Article(id=1322931454233149633, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.13.024, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1749571200000, receivedDateStr=2025-06-11, revisedDate=1778947200000, revisedDateStr=2026-05-17, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341037566, onlineDateStr=2026-10-30, pubDate=1783612800000, pubDateStr=2026-07-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341037566, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341037566, creator=13701087609, updateTime=1793341037566, updator=13701087609, issue=Issue{id=1322931411006665649, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='13', pageStart='2193', pageEnd='2384', issueExtLink='null', onlineDate='null', pubDate='1783612800000', pubDateStr='2026-07-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341027261, creator='13701087609', updateTime=1793343114456, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940165425082661, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940165425082662, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2370, endPage=2375, ext={EN=ArticleExt(id=1322931455810207938, articleId=1322931454233149633, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Research progress on impact of cognitive flexibility decline on instrumental activities of daily living in the elderly, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This article overviewed the cognitive flexibility decline,summarized its mechanisms, measurement tools,and its impact on instrumental activities of daily living,as well as related nursing approaches.The aim is to offer references for the development of relevant nursing research.

, authors=Le CHEN1, Xuefeng SUN1, Jindan ZHANG1, Xiaohui WANG2, Hongshi ZHANG1, authorsList=Le CHEN, Xuefeng SUN, Jindan ZHANG, Xiaohui WANG, Hongshi ZHANG, authorCompany=null, correspAuthors=Hongshi ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322931456703594691, articleId=1322931454233149633, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=认知灵活性衰退对老年人工具性日常生活活动能力影响的研究进展, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

对认知灵活性衰退进行概述,梳理其发生机制、测量工具及其对工具性日常生活活动能力的影响与护理方法,旨在为开展相关护理研究提供参考。

, authors=陈乐1, 孙雪峰1, 张锦丹1, 王晓慧2, 张红石1, *, *, authorsList=陈乐, 孙雪峰, 张锦丹, 王晓慧, 张红石, authorCompany=null, correspAuthors=张红石, authorNote=

陈乐,硕士研究生在读

, correspAuthorsNote=
张红石,E-mail:
ZHANG Hongshi, E-mail:
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陈乐,硕士研究生在读

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陈乐,硕士研究生在读

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认知灵活性衰退对老年人工具性日常生活活动能力影响的研究进展
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陈乐 1 , 孙雪峰 1 , 张锦丹 1 , 王晓慧 2 , 张红石 1, *, *
护理研究 | 科研综述 2026,40(13): 2370-2375
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护理研究 |科研综述 2026 , 40 (13) : 2370 -2375
认知灵活性衰退对老年人工具性日常生活活动能力影响的研究进展
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陈乐1, 孙雪峰1, 张锦丹1, 王晓慧2, 张红石1, *, *
作者信息
  • 1长春中医药大学护理学院,吉林 130117
  • 2内蒙古民族大学护理学院
通讯作者:
张红石,E-mail:
ZHANG Hongshi, E-mail:
作者简介:

陈乐,硕士研究生在读

Research progress on impact of cognitive flexibility decline on instrumental activities of daily living in the elderly
Le CHEN1, Xuefeng SUN1, Jindan ZHANG1, Xiaohui WANG2, Hongshi ZHANG1
Affiliations
  • 1School of Nursing, Changchun University of Chinese Medicine, Jilin 130117 China
  • 2School of Nursing, Inner Mongolia Minzu University
出版时间: 2026-07-10 doi: 10.12102/j.issn.1009-6493.2026.13.024
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对认知灵活性衰退进行概述,梳理其发生机制、测量工具及其对工具性日常生活活动能力的影响与护理方法,旨在为开展相关护理研究提供参考。

老年人  /  认知灵活性  /  日常生活活动能力  /  测量工具  /  综述

This article overviewed the cognitive flexibility decline,summarized its mechanisms, measurement tools,and its impact on instrumental activities of daily living,as well as related nursing approaches.The aim is to offer references for the development of relevant nursing research.

