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Article(id=1241067199784341921, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202409057, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1725465600000, receivedDateStr=2024-09-05, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773823078341, onlineDateStr=2026-03-18, pubDate=1741536000000, pubDateStr=2025-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773823078341, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773823078341, creator=13701087609, updateTime=1773823078341, updator=13701087609, issue=Issue{id=1241067197318091153, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773823077754, creator=13701087609, updateTime=1773823268053, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241067995544482681, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241067995544482682, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=893, endPage=899, ext={EN=ArticleExt(id=1241067202661634485, articleId=1241067199784341921, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Latent profile analysis of cognitive function in older adults and its influencing factors, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the latent categories of cognitive function in older adults and their influencing factors.

Methods

Data from the 2020 CHARLS (China Health and Retirement Longitudinal Study) were used, including 4 606 participants aged 60 years and above. Latent profile analysis (LPA) was employed to identify the latent categories of cognitive function, and multivariate logistic regression and restricted cubic spline analysis were conducted to examine the influencing factors.

Results

Cognitive function in older adults was classified into four categories: “Low Cognitive Function-Low Attention Group” (21%), “Moderate Cognitive Function-Balanced Group” (18.6%), “High Cognitive Function-High Attention Group” (47.7%), and “Low Cognitive Function-High Visuospatial Ability Group” (12.7%). Protective factors for the “High Cognitive Function-High Attention Group” included age <70 years, higher education level, male gender, internet use, non-smoking, and absence of depressive symptoms (P < 0.05). Age exhibited a non-linear dose-response relationship with the risk of belonging to the “Low Cognitive Function-Low Attention Group” (P overalltrend <0.001, P non-linearity <0.001), “Moderate Cognitive Function-Balanced Group” (P overalltrend =0.016, P non-linearity =0.006), and “Low Cognitive Function-High Visuospatial Ability Group” (Poveralltrend =0.007, Pnon-linearity =0.004).

Conclusion

Cognitive function in older adults demonstrates distinct categorical characteristics, suggesting that healthcare professionals should develop targeted and personalized intervention strategies based on these categories and their influencing factors to prevent and delay cognitive impairment.

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目的

探讨老年人认知功能潜在类别及其影响因素。

方法

采用CHARLS 2020年数据，共纳入60岁及以上研究对象4 606名。使用潜在剖面分析方法探讨老年人认知功能的潜在类别，并通过多元logistic回归和限制性立方样条分析其影响因素。

结果

老年人认知功能分为低认知功能-低注意力组(21%) 、中等认知功能-均衡组(18.6%) 、高认知功能-高注意力组(47.7%) 和低认知功能-高视空间能力组(12.7%) 。年龄<70岁、高受教育程度、男性、使用网络、不吸烟和无抑郁症状是高认知功能-高注意力组的保护因素(P<0.05) 。年龄与低认知功能-低注意力组(P总趋势<0.001, P非线性<0.001)、中等认知功能-均衡组(P总趋势=0.016, P非线性=0.006)、 低认知功能-高视空间能力组(P总趋势=0.007,P非线性=0.004) 发生风险之间存在非线性剂量-反应关系。

结论

老年人认知功能存在明显类别特征，提示医护人员应根据其不同类别特征及影响因素制定针对性、个性化的干预策略，以预防和延缓认知障碍发生。

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应燕萍，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Bevaj75CQptOI5CBgAHRzQ==, magXml=jkEOx11/SB0Z7wt0QrmyRg==, pdfUrl=null, pdf=FuwxvJLvTA1bX+4Nyks4GA==, pdfFileSize=975570, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=r623YfHwmQsZV+MB1JLogA==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=AQs7HW8hgvdf/oke8R+p8A==, mapNumber=null, authorCompany=null, fund=null, authors=

