目的 基于中国健康与养老追踪调查(China health and retirement longitudinal survey,CHARLS)数据,探讨中国老年人的身体与认知功能各维度间的跨时间预测关系,为老年护理评估提供干预靶点。方法 获取2015-2018年3850名老年人(年龄≥60岁)的CHARLS数据,采用日常活动能力(activities of daily living,ADL)及基于简易精神状态检查表(minimum mental state examination, MMSE)改编的认知功能评估模块评估其身体功能和认知功能,借助R软件构建并可视化偏相关网络模型,计算节点的中心性。结果 网络共估计49条滞后路径,17条路径为非零边缘。语言能力的out-EI最高,可正向预测延迟回忆(OR=1.738)和瞬时记忆(OR=1.501);延迟回忆的in-EI最高,受语言能力、定向力及工具性日常生活活动能力(instrumental activities of daily living,IADL)联合预测;定向力正向预测延迟回忆(OR=1.375),IADL负向预测延迟回忆(OR=0.948)和定向力(OR=0.948)。网络稳定可靠(CS=0.672)。结论 语言能力是网络中跨维度预测作用最强,延迟回忆是被联合预测强度最高的节点,二者可作为潜在监测指标。

Objective To explore the cross-temporal predictive relationships among dimensions of physical and cognitive functions in Chinese older adults based on data from the China Health and Retirement Longitudinal Study (CHARLS),so as to identify potential intervention targets for geriatric nursing assessment.Methods CHARLS data of 3,850 older adults (aged≥60 years) from 2015 to 2018 were obtained.Physical function was assessed using the Activities of Daily Living(ADL),and cognitive function was assessed using a module adapted from the Mini-mental State Examination (MMSE).Partial correlation network models were constructed and visualized using R software,and node centrality indices were calculated.Results The network estimated 49 lagged paths,of which 17 were non-zero edges.Language ability had the highest out-expected influence(out-EI) and positively predicted delayed recall(OR=1.738) and immediate memory(OR=1.501).Delayed recall had the highest in-expected influence(in-EI) and was jointly predicted by language ability,orientation,and instrumental activities of daily living (IADL).Orientation positively predicted delayed recall (OR=1.375),while IADL negatively predicted delayed recall(OR=0.948) and orientation(OR=0.948).The network was stable and reliable (CS=0.672).Conclusions Language ability has the strongest cross-dimensional predictive effect in the network,and delayed recall is the node with the strongest joint predictive influence,both of which can serve as potential monitoring indicators of cognitive dimensions in geriatric nursing assessment.

R473.59

教育部人文社会科学研究青年基金项目(21YJC890026)