the elderly  /  cognitive flexibility  /  activities of daily living  /  measurement tools  /  review
陈乐, 孙雪峰, 张锦丹, 王晓慧, 张红石. 认知灵活性衰退对老年人工具性日常生活活动能力影响的研究进展. 护理研究, 2026 , 40 (13) : 2370 -2375 . DOI: 10.12102/j.issn.1009-6493.2026.13.024
Le CHEN, Xuefeng SUN, Jindan ZHANG, Xiaohui WANG, Hongshi ZHANG. Research progress on impact of cognitive flexibility decline on instrumental activities of daily living in the elderly[J]. Chinese Nursing Research, 2026 , 40 (13) : 2370 -2375 . DOI: 10.12102/j.issn.1009-6493.2026.13.024
认知灵活性衰退指个体适应新环境、切换思维定式的能力减退。在任务表现上,体现为信息处理速度减慢和准确性降低[1]。认知功能衰退通常首先影响老年人工具性日常生活活动能力(instrumental activities of daily living,IADL)。IADL是个体独立生活所必需的复杂活动,其受损可表现为:在服药管理上出现时间或剂量混淆;在购物时财务处理中难以准确计算和比较价格;在面临多种选择时无法做出合理决策,降低个体独立生活能力等[2]。预计到2050年,全球范围内60岁及以上人口占比将上升至22%[3],与年龄增长相关健康问题日渐凸显。关注老年人认知灵活性及其衰退表现,并在早期采取针对性的护理干预措施,对改善其功能独立性和生活质量具有重要意义。然而,目前针对该领域的研究缺乏系统性整理。因此,现从认知灵活性衰退概述和发生机制、认知灵活性评估工具及其衰退对IADL的影响与常见护理策略进行综述,旨在为提升临床医护人员与社区护理人员对认知灵活性衰退的认识,延缓老年人认知衰退进程,提高其独立生活能力提供参考。
20世纪中期,神经心理学家亚历山大·卢里亚(Alexander Luria)开展了额叶损伤病人的相关研究,被视为认知功能相关研究的起源之一[4]。同期,有学者开发的威斯康星卡片分类测验(Wisconsin Card Sorting Test,WCST)[5],成为评估定时转换能力的重要工具,为认知灵活性衰退研究奠定了行为学研究基础。此后,美国神经心理学家Lezak等[6]提出了执行功能概念,并将认知灵活性列为其核心内容之一,成为认知灵活性研究的早期理论基础。此后,诸多神经心理学家揭示了认知灵活性随年龄增长和神经系统疾病而衰退的规律。研究表明,儿童前额叶皮层的成熟度决定认知灵活性水平的提升[7]。正常衰老伴随着前额叶皮层灰质体积的减少与白质完整性的下降,会导致老年人执行功能降低[8-9]。21世纪以来,随着功能磁共振成像(fMRI)技术的应用,推动了研究者在脑机制层面关于认知灵活性衰退的研究[10]。在我国,认知灵活性的研究虽有十余年的发展历程,但早期研究多集中于病理性因素,如神经退行性疾病所导致的认知功能下降。随着该领域研究的不断深入,正常衰老过程中认知灵活性的减退逐渐被证实且得到重视,这为促进健康老龄化制定护理策略提供了重要的科学依据。