莫海妮（1999—），女，硕士在读，研究方向：老年护理

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莫海妮（1999—），女，硕士在读，研究方向：老年护理

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莫海妮（1999—），女，硕士在读，研究方向：老年护理

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Alzheimer's & Dementia : the Journal of the Alzheimer's Association, 2021, 17(5): 768-776., articleTitle=Multimorbidity burden and dementia risk in older adults: The role of inflammation and genetics, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241067204230304270, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, xref=null, ext=[AuthorCompanyExt(id=1241067204238692879, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, companyId=1241067204230304270, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China), AuthorCompanyExt(id=1241067204247081488, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, companyId=1241067204230304270, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=广西医科大学第一附属医院，广西 南宁 530021)])], figs=[ArticleFig(id=1241067210697921406, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Figure 1, caption=The characteristic distribution of 4 latent categories of cognitive function among elderly individuals, figureFileSmall=oRwCTXtC5AHZLlFDfDOuYg==, figureFileBig=r623YfHwmQsZV+MB1JLogA==, tableContent=null), ArticleFig(id=1241067210832139144, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=图1, caption=老年人认知功能4个潜在类别的特征分布, figureFileSmall=oRwCTXtC5AHZLlFDfDOuYg==, figureFileBig=r623YfHwmQsZV+MB1JLogA==, tableContent=null), ArticleFig(id=1241067211184460715, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Figure 2, caption=Relationship between number of chronic diseases and latent categories of cognitive function, figureFileSmall=zQoBOKK8weLOgVRPzWK+fw==, figureFileBig=SZ6SYUSGag+ly3UEdzP6mw==, tableContent=null), ArticleFig(id=1241067211360621493, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=图2, caption=慢性病个数与认知功能潜在类别的关系

注：图A、B、C分别指低认知功能-低注意力组、中等认知功能-均衡组、 低认知功能-高视空间能力组；OR 和95%CI分别用实线和阴影面积表示；对受教育程度、年龄、性别、网络使用、吸烟和抑郁症状进行校正。

, figureFileSmall=zQoBOKK8weLOgVRPzWK+fw==, figureFileBig=SZ6SYUSGag+ly3UEdzP6mw==, tableContent=null), ArticleFig(id=1241067211486450627, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Figure 3, caption=Relationship between number of chronic diseases and latent categories of cognitive function in elderly individuals of different genders, figureFileSmall=/Yv/3aJXty3yxRHku6wZRA==, figureFileBig=2HsIOn8+G3APNKtW/xy1dg==, tableContent=null), ArticleFig(id=1241067211603891151, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=图3, caption=不同性别老年人的慢性病个数与认知功能潜在类别的关系

注：图A、B、C分别指低认知功能-低注意力组、中等认知功能-均衡组、 低认知功能-高视空间能力组；OR 和95%CI分别用实线和阴影面积表示；对受教育程度、年龄、性别、网络使用、吸烟和抑郁症状进行校正。

, figureFileSmall=/Yv/3aJXty3yxRHku6wZRA==, figureFileBig=2HsIOn8+G3APNKtW/xy1dg==, tableContent=null), ArticleFig(id=1241067211859743708, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Figure 4, caption=Relationship between age and latent categories of cognitive function, figureFileSmall=tc5FWjKicU8POdbaHOytzg==, figureFileBig=drWN5ucJxMtsvYV2CwfszA==, tableContent=null), ArticleFig(id=1241067212107207657, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=图4, caption=年龄与认知功能潜在类别的关系

注：图A、B、C分别指低认知功能-低注意力组、中等认知功能-均衡组、 低认知功能-高视空间能力组；OR 和95%CI分别用实线和阴影面积表示；对受教育程度、性别、网络使用、吸烟和抑郁症状进行校正。

, figureFileSmall=tc5FWjKicU8POdbaHOytzg==, figureFileBig=drWN5ucJxMtsvYV2CwfszA==, tableContent=null), ArticleFig(id=1241067215529759738, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Figure 5, caption=Relationship between age and latent categories of cognitive function in elderly individuals of different genders, figureFileSmall=9j79UVphuJeOYbDKC6hcvg==, figureFileBig=p2bpGI07j6zq7awopUDpCQ==, tableContent=null), ArticleFig(id=1241067215638810630, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=图5, caption=不同性别老年人的年龄与认知功能潜在类别的关系

注：图A、B、C分别指低认知功能-低注意力组、中等认知功能-均衡组、 低认知功能-高视空间能力组；OR 和95%CI分别用实线和阴影面积表示；对受教育程度、性别、网络使用、吸烟和抑郁症状进行校正。

, figureFileSmall=9j79UVphuJeOYbDKC6hcvg==, figureFileBig=p2bpGI07j6zq7awopUDpCQ==, tableContent=null), ArticleFig(id=1241067215760445457, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Table 1, caption=

