Abstract：Objective To comprehensively estimate the health status of patients with cardio-cerebrovascular diseases among elderly population with physical examination, and to analyze the related influencing factors. Methods A total of 532 elders aged ≥ 60 years who had physical examination in Health Management Center, Jiangsu Provincial Official Hospital from January to December in 2016 were enrolled in this study. Their demographic characteristics, distribution features of cardiovascular and cerebrovascular diseases and health status were investigated by a demographic survey, Activity of Daily Living Scale, Nutritional Risk Screening 2002(NRS 2002), Fall Risk Assessment Scale, the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF), Athens Insomnia Scale and Osteoporosis Self-assessment Tool for Asians. Results Among the 532 elders surveyed, there were 122 (22.93%) patients with cardiovascular diseases, 71 (13.35%) patients with coronary heart disease and 48 (9.02%) patients with cerebral infarction. The prevalence rate increased gradually with the increasing age (Trend χ2=54.52, P<0.001). There were statistically significant differences in age, pre-retirement occupation, the proportion of combining with hypertension or diabetes,the levels ofdiastolic blood pressure, total cholesterol and low-density lipoprotein cholesterol and the ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol between patients with cardio-cerebrovascular diseases and elders without cardio-cerebrovascular diseases (all P<0.05). Multivariate logistic analysis showed that the risk of suffering from cardio-cerebrovascular diseases in the elders with obesity and ones complicated with diabetes was respectively 2.13 times (95%CI:1.10-4.14) and 2.03 times (95%CI:1.11-3.71) those of the elders with normal BMI and ones without diabetes. The risk of suffering from cardio-cerebrovascular diseases in the retirees from government organizations and public institutions was double (95%CI:1.12-3.86) that of the retirants from factories and enterprises. The comprehensive assessment of health status of the elderly indicated that the risk of suffering from malnutrition, falls, urinary incontinence, sleep disorders and osteoporosis showed statistically significant differences between the elders with and without cardio-cerebrovascular diseases (all P<0.05).Conclusions As for the elderly patients with cardio-cerebrovascular diseases, we should actively treat stroke, coronary heart disease and other primary symptoms and simultanously implement nutrition support, weight management, antidepressant treatment and psychological counseling based on the comprehensive assessment of health status so as to improve health level of the patients and promote their quality of life at the same time.
[1] GBD 2013 Mortality and Causes of Death Collaborators.Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013[J].Lancet, 2015, 385(9963):117-171. [2] 蹇在金.老年人综合评估[J].中华老年医学杂志, 2012, 31(3):177-181. [3] Porte P, Lahmi K, Auque JM, et al.Screening of patients with cognitive impairment when entering a rehabilitation unit[J].Geriatr Gerontol Int, 2012, 12(1):23-29. [4] Marshall EG, Clarke BS, Varatharasan N, et al .A Long-term Care-Comprehensive Geriatric Assessment (LTC-CGA) tool: improving care forfrail older adults?[J].Can Geriatr J, 2015,18(1):2-10. [5] Ellis G, Whitehead MA, O’Neill D, et al .Comprehensive geriatric assessment for older adults admitted to hospital[J].Cochrane Database Syst Rev, 2011,(7):CD006211. [6] Ellis G, Whitehead MA, Robinson D, et al .Comprehensive geriatric assessment for older adults admitted to hospital: meta-analysis of randomised controlled trials[J].BMJ, 2011, 343:d6553. [7] Beswick AD, Rees K, Dieppe P, et al .Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis[J].Lancet, 2008, 371(9614):725-735. [8] Houlden H, Edwards M, McNeil J, et al.Use of the Barthel Index and the Functional Independence Measure during early inpatient rehabilitation after single incident brain injury[J].Clin Rehabil, 2006, 20(2):153-159. [9] 凡芸, 杜兆辉, 丁燕畅.Barthel 指数在老年分级护理评估中的应用[J].