认知灵活性衰退与脑各区之间的功能连接异常关系密切。目前研究常集中在默认模式网络(DMN)、背侧注意网络(DAN)和额顶网络(FPN)。DMN核心区域包括后扣带回皮层(PCC)、内侧前额叶皮层(mPFC)、颞顶联合区等[11];研究表明,随年龄增长,DMN核心区域功能连接下降,降低了病人内部导向认知过程的能力。这些区域主要负责内省思维、情景记忆提取等高级认知过程[4],如老年人难以回忆过去事情的细节,与DMN连接能力下降、导致记忆检索效率降低有关。DAN是负责外部环境定向注意的核心网络。DMN和DAN的动态调节可保障认知资源的灵活分配[12]。正常情况下,当DMN激活时DAN抑制以支持内部思维,而DAN激活时DMN抑制以支持外部注意。但在衰老过程中,DMN与DAN之间的负功能连接减弱,导致内部思维与外部注意的切换效率下降,干扰病人在多任务或需要快速调整注意力任务中的表现[13]。FPN是负责执行功能、目标导向认知的核心网络,通过与DMN的动态协同,保证目标导向思维[14]。研究表明,在衰老过程中,DMN与FPN连接下降,会导致病人以目标为导向的记忆检索能力受损,难以从记忆中提取与当前任务相关的信息,出现对重要信息检索能力下降,无法在复杂环境中灵活分配注意力[4]。因此,脑网络内部及网络间功能出现异常时,会导致病人在执行需要灵活记忆检索、注意力分配和决策调整的任务时出现困难,降低病人的认知灵活性。
认知灵活性衰退与脑结构和功能的退行性改变有关。当个体处于30~50岁年龄段时,全脑的萎缩率约0.2%,而70~80岁时,全脑萎缩率将上升至0.5%,且几乎所有的大脑皮层都能发现明显的萎缩趋势[15]。随着年龄增长,前额叶皮质和基底神经节等脑区灰质发生萎缩,伴随白质纤维完整性降低,导致轴突传导速度减慢和功能连接强度减弱,降低功能网络的同步性及跨脑区信息传递效率[16-17]。例如,老年人群中顶叶和颞叶区域的结构-功能耦合相似性降低,且这种降低与认知测试表现下降相关[18],这意味着脑区难以通过结构连接协调功能活动,导致信息整合效率下降。白质损伤可通过减少髓鞘依赖性信号传导削弱功能网络协调性,而功能连接的异常可能通过神经活动-代谢耦联失衡进一步加剧脑结构退行性改变形成恶性循环,共同影响认知灵活性[18]。Wu等[19]发现,与年轻人相比,老年人的灰质体积明显降低,且在视觉网络、默认模式网络等与认知相关网络中的减少更明显。灰质含有神经元胞体,是信息处理的核心区域,其体积减小,导致神经元数量减少和突触连接丢失,削弱脑区的信息处理能力。在该研究中,研究者通过构建厄尔多斯-雷尼随机网络模型模拟大脑衰老。该模型中包含10万个神经元,每个神经元初始连接10个突触,通过逐步移除突触或神经元模拟衰老对神经网络动态的影响。结果表明,老年脑网络中神经元和突触减少,导致个体信息整合能力下降,如记忆编码、目标识别等,进而影响认知功能。
多巴胺、乙酰胆碱等神经递质水平的变化会影响认知灵活性。多巴胺能系统通过前额叶-纹状体环路调控认知灵活性,其投射至前额叶皮质的纤维释放多巴胺,作用于多巴胺D1和多巴胺D2受体以调节策略更新、注意力及任务切换等过程[20]。D1受体激活通过增强前额叶皮层神经元的持续性放电维持工作记忆和注意力,D2受体通过抑制背侧纹状体的竞争性信号通路促进任务切换和反应抑制。随着年龄增长,多巴胺能投射密度降低及D1受体表达下调,导致前额叶-纹状体环路信号减弱,从而损害工作记忆和认知灵活性[21]。乙酰胆碱在维持海马胆碱能环路的稳定性和功能中起关键作用。正常情况下,乙酰胆碱通过调节海马神经元的兴奋-抑制平衡,支持工作记忆和认知灵活性。海马成年新神经元的生成会随年龄增加而减少,为应对神经发生减少导致的胆碱功能缺陷,隔核-海马胆碱能投射会发生代偿性重组,约40%的腹侧投射神经元异常分支至背侧海马,形成“双重投射“。这种重组会降低背侧海马释放乙酰胆碱的能力,导致海马乙酰胆碱的基础水平和任务诱发释放量降低,形成恶性循环进而损害认知灵活性[22]。
