基于中医体质分类的中老年认知功能下降的危险因素分析研究OA

Objective To investigate risk factors associated with cognitive decline in middle-aged and elder adults based on traditional Chinese medicine(TCM)body constitution classification.Methods A total of 221 middle-aged and elderly patients with cognitive decline,recruited from our hospital screenings and clinical visits between August 2023 and August 2024,were retrospectively analyzed and divided into a subjective cognitive decline(SCD)group(n=71)and a mild cognitive impairment(MCI)group(n=150).Univariate and multivariate Logistic regression analyses were performed to identify risk factors.A structural equation model was constructed to assess cognitive knowledge,attitude,and practice(KAP).Comprehensive evaluations were conducted using the Mini-Mental State Examination(MMSE),TCM syndrome scores,serum biomarkers,and C-reactive protein(CRP)measurements.Results Univariate analysis showed that the age and proportion of Qi-deficiency constitution in the MCI group were higher than those in the SCD group significantly(P<0.05),while the proportions of Phlegm-Dampness constitution,prevalence of diabetes,incidence of cerebral artery stenosis,and incidence of anxiety/depression were lower in the MCI group than in the SCD group significantly(P<0.05).Multivariate logistic regression analysis indicated that age(OR=1.118),Phlegm-Dampness constitution(OR=2.353),diabetes(OR=2.517),and anxiety/depression(OR=2.205)were independent risk factors.The structural equation model showed good fit(χ²/df=1.82,RMSEA=0.052),and the standardized path coefficients of the above factors for disease severity were 0.25 to 0.32(P<0.001).The ROC curve analysis showed that the combined factors had a predictive AUC of 0.835,with a sensitivity of 82.12%and a specificity of 69.22%.After intervention,the improvement in scores of health knowledge,daily life,and TCM syndrome scores in the MCI group was better than that in the SCD group significantly(P<0.001).Conclusion Age,Phlegm-Dampness constitution,diabetes,and anxiety/depression are key risk factors for the progression from SCD to MCI.The combined factors have good predictive efficiency,and early intervention can improve cognitive function.