健康生态学视角下我国老年人认知障碍识别模型的构建OA
Construction of cognitive impairment identification model for older adults in China from the perspective of health ecology
目的:基于健康生态学模型探讨我国老年人认知障碍发生情况及其影响因素,并构建识别模型,为老年人认知障碍的早期精准识别提供数据支撑和理论依据.方法:选取中国健康与养老追踪调查2018年数据中4 204名年龄≥60岁的老年人作为研究对象,依照7∶3的比例随机分为训练集与验证集.采用LASSO回归筛选变量,基于Logistic回归构建认知障碍识别模型,使用受试者工作特征曲线下面积(AUC)、灵敏度、特异度评价模型性能.结果:我国60岁以上老年人认知障碍发生率为19.60%.Logistic回归分析结果显示,个人特质中的工具性日常生活活动能力(IADL),人际网络中的已婚、与子女见面频率、社会参与水平,工作和生活条件中的退休、住房供暖设施,政策环境中的养老保险、医疗保险是老年人认知障碍发生的保护因素(P<0.05);个人特质中的年龄、残疾、抑郁,行为特征中的吸烟,政策环境中的中部地区、西部地区是老年人认知障碍发生的危险因素(P<0.05).构建的老年人认知障碍识别模型训练集和验证集的AUC分别为0.81,0.78.结论:老年人认知障碍发生率较高,影响因素涉及个人特质、行为特点、人际网络、工作和生活条件、政策环境5个层面.构建的老年人认知障碍识别模型有助于实现老年人认知障碍的早期精准识别.
Objective:To explore the occurrence rate of cognitive impairment among older adults in China and its influencing factors based on the health ecological model,and to construct the identification model to provide data support and theoretical basis for the early and accurate identification of cognitive impairment in older adults.Methods:A total of 4 204 older adults aged 60 and above from the 2018 data of the China health and retirement longitudinal study(CHARLS)were selected as the research subjects.They were randomly divided into training set and validation set at a ratio of 7∶3.LASSO regression was used to screen variables.Cognitive impairment identification model was constructed based on Logistic regression.The performance of the model was evaluated using the area under the receiver operating characteristic curve(AUC),sensitivity,and specificity.Results:The incidence of cognitive impairment among older adults aged 60 and above in China was 19.60%.The results of the Logistic regression analysis showed that personal traits(IADL),interpersonal networks(being married,frequency of meeting with children,social participation level),work and life conditions(retirement,heating facilities of housing),and policy environment(endowment insurance,medical insurance)were protective factors of cognitive impairment in older adults(P<0.05),and personal traits(age,disability,depression),behavioral characteristics(smoking),and policy environment(central region,western region)were risk factors of cognitive impairment in older adults(P<0.05).The AUC of the training set and validation set of the elderly cognitive impairment identification model constructed were 0.81 and 0.78,respectively.Conclusions:The incidence of cognitive impairment among older adults was relatively high.The influencing factors included five aspects:personal traits,behavioral characteristics,interpersonal networks,working and living conditions,and policy environment.The constructed cognitive impairment identification model for the elderly was helpful for achieving early and accurate identification of cognitive impairment among people aged 60 and above.
黎美娴;王宗华;张小迪;付海炜
陆军军医大学护理学院,重庆 400038陆军军医大学护理学院,重庆 400038陆军军医大学护理学院,重庆 400038陆军军医大学护理学院,重庆 400038
老年人认知障碍健康生态学影响因素
older adultscognitive impairmenthealth ecologyinfluencing factors
《护理研究》 2026 (8)
1298-1306,9
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