日常家务活动是IADL的重要组成部分,其顺利完成与记忆能力、执行控制和空间处理能力相关[23-25]。Chevignard等[23]在职业治疗厨房中进行了一项半结构化的烹饪任务,比较了执行功能障碍病人与健康对照组的表现,结果显示,病人出现了大量错误,包括忽视情境、无目的行为以及对环境的过度依赖等,表明他们对情境和环境线索的反应存在异常。认知灵活性衰退会阻碍病人以目标为导向任务的完成,如烹饪过程中忘记添加必要食材或疏忽关火步骤,致使任务失败,对病人的个人安全构成潜在威胁[24]。有研究表明,执行功能障碍病人接听电话的同时进行家务活动,难以快速调整认知资源分配,导致中断正在进行的家务流程;而当恢复任务时,需要额外时间来重组认知策略,降低任务处理的效率。因此,很多研究者也将烹饪活动作为提升病人认知功能的训练内容之一[24-25]。此外,认知灵活性衰退会削弱老年人对家电的操作和学习能力,如使用洗衣机时,出现文字误读、操作顺序混乱等问题,对器具的“有用性”和“可用性”感知下降[26],进而抵触使用辅助工具,对家务执行造成阻碍。总之,认知灵活性衰退可通过影响记忆连贯性、任务切换效率和工具适应能力,进而对老年人的日常家务能力造成影响。
财务管理是IADL中最复杂的任务之一,认知灵活性衰退会影响老年人的财务管理能力。Tannou等[27]对40篇研究进行系统综述,指出正常认知老化过程中,前额叶皮层的萎缩会导致老年人处理速度、工作记忆及执行功能衰退。这种认知衰退削弱了老年人在模糊情境下的决策能力,使其更倾向于采取以规避损失为导向的保守策略,而非追求收益。Baugma等[28]对180名参与者的研究表明,在控制了相关变量后,随着年龄增长,认知功能的下降导致个体完成复杂财务决策任务的难度增加。在老年人日常生活中,财务管理能力下降可表现为在超市购买商品和计算找零时出现困难,难以理解交易流程,导致交易时间延长甚至无法完成交易;在财务判断方面,防范和识别信息诈骗风险方面的能力下降,容易陷入诈骗陷阱,对病人的资金安全造成威胁[29]。这些问题不仅降低老年人的日常生活便利性,还对其经济安全状况和维持独立生活的能力产生负面影响。
老年人出行的交通方式可分为自驾和乘坐公共交通工具两大类。车辆驾驶需依赖注意反应、执行处理等认知功能[30]。Schlueterd等[31]通过对老年司机进行前瞻性研究表明,随着年龄的增长和认知功能下降,老年司机驾驶风险增高。Murphy等[32]对老年人驾驶行为影响的纵向研究发现,神经元损失导致海马体和全脑体积发生萎缩,导致老年驾驶者不得不改变驾驶行为,补偿认知和神经功能的下降。老年驾驶人的感知能力、执行能力等认知功能下降,增加了驾驶车辆的事故风险。此外,老年人在策略转换能力方面存在明显缺陷[33]。当乘公交时,老年人面对复杂的换乘环境,特别是在需要从一种策略切换到另一种策略时,难以快速适应和做出正确决策。Zhai等[34]基于中国老年健康影响因素跟踪调查(CLHLS)数据,对社区老年人建立交叉滞后面板网络模型,发现“注意与计算”和“乘坐公共交通”受限之间存在双向关联,表明认知功能与IADL之间存在相互影响的关系。Chung等[35]通过采用带有全球定位系统(GPS)的手表对社区老年人的生活空间移动性进行监测发现,认知障碍老年人的生活空间移动性受限,表现为移动距离更短、移动速度更慢。这一结果提示,认知功能下降可能通过影响环境感知与行动能力,从而限制其出行范围与效率。因此,老年人的认知功能减退会对其交通出行能力产生影响;无论自驾时对路况的判断、车辆的操控,还是乘坐公共交通工具时对线路的识别、站点的记忆,认知功能减退的老年人都会出现困难。
随着人口老龄化的加深,糖尿病、心血管等慢性病给社会带来巨大负担,长期、规范遵医嘱服药是防治慢性病的关键。因此,药物管理是大多数老年人日常生活中的一项重要任务。Advinha等[36]利用Logistic回归方法分析得出,认知功能是老年人药物管理能力的重要预测因素。认知功能下降使老年人难以确定每日服药时间,即便他们能记住服药剂量,但将剂量与服药时间结合时会出现困难,无法准确安排服药时间,进而影响药物管理的准确性和规范性。此外,认知灵活性衰退会损害工作记忆。Xu等[37]研究发现,累积血压负荷与老年人的即时记忆相关,即时记忆衰退会影响老年人对药物名称和剂量的记忆能力,增加用药错误风险。这可能导致老年人吃错药物、漏服药物或服用错误剂量,从而带来潜在的安全隐患。针对药物自我管理能力缺陷病人可使用智能药物管理系统,对病人用药情况进行实时监测并按时提醒用药,防止用药错误,提高老年人的服药依从性[38]。