General data and univariate analysis of latent categories of cognitive function in elderly ［M（P25，P75），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
项目总例数
（n=4 606)		低认知功能-低注意力组
（n=966）		中等认知功能-均衡组
（n=863）		高认知功能-高注意力组
（n=2 192）		低认知功能-高视空间能力组
（n=585）		χ2/H值P值
年龄（岁)66(63.0,71.0)66(63.0,70.0)67(63.0,71.0)66(63.0,71.0)66(63.0,71.0)3.3250.344
60～693 208(69.6)672(69.6)609(70.6)1 529(69.8)398(68.0)4.7200.094
70～791 243(27.0)251(26.0)215(24.9)619(28.2)158(27.0)
80～95155(3.4)43(4.5)39(4.5)44(2.0)29(5.0)
性别57.192<0.001
女1 888(41.0)477(49.4)381(44.1)783(35.7)247(42.2)
男2 718(59.0)489(50.6)482(55.9)1 409(64.3)338(57.8)
受教育程度68.092<0.001
文盲535(11.6)182(18.8)120(13.9)150(6.8)83(14.2)
小学2 293(49.8)497(51.4)452(52.4)1 049(47.9)295(50.4)
初中1 057(22.9)188(19.5)186(21.6)560(25.5)123(21.0)
高中或中专612(13.3)84(8.7)90(10.4)366(16.7)72(12.3)
大专及以上109(2.4)15(1.6)15(1.7)67(3.1)12(2.1)
婚姻状况6.5760.087
其他751(16.3)180(18.6)147(17.0)331(15.1)93(15.9)
已婚3 855(83.7)786(81.4)716(83.0)1 861(84.9)492(84.1)
居住地20.491<0.001
其他1 876(40.7)363(37.6)322(37.3)968(44.2)223(38.1)
农村2 730(59.3)603(62.4)541(62.7)1 224(55.8)362(61.9)
午睡11.1080.011
否1 475(32.0)334(34.6)303(35.1)664(30.3)174(29.7)
是3 131(68.0)632(65.4)560(64.9)1 528(69.7)411(70.3)
规律锻炼7.0690.070
否364(7.9)93(9.6)67(7.8)153(7.0)51(8.7)
是4 242(92.1)873(90.4)796(92.2)2 039(93.0)534(91.3)
社交活动3.1820.364
否2 276(49.4)473(49.0)441(51.1)1 060(48.4)302(51.6)
是2 330(50.6)493(51.0)422(48.9)1 132(51.6)283(48.4)
网络使用60.085<0.001
否3 078(66.8)696(72.0)631(73.1)1 343(61.3)408(69.7)
是1 528(33.2)270(28.0)232(26.9)849(38.7)177(30.3)
吸烟23.088<0.001
否1 889(41.0)347(35.9)330(38.2)966(44.1)246(42.1)
是2 717(59.0)619(64.1)533(61.8)1 226(55.9)339(57.9)
饮酒21.272<0.001
否2 728(59.2)607(62.8)546(63.3)1 225(55.9)350(59.8)
是1 878(40.8)359(37.2)317(36.7)967(44.1)235(40.2)
抑郁症状50.121<0.001
否3 114(67.6)570(59.0)588(68.1)1 571(71.7)385(65.8)
是1 492(32.4)396(41.0)275(31.9)621(28.3)200(34.2)
BADL受损2.7450.433
否3 698(80.3)762(78.9)689(79.8)1 781(81.2)466(79.7)
是908(19.7)204(21.1)174(20.2)411(18.8)119(20.3)
IADL 受损14.6640.002
否3 760(81.6)752(77.8)703(81.5)1 831(83.5)474(81.0)
是846(18.4)214(22.2)160(18.5)361(16.5)111(19.0)
ADL 受损6.0100.111
否3 275(71.1)662(68.5)612(70.9)1 592(72.6)409(69.9)
是1 331(28.9)304(31.5)251(29.1)600(27.4)176(30.1)
慢性病共病4.5350.209
否1 778(38.6)357(37.0)318(36.8)861(39.3)242(41.4)
是2 828(61.4)609(63.0)545(63.2)1 331(60.7)343(58.6)
慢性病（种）2(1.0,3.0)2(1.0,3.0)2(1.0,3.0)2(1.0,3.0)2(1.0,3.0)2.3060.511
), ArticleFig(id=1241067215882080287, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=表1, caption=

