摘要
目的 探讨影响阿尔茨海默病（AD）的可调控危险因素，为早期预防与干预提供相应措施。方法 采用1：2配对的病例对照的研究方法，将确诊的15例AD患者作为病例组，同时收集30例非AD正常老人作为对照组；采用卡方检验、多因素Logistic回归法来筛选影响患者发病的心理因素。结果 多因素分析显示，少脑力活动、负性生活事件多、社交活动少和多抑郁症状均为AD发病的独立危险因素。结论 影响AD发病的促进因素包括负性生活事件多（OR=18.357）、社交活动（OR=5.243）和少脑力活动（OR=8.227），阻碍因素为无抑郁情绪（OR=0.045），针对这些可改变的独立因素应提高警惕，尽早干预与治疗。
关键词： 阿尔茨海默病；心理因素；可调控危险因素；病例对照研究
Abstract
Objective To explore the controllable risk factors influencing Alzheimer's disease (AD) and provide corresponding measures for early prevention and intervention. Methods A 1:2 paired case-control study was used, 15 diagnosed AD patients were taken as the case group, and 30 non-AD normal elderly persons were collected as the control group; Chi-square test and multivariate Logistic regression were used to screen the influence of AD. Psychological factors of the patient's morbidity. Results Multivariate analysis showed that less mental activity, more negative life events, less social activities and more depressive symptoms were independent risk factors for AD. Conclusion The promoting factors that affect the incidence of AD include more negative life events (OR=18.357), less social activities (OR=5.243) and less mental activity (OR=8.227), and the hindering factor is lack of depression (OR=0.045). In view of these modifiable independent factors, we should be vigilant and intervene and treat as soon as possible.
Key words： Alzheimer's disease; Psychological factors; Controllable risk factors; Case-control study
参考文献 References
[1] 李杨,杜捷,刘晗.阿尔茨海默病的病因及遗传与病理学分析[J].基因组学与应用生物学,2021,40(02):916-922.
[2] 周婵,兰文杰.老年人阿尔茨海默病的病因病机及认知治疗研究进展[J].大家健康(学术版),2016,10(09):61-62.
[3] 阿尔茨海默病的诊疗规范（2020年版）[J].全科医学临床与教育,2021,19(01):4-6.
[4] 关丽征,时雨萌.病例对照研究在医学科研中的理论、设计和实践[J].北京医学,2020,42(07):660-663.
[5] Xu W, Tan L, Wang HF, et al. Meta-analysis of modifiable risk factors for Alzheimer's disease [J]. J Neurol Neurosurg Psy-chiatry, 2015, 86 (12): 1299-1306.
[6] 张雪海,周少珑,张倩,蔡奕秋,周辉,邢爱群.阿尔茨海默病发病的相关危险因素的病例对照研究[J].中国全科医学,2017,20(S3):106-108.
[7] 何斌,胡武昌,夏志敏,叶慧,肖冬梅,张伟娟,刘正,文桂芳.痴呆与负性生活事件相关性的调查[J].实用临床医学, 2011, 12(09):124-126.
[8] IIZUKA A, SUZUKI H, OGAWA S, et al. Can cognitive leisure activity prevent cognitive decline in older adults? A systematic review of intervention studies[J]. Geriatr Gerontol Int, 2019, 19(6): 469-482.
[9] 唐牟尼,刘协和,云扬,韩海英,唐铭民,彭祖贵,任会,覃林敏,罗祖明.社区阿尔茨海默病危险因素病例对照研究[J].中国心理卫生杂志,2001(01):22-25.