行为学评估方法通过分析受试者在执行任务过程中的外在行为表现,如任务准确率、反应时和错误类型等,推断其认知灵活性水平。目前,常用的行为学评估工具包括斯特鲁普颜色-词语测验(Stroop color and word test,SCWT)、威斯康星卡片分类测验(Wisconsin card sorting test,WCST)、任务切换范式(task-switching paradigm)、维度变化卡片分类测试(dimensional change card sort,DCCS)以及托伦斯创造性思维测验(Torrance tests of creative thinking,TTCT)等[39]。然而,行为学评估存在局限性,难以动态反映认知功能的连续变化,其本身不能诊断出主要的神经认知障碍,需结合日常任务功能下降才能满足诊断标准。因此,可通过重复进行行为学评估方法,以记录衰退的进展。
神经影像学评估通过监测个体在执行特定认知任务时的大脑生理活动变化,为揭示认知灵活性相关的神经机制提供重要手段。常用技术包括功能性磁共振成像(functional magnetic resonance imaging, fMRI)、脑电图(electroencephalogram,EEG)以及功能性近红外光谱技术(functional near-infrared spectroscopy,fNIRS)等[39-40]。其中,fNIRS是一种基于血流动力学的神经成像技术,是近年来新兴的技术手段,具有成本低、便携性好、空间分辨率高等优势,更适合在自然环境中使用[40]。虽然fNIRS在监测认知功能方面的准确性和可靠性不断得到验证,但由于设备及运营成本较高,目前仍难以作为常规临床评估手段广泛推广。未来研究可进一步整合多模态神经影像技术,深入探讨认知灵活性下降的神经基础,为推动相关脑机制研究和护理干预提供新视角。
认知训练是指通过特定任务提高或维持老年人认知功能的干预手段,通常可借助纸笔或数字化媒介进行。任务形式包括图形复制、符号配对、图片排序及记忆翻转等,旨在提升记忆、识别、联想以及细节观察、空间再现等多种认知功能[41]。该训练不仅能直接强化所训练的认知领域,还可对其他认知功能产生积极的迁移效应。Anguera等[42]采用一项自适应难度的多任务赛车游戏干预发现,老年参与者在训练后认知功能明显改善,且训练效果可维持6个月。脑电图数据显示,中线额叶及额后区θ波段一致性增强,表明训练效果迁移至持续注意和工作记忆等未直接训练的认知领域。此外,虚拟现实(virtual reality,VR)、增强现实(augmented reality,AR)及混合现实(mixed reality,MR)等沉浸式技术可通过给病人提供熟悉的生活场景,增强即刻记忆和延迟记忆,进而改善视觉记忆和空间记忆[43]。如Yang等[44]进行的一项研究发现,基于VR的日常任务游戏,包括制作果汁、射击乌鸦、查找烟花数量和记忆屋内物品等,结果证实该训练对认知功能有积极影响。然而,认知训练面临参与者依从性低、干预成本高及医疗资源可及性不均等问题,未来研究可致力于开发更具可及性、成本效益更高的干预模式,以促进其在更广泛人群中的有效应用。
运动训练是有效改善认知功能的非药物干预方法之一,包括抗阻运动、有氧运动、多种运动方式组合等形式[45]。在护理实践中,运动训练应注重通过放松练习、运动游戏及多样化活动,提升个体的整体活动能力、粗大与精细运动技能、平衡能力及感官知觉。如球类练习可增强协调与反应能力,魔术绳训练可提高柔韧性与协调性,镜像模仿练习以及坐姿舞蹈可加强身体意识与动作计划能力等[41]。研究表明,运动训练对认知功能具有广泛益处。Northey等[46]对39项随机对照试验进行的荟萃分析表明,运动训练可改善整体认知功能,在注意力、记忆与执行功能等领域效果突出。Dhahbid等[47]进一步指出,每周进行3次中等强度有氧运动,每次30~60 min并结合2次抗阻训练,可有效提升老年人的认知灵活性。而运动训练效果受年龄、健康状况、运动习惯及训练强度等个体差异因素的影响。因此,在制定运动方案时,护理人员应基于对老年人身体状况的全面综合评估结果设计个性化训练计划,以实现最大化认知促进效益。
