益智活动对老年人认知功能的影响

摘要

Objective To observe the effect of intellectual activity on the cognitive function of the elderly.Methods The longi-tudinal follow-up study and the cross-sectional study were undertaken among physical examination people.The intellectual activity group (92 cases,more than 60 years old)often to take part in any one or more of the following activities for 5 years and above:pla-ying chess,playing the game of go,playing mahjong,playing cards,playing checkers,calligraphy,painting,reading,etc.The frequen-cy of intellectual activity was more than once per week at least.According to gender,age and educational level,92 cases were screened out as the control group and the control group was not to take part in above-mentioned intellectual activities or occasionally attend.The respondents had no baseline cognitive impairment.MoCA,MMSE,ADL and self-made questionnaire were adopted to conduct the evaluation.One year later when health check-up,the above-mentioned scales were used to evaluate again.The score changes were compared between the control group and experimental group.Results When enrolling,there was no significant differences in the MoCA scores,MMSE scores and ADL scores between the two groups.One year later,the comparison of the MMSE scores and ADL scores between the control group and experimental group had no significant difference (P>0.05).The Mo-CA scores manifested 2 cases (2.2%)of below the critical value of cognitive impairment in the experimental group and 6 cases (6.5%)in the control group,reaching the mild cognitive impairment(MCI)standards,the difference between the two groups showed the statistical significance (P<0.05).Conclusion The intellectual activity may be beneficial for the prevention of cognitive decline of the elderly and the MoCA scale is more suitable for screening MCI.%目的：观察参加益智活动对老年人认知功能的影响。方法在健康体检人群内进行抽样横断面调查和纵向随访研究。益智组92例（年龄大于或等于60岁），经常参加下列活动中任何一项或多项，持续时间达5年及以上：象棋、围棋、麻将、扑克、跳棋、书法、绘画及阅读等，参加的频率至少每周2次。筛选性别、年龄、文化程度匹配的健康体检者92例为对照组，对照组均不参加上述益智活动或偶尔参加，未达到前述标准。入选者均无基线认知功能损害，排除继续参加工作者。采用蒙特利尔认知评估量表（MoCA）、简易精神状态评定量表（MMSE）、日常生活能力量表（ADL）、自制问卷调查等方法进行评定。1年后健康体检时，对两组人员再次使用上述量表进行评估，观察两组评分变化。结果入组时，两组人员 MoCA、MMSE、ADL评分差异均无统计学意义（P＞0．05）；1年后，益智组与对照组 MMSE、ADL评分比较差异无统计学意义（P＞0．05）。MoCA评分显示益智组有2例（2．2％）低于认知损害的临界值，对照组有6例（6．5％）低于认知损害的临界值，达到轻度认知功能损害（MCI）的标准，两组比较差异有统计学意义（P＜0．05）。结论益智活动可能对预防老年人认知功能的下降有益，MoCA更适于轻度认知功能障碍的筛查。