalence of osteoporosis.At the same time,patients with osteoporosis have an in-creased fall risk and a decreased cognitive function.Key words:Bengbu city;Bengshan district;Elderly;Osteoporosis;Epidemiology;Fall risk;Cognitive functionChinese Library Classification(CLC):R68;R181Document code:AArticle ID:1673-6273(2023)01-113-05前言骨质疏松症是以骨强度降低和骨折危险性增加为特征的一种全身性骨疾病，年龄因素能够通过影响基础性的钙磷代谢水平，打破骨盐代谢平衡1。因此，老年人群骨质疏松症发病率高，且随着人口老龄化进程的加快，骨质疏松症的发病率处于逐年升高趋势2。骨质疏松症可导致活动障碍、骨痛、骨折等多种症状，增加跌倒风险，部分患者甚至可并发认知功能障碍，严重影响患者的生活质量，骨质疏松症疾病的防治工作面临巨大挑战3。蚌山区位于安徽省蚌埠市，属于蚌埠市中心城区，蚌埠市政治、经济、文化、科教、金融和商贸中心。但关于该地区老年人群骨质疏松症流