护士可通过环境改造及优化,为病人提供安全、熟悉的居住环境,减少错误操作和认知困惑;并给予适度的刺激和提示,提高日常生活参与度,减轻照顾者的照护压力[48]。可通过在家中摆放旅游纪念品、老照片等怀旧物品,让病人回忆过去生活细节来强化旧有记忆,以减缓记忆衰退;此外,可在卫生间、厨房等场所利用图片或标识辅助分辨位置,但标识要符合病人的认知和教育程度,且避免数量过多导致混乱。同时,居家环境改造需为老年人提供独处空间与社交互动机会。若老年人没有独立房间,可借助屏风或家具隔出专属区域;客厅内摆放符合老年人身体特点的座椅,将餐桌调整至适宜高度,鼓励病人在客厅就餐,既满足其独处需求,又创造与家人交流的场景[49]。同时,数字技术也在老年认知支持中扮演重要角色。研究表明,智能手机使用与老年人认知功能呈正相关[50]。针对认知功能下降人群开发的应用程序,具备用药提醒、健康指导及社交支持等功能,有助于提升病人的自我管理能力和社会参与水平,从而改善其生活质量并促进社区融入[51]。但环境改造受居住条件、地区文化差异的影响;数字技术的应用面临老年人数字素养不足、接受度差异及安全隐私等问题,未来应开发更全面的环境评估工具,制定个性化易操作的技术方案,并验证其长期效果与推广价值,以提升护理干预的科学性与普适性。
认知灵活性衰退是正常衰老过程中的核心特征之一。由于其早期发病隐匿且进展缓慢,易被家属及医护人员忽视。在衰退早期,通常会先影响IADL,进而削弱老年人的生活自理能力,最终导致其生活质量下降。但目前关于认知灵活性衰退的评估工具多使用行为学测试,且与IADL之间关联的研究欠佳,导致制定的个性化康复方案精准性欠佳,干预策略开发受阻。因此,有必要通过使用客观的神经影像学技术检测老年人的认知灵活性变化,从而探究该能力衰退的机制,为临床和社区制定策略提供理论依据。此外,认知灵活性衰退通常会增加照护负担。因此,在对病人实施干预和护理的同时,也应重视并加强对家庭照护人员的支持,以减轻照护者的负担和心理压力,提升其照护效率,实现持久、有效的整体护理效果。未来,可构建多学科协作的干预体系,整合医疗、康复和社会支持资源,实现早期识别与及时干预,延缓认知灵活性衰退进程,维护病人独立生活能力并减轻照护负担,提高老年人的生活质量。

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doi: 10.12102/j.issn.1009-6493.2026.13.024
  • 接收时间:2025-06-11
  • 首发时间:2026-10-30
  • 出版时间:2026-07-10
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  • 收稿日期:2025-06-11
  • 修回日期:2026-05-17
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    1长春中医药大学护理学院,吉林 130117
    2内蒙古民族大学护理学院

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张红石,E-mail:
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2种不同金属材料的力学参数
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genus
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species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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