中国老年学杂志, 2012, 32(20):4545-4546. [10] Kondrup J, Rasmussen HH, Hamberg O, et al.Nutritional Risk Screening(NRS 2002): a new method based on an analysis of controlled clinical trials[J].Chin Nutr, 2003, 22(4):321-336. [11] 刘青青, 张红英, 肖敏.跌倒评估量表对我国住院老年患者的适用性研究[J].护理学杂志, 2010, 25(1):50-51. [12] Christian OT, Melissa CF, Victor WN.Comparison between reduction in 24-hour pad weight, International Consultation on Incontinence-Short Form(ICIQ-SF)score, International Prostate Symptom Score(IPSS), and Post-Operative Patient Global Impression of Improvement(PGI-I)score in patient evaluation after male perineal sling[J].Neurourol Urodyn, 2007, 26(1): 8-13. [13] 李海燕, 姜丽萍, 肖海鸟, 等.前列腺增生术后患者尿失禁现象影响因素分析[J].实用医学杂志, 2011, 36(1): 4008-4011. [14] Soldatos CR, Dikeos DG, Paparrigopoilos TJ.Aethens Insomnia Scale: validation of instrument based on ICD-10 criteria[J].J Psychosom Res, 2000, 48(6): 555-560. [15] 刘敏燕, 李春霖, 裴育, 等.亚洲人骨质疏松自我筛查工具对老年男性骨质疏松症的诊断价值[J].中华医学杂志,2011, 91(30):2112-2115. [16] 中国医师协会心血管内科医师分会《中华内科杂志》编辑委员会.心血管疾病一级预防中国专家共识[J].中华内科杂志, 2010,49(2):174-185. [17] 许予明,谭颂,刘呜,等.脑血管疾病诊断与治疗临床指南[J].内科急危重症杂志,2015,11(5):243-245. [18] Schoenborn CA, Adams PF.Health behaviors of adults: United States, 2005-2007[J].Vital Health Stat 10, 2010,10(245):3-4. [19] 叶慧玲, 李美婷, 黄志钢, 等.社区老年高血压患者合并其他心血管危险因素及心脑血管疾病的调查[J].中国老年医学杂志, 2009,11(29):1400-1401. [20] 吉凤, 刘首峰, 王惠, 等.天津社区老年脑卒中患者现状调查[J].中华老年心血管病杂志, 2012, 14(5):503-506. [21] Li Z, Heber D.Sarcopenic obesity in the elderly and strategies for weight management[J].Nutr Rev, 2012, 70(1):57-64. [22] 黄通, 李桂炼, 彭晓琳, 等.深圳某社区人群血脂异常的相关危险因素分析[J].实用预防医学,2016,23(7):823-825. [23] 栗华, 张建新, 张中朝, 等.河北省城乡成年居民血脂异常及其危险因素调查分析[J].实用预防医学, 2008, 15(2): 327-331. [24] Nimkuntod P, Tongdee P.Plasma low-density lipoprotein cholesterol/high-density lipoprotein cholesterol concentration ratio and early marker of carotid artery atherosclerosis[J].J Med Assoc Thai, 2015, 98(S4):S58-63. [25] Byun AR, Lee SW, Lee HS, et al.What is the most appropriate lipid profile ratio predictor for insulin resistance in each sex? A cross-sectional study in Korean populations(The Fifth Korea National Health and Nutrition Examination Survey)[J].Diabetol Metab Syndr, 2015, 7(1):59. [26] Ridker PM, Rifai N, Cook NR, et al.Non- HDL cholesterol, apolipoproteins AI and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women[J].JAMA, 2005, 294(3): 326-333. [27] 梁酉, 石梅初, 余开选, 等.常见慢性病患病率的年龄分布特征及相关性分析[J].中国心脑血管疾病预防与控制, 2003, 11(4): 170-171. [28] 卢一悦.健康教育对心脑血管疾病发生的干预效应[J].中国误诊学杂志, 2006, 6(6): 1911-1912. [29] 刘新荣, 郝铁荣, 柴小明.心脑血管疾病行为危险因素及干预初探[J].中国公共卫生管理, 2006, 22(1): 54. [30] Samuel P,Antonisamy B,Raghupathy P,et al.Socio-economic status and cardiovascular risk factors in rural and urban areas of Vellore,Tamilnadu,South India[J].Int J Epidemiol,2012,41(5):1315-1327. [31] 陈定湾,何凡.不同社会经济地位人群三种常见健康相关行为差异研究[J].中华预防医学杂志,2010,44(9):841-844. [32] 张拓红,王成彪,杨辉,等.社会经济地位与老年人健康状况[J].中国初级卫生保健,2002,16(1):5-7. [33] 唐大年, 韦军民, 朱明炜, 等.老年住院患者营养风险、营养不足发生率及营养支持应用状况的调查[J].中华老年医学杂志, 2011, 30(11): 974-976. [34] Martino R, Foley N, Bhogal S, et al.Dysphngia after stroke: incidence, diagnosis, and pulmonary complications[J].Stroke, 2005,36(12):2756-2763. [35] 杨晓国, 林一均, 陈晓顶.氟西汀改善脑卒中后抑郁及神经功能缺损的临床研究[J].实用医学杂志, 2009, 25(7):1127-1128. [36] 王延平, 徐桂兰, 杨少青, 等.蒙特利尔认知评估量表识别首次卒中后轻度血管性认知障碍的作用[J].中华神经医学杂志, 2010, 9(5):503-507. [37] Oliviero A, Leon AM, Holier I, et al.Reduced sansorimotor inhibition in the ipsilesional motor cortex in a patient with chronic stroke of the paramedian thalamus[J].Clin Neurophysiol, 2005, l160(11):2592-2598. [38] Xia J, Chen K, Song C, et al.Postsynaptic excitation of prefrontal cortical pyramidal neurons by hypocretin-1/orexin A through the inhibition of potassium currents[J].J Ncurosei Res, 2005, 82(5):729-736. [39] 周际.卒中患者睡眠障碍特点及影响因素分析[J].中国脑血管病杂志, 2005, 2(4):173-174. [40] Kim H, Kim YL, Lee SM.Effects of therapeutic Tai Chi on balance, gait, and quality of life in chronic stroke patients[J].Int J Rehabil Res, 2015, 38(2):156-161. [41] Bagger YZ, Tanko LB, Alexandersen P, et al.Radiographic measure of aorta calcification is a site-specific predictor of bone loss and fracture risk at the hip[J].J Intern Med, 2006, 259(16):598-605.
2018, Vol. 25 
