摘要/Abstract
摘要： 目的 ·了解老人常见老年综合征的分布特征，为不同类型老人的照护提供参考。方法 ·于 2017年 5— 11月对上海市 5所医疗机构和 6所养老机构的 590位老人进行问卷调查，采用中文版老年连续评估记录和评价条目集（ continuity assessment record and evaluation，CARE）为调查工具，对常见的 13种老年综合征进行 k-均值聚类并分析各类老年综合征的分布特征。结果 · 590位老人中， 97.8%的老人患有至少 1种老年综合征。发生率位居前 5位的老年综合征依次为日常生活能力下降（ 80.7%）、认知功能障碍（80.5%）、多重用药（ 44.7%）、视力障碍（ 45.3%）和听力障碍（ 42.9%）。k-均值聚类结果显示，老人老年综合征分为 4类较为合理：第 1类老人表现为老年综合征发生率较高（即为高发组），平均每位老人患有（ 5.6±1.1）种老年综合征，其日常生活能力下降、认知功能障碍、视力障碍、听力障碍和谵妄的发生率较高；第 2类老人表现为老年综合征发生率极高（即为极高组），平均每位老人患有（8.3±1.1）种老年综合征，除了疼痛、抑郁和压疮发生率较低外，其余老年综合征发生率几乎均高于其他 3类；第 3类老人表现为老年综合征发生率较低（即为低发组），平均每位老人患有（ 2.0±1.2）种老年综合征，其多重用药和跌倒的发生率较高；第 4类老人表现为老年综合征发生率适中（即为中等组），平均每位老人患有（ 4.0±1.3）种老年综合征，其日常生活能力下降、认知功能障碍、多重用药、尿失禁和跌倒的发生率较高。结论 ·对老年综合征进行分类分析，有助于识别发生不同类型老年综合征的高危人群，进而开展有针对性的干预治疗。
关键词: 老人, 老年综合征, 聚类分析, 认知功能障碍
Abstract:
Objective · To investigate the distribution of geriatric syndromes in older adults into provide reference for the care of different types of the elderly. Methods · This study described distribution of 13 geriatric syndromes of 590 older adults 5 hospitals and 6 nursing homes in Shanghai based on k-means clustering. The data were collectedChinese version of continuity assessment record and evaluation (CARE) between May and November 2017. Results · 97.8% of the 590 older adults suffered at least 1 geriatric syndrome. The top 5 geriatric syndromes were impairment in activities of daily living (80.7%), cognitive impairment (80.5%), polypharmacy (44.7%), visual impairment (45.3%), and hearing impairment (42.9%). The results of k-means clustering showed that the geriatric syndrome was divided into 4 clusters. Cluster 1 (named high incidence group of geriatric syndromes) exhibited high prevalence of impairment in activities of daily living, cognitive impairment, visual impairment, hearing impairment and delirium. On average, each older adult had 5.6±1.1 geriatric syndromes. Cluster 2 (named extremely high group) exhibited the highest prevalence of geriatric syndromes, excluding pain, depression and pressure ulcer. On average, each older adult had 8.3±1.1 geriatric syndromes. Cluster 3 was named low incidence group of geriatric syndromes, each older adult having 2.0±1.2 geriatric syndromes. The incidence of polypharmacy and fall was relatively high. Cluster 4 (named medium group) exhibited high prevalence of impairment in activities of daily living, cognitive impairment, polypharmacy, urinary incontinence and fall. On average, each older adult had 4.0±1.3 geriatric syndromes. Conclusion · Classification of geriatric syndromes is helpful to identify the high-risk older adults who may suffer certain patterns of geriatric syndromes, and thus to carry out targeted interventions.
Key words: older adult, geriatric syndrome, cluster analysis, cognitive impairment
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