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山东大学学报 (医学版) ›› 2026, Vol. 64 ›› Issue (6): 115-126.doi: 10.6040/j.issn.1671-7554.0.2025.1162

• 公共卫生与预防医学 • 上一篇    

农村中老年人慢性病共病与主客观认知功能的关系

孟可心1,王琪1,于瑞洪2,徐瑞祺1,付春迎1,谢博1,朱东山1,3   

  1. 1.山东大学齐鲁医学院公共卫生学院流行病学系, 山东 济南 250012;2.山东省济南市平阴县疾病预防控制中心, 山东 济南 250400;3.山东大学临床流行病学和循证医学中心, 山东 济南 250012
  • 发布日期:2026-06-29
  • 通讯作者: 朱东山. E-mail:dongshan.zhu@sdu.edu.cn
  • 基金资助:
    国家自然科学基金(82273702);山东省优秀青年学者资助项目(2022HWYQ-030);泰山学者项目专项基金(tsqnz20221103)

Association between multimorbidity of chronic diseases and subjective and objective cognitive function in rural middle-aged and older adults

MENG Kexin1, WANG Qi1, YU Ruihong2, XU Ruiqi1, FU Chunying1, XIE Bo1, ZHU Dongshan1,3   

  1. 1. Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Pingyin Center for Disease Control and Prevention, Jinan 250400, Shandong, China;
    3. Center for Clinical Epidemiology and Evidence-Based Medicine, Shandong University, Jinan 250012, Shandong, China
  • Published:2026-06-29

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摘要： 目的 探讨中国农村中老年人慢性病及共病与主客观认知功能的关联特征,为制定针对性干预策略提供依据。 方法 基于平阴县慢性病与认知老化队列,采用多阶段抽样法纳入3 132名45~70岁农村居民。主观认知功能评估采用主观认知下降问卷(Subjective cognitive decline questionnaire-9, SCD-Q9),客观认知功能评估采用基础版蒙特利尔认知评估量表(Montreal cognitive assessment-basic, MoCA-B)。结合19种慢性病数据,根据患病数量对共病水平进行分类:无共病(0~1种)、低水平共病(2~3种)和高水平共病(≥4种)。采用logistic回归及多元线性回归分析共病与认知功能的关系。 结果 SCD-Q9和MoCA-B得分异常率分别为57.5%和60.5%。单因素分析显示,主客观认知得分异常率均随共病水平升高而增加(P<0.001)。多因素logistic回归分析显示,在校正人口学特征、生活方式及抑郁状态后,共病水平与SCD-Q9得分异常呈独立正相关(低水平共病:OR=1.52,95%CI:1.27~1.82;高水平共病:OR=3.00,95%CI:1.80~5.03),而与MoCA-B得分异常无独立关联(P>0.05)。多元线性回归分析进一步证实,SCD-Q9得分随患病数量增加呈线性升高趋势(β=0.34,95%CI:0.27~0.42),而MoCA-B得分与患病数量无显著关联。高龄、低文化程度及抑郁状态是主客观认知得分异常的共性危险因素,女性在主观认知得分异常中表现出特异性易感。 结论 慢性病共病与农村中老年人主观认知功能下降显著相关,且呈剂量-反应关系,而与客观认知功能异常无独立关联。

关键词: 认知功能, 慢性病, 共病, 农村中老年人, 健康老龄化

Abstract: Objective To investigate the association between chronic diseases/multimorbidity and subjective/objective cognitive function among middle-aged and older adults in rural China, providing evidence for developing targeted intervention strategies. Methods Utilizing data from the Pingyin Chronic Disease and Cognitive Aging Cohort, 3,132 rural residents aged 45-70 years were enrolled through multi-stage sampling. Subjective cognitive decline was assessed using the subjective cognitive decline questionnaire-9(SCD-Q9), while objective cognitive function was evaluated with the Montreal cognitive assessment-basic(MoCA-B). Based on 19 chronic diseases, participants were categorized by multimorbidity level: no multimorbidity(0-1 disease), low-level multimorbidity(2-3 diseases), and high-level multimorbidity(≥4 diseases). Logistic regression and multiple linear regression models were applied to examine the associations. Results The prevalence rates of abnormal subjective and objective cognitive scores were 57.5% and 60.5%, respectively. Univariate analysis showed that both subjective and objective cognitive impairment rates increased with higher multimorbidity levels(P<0.001). Multivariable logistic regression analysis revealed that, after adjusting for demographic characteristics, lifestyle factors, and depression status, multimorbidity level was independently and positively associated with abnormal SCD-Q9 scores(low-level multimorbidity: OR=1.52, 95%CI: 1.27-1.82; high-level multimorbidity: OR=3.00, 95%CI: 1.80-5.03), but showed no independent association with abnormal MoCA-B scores(P>0.05). Multiple linear regression analysis further confirmed a linear dose-response relationship between the number of chronic diseases and SCD-Q9 scores(β=0.34, 95%CI: 0.27-0.42), whereas no significant association was found with MoCA-B scores. Advanced age, low education level, and depression were common risk factors for both subjective and objective cognitive impairment, while females exhibited higher susceptibility specifically to subjective cognitive decline. Conclusion Multimorbidity is significantly associated with subjective cognitive decline in a dose-response manner among rural middle-aged and older adults, but shows no independent association with objective cognitive impairment.

Key words: Cognitive function, Chronic disease, Multimorbidity, Rural middle-aged and older adults, Healthy aging

中图分类号: 

  • R195.4
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