Research on Influencing Factors and Risk Prediction of Cognitive Function in Community-dwelling Middle-aged and Elderly People
摘要
Background The incidence of cognitive impairment is rising year by year among middle-aged and elderly individuals, yet its pathogenesis remains unclear and effective treatments are lacking. Integrating multidimensional factors to construct a predictive model can enhance the early identification and intervention of high-risk populations for cognitive impairment. Objective To explore and construct a risk prediction model for cognitive impairment in community-dwelling middle-aged and elderly adults based on a biomarkers-genetic-environment multidimensional perspective. Methods A total of 2 243 middle-aged and elderly people in the community who underwent health examinations at Songjiang District Sijing Community Health Center of Shanghai from April to September 2021 were included as the research subjects. Their sociodemographic data, lifestyle, personal disease history and physical examination indicators were collected. The homocysteine (Hcy) concentration was measured by fully automatic biochemical analyzer to determine whether it was hyperhomocysteinemia (HHcy), and single nucleotide polymorphism (SNP) gene sites rs429358 and rs7412 were detected by ligase detection reaction technology to determine the Apolipoprotein E (APOE) genotype. Cognitive function was assessed using Two-tiered Cognitive Self-Assessment (TCSA), and the subjects were divided into normal cognitive group and cognitive impairment risk group according to the assessment results. The general data and physical examination indicators of the two groups were compared. The multivariate logistic stepwise regression method was used to screen independent predictors, and a nomogram prediction model for the risk of cognitive impairment in middle-aged and elderly people was constructed. The Bootstrap self-sampling method was used for internal validation to determine the accuracy of the prediction model. Results The incidence rate of cognitive impairment risk in the community-dwelling middle-aged and elderly peop