老年人的一般资料及认知功能潜在类别的单因素分析结果［M（P25，P75），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
项目总例数
（n=4 606)		低认知功能-低注意力组
（n=966）		中等认知功能-均衡组
（n=863）		高认知功能-高注意力组
（n=2 192）		低认知功能-高视空间能力组
（n=585）		χ2/H值P值
年龄（岁)66(63.0,71.0)66(63.0,70.0)67(63.0,71.0)66(63.0,71.0)66(63.0,71.0)3.3250.344
60～693 208(69.6)672(69.6)609(70.6)1 529(69.8)398(68.0)4.7200.094
70～791 243(27.0)251(26.0)215(24.9)619(28.2)158(27.0)
80～95155(3.4)43(4.5)39(4.5)44(2.0)29(5.0)
性别57.192<0.001
女1 888(41.0)477(49.4)381(44.1)783(35.7)247(42.2)
男2 718(59.0)489(50.6)482(55.9)1 409(64.3)338(57.8)
受教育程度68.092<0.001
文盲535(11.6)182(18.8)120(13.9)150(6.8)83(14.2)
小学2 293(49.8)497(51.4)452(52.4)1 049(47.9)295(50.4)
初中1 057(22.9)188(19.5)186(21.6)560(25.5)123(21.0)
高中或中专612(13.3)84(8.7)90(10.4)366(16.7)72(12.3)
大专及以上109(2.4)15(1.6)15(1.7)67(3.1)12(2.1)
婚姻状况6.5760.087
其他751(16.3)180(18.6)147(17.0)331(15.1)93(15.9)
已婚3 855(83.7)786(81.4)716(83.0)1 861(84.9)492(84.1)
居住地20.491<0.001
其他1 876(40.7)363(37.6)322(37.3)968(44.2)223(38.1)
农村2 730(59.3)603(62.4)541(62.7)1 224(55.8)362(61.9)
午睡11.1080.011
否1 475(32.0)334(34.6)303(35.1)664(30.3)174(29.7)
是3 131(68.0)632(65.4)560(64.9)1 528(69.7)411(70.3)
规律锻炼7.0690.070
否364(7.9)93(9.6)67(7.8)153(7.0)51(8.7)
是4 242(92.1)873(90.4)796(92.2)2 039(93.0)534(91.3)
社交活动3.1820.364
否2 276(49.4)473(49.0)441(51.1)1 060(48.4)302(51.6)
是2 330(50.6)493(51.0)422(48.9)1 132(51.6)283(48.4)
网络使用60.085<0.001
否3 078(66.8)696(72.0)631(73.1)1 343(61.3)408(69.7)
是1 528(33.2)270(28.0)232(26.9)849(38.7)177(30.3)
吸烟23.088<0.001
否1 889(41.0)347(35.9)330(38.2)966(44.1)246(42.1)
是2 717(59.0)619(64.1)533(61.8)1 226(55.9)339(57.9)
饮酒21.272<0.001
否2 728(59.2)607(62.8)546(63.3)1 225(55.9)350(59.8)
是1 878(40.8)359(37.2)317(36.7)967(44.1)235(40.2)
抑郁症状50.121<0.001
否3 114(67.6)570(59.0)588(68.1)1 571(71.7)385(65.8)
是1 492(32.4)396(41.0)275(31.9)621(28.3)200(34.2)
BADL受损2.7450.433
否3 698(80.3)762(78.9)689(79.8)1 781(81.2)466(79.7)
是908(19.7)204(21.1)174(20.2)411(18.8)119(20.3)
IADL 受损14.6640.002
否3 760(81.6)752(77.8)703(81.5)1 831(83.5)474(81.0)
是846(18.4)214(22.2)160(18.5)361(16.5)111(19.0)
ADL 受损6.0100.111
否3 275(71.1)662(68.5)612(70.9)1 592(72.6)409(69.9)
是1 331(28.9)304(31.5)251(29.1)600(27.4)176(30.1)
慢性病共病4.5350.209
否1 778(38.6)357(37.0)318(36.8)861(39.3)242(41.4)
是2 828(61.4)609(63.0)545(63.2)1 331(60.7)343(58.6)
慢性病（种）2(1.0,3.0)2(1.0,3.0)2(1.0,3.0)2(1.0,3.0)2(1.0,3.0)2.3060.511
), ArticleFig(id=1241067216012103717, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Table 2, caption=

Model fit indices of latent categories of cognitive function in elderly

, figureFileSmall=null, figureFileBig=null, tableContent=
模型Log-likelihoodAICBICaBICLMR(P)BLRT(P)Entropy类别概率
1-32 675.65465 371.30865 435.65965 403.883————
2-31 201.18662 434.37162 537.33362 486.491<0.001<0.0010.9110.45/0.55
3-30 192.91860 429.83660 571.40860 501.501<0.001<0.0010.9780.21/0.24/0.55
4-29 434.44358 924.88659 105.06959 016.095<0.001<0.0010.9950.21/0.19/0.48/0.13
5-29 331.96158 731.92258 950.71658 842.677<0.001<0.0010.8810.08/0.23/0.13/0.15/0.42
6-29 029.04658 138.09258 395.49658 268.3920.9801.0000.8750.14/0.07/0.09/0.14/0.4/0.16
), ArticleFig(id=1241067216116961326, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=表2, caption=

老年人认知功能的潜在类别模型拟合指标

, figureFileSmall=null, figureFileBig=null, tableContent=
模型Log-likelihoodAICBICaBICLMR(P)BLRT(P)Entropy类别概率
1-32 675.65465 371.30865 435.65965 403.883————
2-31 201.18662 434.37162 537.33362 486.491<0.001<0.0010.9110.45/0.55
3-30 192.91860 429.83660 571.40860 501.501<0.001<0.0010.9780.21/0.24/0.55
4-29 434.44358 924.88659 105.06959 016.095<0.001<0.0010.9950.21/0.19/0.48/0.13
5-29 331.96158 731.92258 950.71658 842.677<0.001<0.0010.8810.08/0.23/0.13/0.15/0.42
6-29 029.04658 138.09258 395.49658 268.3920.9801.0000.8750.14/0.07/0.09/0.14/0.4/0.16
), ArticleFig(id=1241067216284733498, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Table 3, caption=

Assignment of independent variables

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量赋值方式
年龄 (岁)60～69=1，70～79=2，80～95=3
性别女=0，男=1
受教育程度文盲=1，小学=2，初中=3，高中或中专=4，
大专及以上=5
婚姻状况其他=0，已婚=1
居住地其他=0，农村=1
午睡否=0，是=1
规律锻炼否=0，是=1
社交活动否=0，是=1
网络使用否=0，是=1
吸烟否=0，是=1
饮酒否=0，是=1
抑郁症状否=0，是=1
BADL受损否=0，是=1
IADL 受损否=0，是=1
ADL 受损否=0，是=1
慢性病共病否=0，是=1
), ArticleFig(id=1241067216410562624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=表3, caption=

自变量赋值方式

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量赋值方式
年龄 (岁)60～69=1，70～79=2，80～95=3
性别女=0，男=1
受教育程度文盲=1，小学=2，初中=3，高中或中专=4，
大专及以上=5
婚姻状况其他=0，已婚=1
居住地其他=0，农村=1
午睡否=0，是=1
规律锻炼否=0，是=1
社交活动否=0，是=1
网络使用否=0，是=1
吸烟否=0，是=1
饮酒否=0，是=1
抑郁症状否=0，是=1
BADL受损否=0，是=1
IADL 受损否=0，是=1
ADL 受损否=0，是=1
慢性病共病否=0，是=1
), ArticleFig(id=1241067216574140499, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=EN, label=Table 4, caption=

Multivariate logistic regression analysis results on influencing factors of latent profiles of cognitive function in elderly individuals

, figureFileSmall=null, figureFileBig=null, tableContent=
项目低认知功能-低注意力组中等认知功能-均衡组低认知功能-高视空间能力组
βP值OR值(95%CI)βP值OR值(95%CI)βP值OR值(95%CI)
常数项-0.0170.9010.983 (0.755～1.281)-0.1680.2470.846 (0.637～1.123)-0.585<0.0010.557 (0.405～0.767)
受教育程度
小学-0.737<0.0010.479 (0.373～0.614)-0.457<0.0010.633 (0.482～0.831)-0.571<0.0010.565 (0.416～0.768)
初中-0.970<0.0010.379 (0.284～0.505)-0.628<0.0010.533 (0.392～0.725)-0.753<0.0010.471 (0.332～0.668)
高中或中专-1.310<0.0010.270 (0.192～0.381)-0.867<0.0010.420 (0.295～0.599)-0.837<0.0010.433 (0.292～0.643)
大专及以上-1.180<0.0010.306 (0.163～0.573)-0.9180.0060.399 (0.208～0.767)-0.9060.0120.404 (0.200～0.817)
年龄（岁）
70～79-0.1040.2570.901 (0.753～1.079)-0.1930.0430.824 (0.684～0.994)-0.0590.5860.943 (0.762～1.166)
80～950.781<0.0012.183 (1.399～3.407)0.7250.0022.065 (1.315～3.243)0.853<0.0012.346 (1.435～3.835)
性别
男-0.361<0.0010.697 (0.592～0.820)-0.2560.0030.774 (0.654～0.916)-0.1530.1230.858 (0.706～1.042)
网络使用
是-0.1900.0430.827 (0.688～0.994)-0.383<0.0010.682 (0.563～0.825)-0.1990.0730.819 (0.659～1.019)
吸烟
是0.2160.0081.242 (1.059～1.456)0.1000.2261.106 (0.940～1.301)-0.0590.5350.943 (0.783～1.136)
抑郁症状
是0.378<0.0011.460(1.238～1.721)0.0140.8761.014 (0.850～1.209)0.1590.1191.173 (0.960～1.432)
), ArticleFig(id=1241067216683192409, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067199784341921, language=CN, label=表4, caption=

老年人认知功能潜在类别影响因素的多元logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
项目低认知功能-低注意力组中等认知功能-均衡组低认知功能-高视空间能力组
βP值OR值(95%CI)βP值OR值(95%CI)βP值OR值(95%CI)
常数项-0.0170.9010.983 (0.755～1.281)-0.1680.2470.846 (0.637～1.123)-0.585<0.0010.557 (0.405～0.767)
受教育程度
小学-0.737<0.0010.479 (0.373～0.614)-0.457<0.0010.633 (0.482～0.831)-0.571<0.0010.565 (0.416～0.768)
初中-0.970<0.0010.379 (0.284～0.505)-0.628<0.0010.533 (0.392～0.725)-0.753<0.0010.471 (0.332～0.668)
高中或中专-1.310<0.0010.270 (0.192～0.381)-0.867<0.0010.420 (0.295～0.599)-0.837<0.0010.433 (0.292～0.643)
大专及以上-1.180<0.0010.306 (0.163～0.573)-0.9180.0060.399 (0.208～0.767)-0.9060.0120.404 (0.200～0.817)
年龄（岁）
70～79-0.1040.2570.901 (0.753～1.079)-0.1930.0430.824 (0.684～0.994)-0.0590.5860.943 (0.762～1.166)
80～950.781<0.0012.183 (1.399～3.407)0.7250.0022.065 (1.315～3.243)0.853<0.0012.346 (1.435～3.835)
性别
男-0.361<0.0010.697 (0.592～0.820)-0.2560.0030.774 (0.654～0.916)-0.1530.1230.858 (0.706～1.042)
网络使用
是-0.1900.0430.827 (0.688～0.994)-0.383<0.0010.682 (0.563～0.825)-0.1990.0730.819 (0.659～1.019)
吸烟
是0.2160.0081.242 (1.059～1.456)0.1000.2261.106 (0.940～1.301)-0.0590.5350.943 (0.783～1.136)
抑郁症状
是0.378<0.0011.460(1.238～1.721)0.0140.8761.014 (0.850～1.209)0.1590.1191.173 (0.960～1.432)
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老年人认知功能的潜在剖面分析及其影响因素研究
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莫海妮 , 吴彩娇 , 应燕萍 , 李莉 , 杨柳 , 吴素怡 , 李梓溶
现代预防医学 | 健康与社会行为 2025,52(5): 893-899
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现代预防医学 | 健康与社会行为 2025, 52(5): 893-899
老年人认知功能的潜在剖面分析及其影响因素研究
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莫海妮, 吴彩娇, 应燕萍 , 李莉, 杨柳, 吴素怡, 李梓溶
作者信息
  • 广西医科大学第一附属医院，广西 南宁 530021

    • 莫海妮（1999—），女，硕士在读，研究方向：老年护理

通讯作者:

应燕萍，E-mail:
Latent profile analysis of cognitive function in older adults and its influencing factors
Hai-ni MO, Cai-jiao WU, Yan-ping YING , Li LI, Liu YANG, Su-yi WU, Zi-rong LI
Affiliations
  • The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China
出版时间: 2025-03-10 doi: 10.20043/j.cnki.MPM.202409057
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摘要
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目的

探讨老年人认知功能潜在类别及其影响因素。

方法

采用CHARLS 2020年数据，共纳入60岁及以上研究对象4 606名。使用潜在剖面分析方法探讨老年人认知功能的潜在类别，并通过多元logistic回归和限制性立方样条分析其影响因素。

结果

老年人认知功能分为低认知功能-低注意力组(21%) 、中等认知功能-均衡组(18.6%) 、高认知功能-高注意力组(47.7%) 和低认知功能-高视空间能力组(12.7%) 。年龄<70岁、高受教育程度、男性、使用网络、不吸烟和无抑郁症状是高认知功能-高注意力组的保护因素(P<0.05) 。年龄与低认知功能-低注意力组(P总趋势<0.001, P非线性<0.001)、中等认知功能-均衡组(P总趋势=0.016, P非线性=0.006)、 低认知功能-高视空间能力组(P总趋势=0.007,P非线性=0.004) 发生风险之间存在非线性剂量-反应关系。

结论

老年人认知功能存在明显类别特征，提示医护人员应根据其不同类别特征及影响因素制定针对性、个性化的干预策略，以预防和延缓认知障碍发生。

认知功能  /  老年人  /  潜在剖面分析
Objective

To explore the latent categories of cognitive function in older adults and their influencing factors.

Methods

Data from the 2020 CHARLS (China Health and Retirement Longitudinal Study) were used, including 4 606 participants aged 60 years and above. Latent profile analysis (LPA) was employed to identify the latent categories of cognitive function, and multivariate logistic regression and restricted cubic spline analysis were conducted to examine the influencing factors.

Results

Cognitive function in older adults was classified into four categories: “Low Cognitive Function-Low Attention Group” (21%), “Moderate Cognitive Function-Balanced Group” (18.6%), “High Cognitive Function-High Attention Group” (47.7%), and “Low Cognitive Function-High Visuospatial Ability Group” (12.7%). Protective factors for the “High Cognitive Function-High Attention Group” included age <70 years, higher education level, male gender, internet use, non-smoking, and absence of depressive symptoms (P < 0.05). Age exhibited a non-linear dose-response relationship with the risk of belonging to the “Low Cognitive Function-Low Attention Group” (P overalltrend <0.001, P non-linearity <0.001), “Moderate Cognitive Function-Balanced Group” (P overalltrend =0.016, P non-linearity =0.006), and “Low Cognitive Function-High Visuospatial Ability Group” (Poveralltrend =0.007, Pnon-linearity =0.004).

Conclusion

Cognitive function in older adults demonstrates distinct categorical characteristics, suggesting that healthcare professionals should develop targeted and personalized intervention strategies based on these categories and their influencing factors to prevent and delay cognitive impairment.

Cognitive function  /  Older adults  /  Latent profile analysis
莫海妮, 吴彩娇, 应燕萍, 李莉, 杨柳, 吴素怡, 李梓溶. 老年人认知功能的潜在剖面分析及其影响因素研究. 现代预防医学, 2025 , 52 (5) : 893 -899 . DOI: 10.20043/j.cnki.MPM.202409057
Hai-ni MO, Cai-jiao WU, Yan-ping YING, Li LI, Liu YANG, Su-yi WU, Zi-rong LI. Latent profile analysis of cognitive function in older adults and its influencing factors[J]. Modern Preventive Medicine, 2025 , 52 (5) : 893 -899 . DOI: 10.20043/j.cnki.MPM.202409057
正文
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认知障碍(cognitive dysfunction) 是指因各种原因导致的不同程度的认知功能损害，以老年人为主要发病人群。根据认知功能损害程度，分为轻度认知障碍(mild cognitive impairment, MCI) 和痴呆[1]，目前尚无治愈手段。2015—2018年，我国60岁及以上老年人MCI 和痴呆患病率分别是15.5%和6.0%[2]，预计2050年全球认知障碍人数将翻3倍，达到1.39亿[3]。为提高老年人生活质量并减轻医疗负担，有必要早期识别和干预认知功能的危险因素。
由于个体认知功能特征复杂，且具有群体异质性[4]，而现有研究主要依据认知功能量表临界值和得分高低来划分有无认知障碍，难以识别不同认知功能特征。潜在剖面分析(latent profile analysis, LPA)是一种以个体为中心的统计分析方法，可根据研究对象的外显连续变量来判断其潜在类别，以探究不同类别人群的特征及影响因素。因此，本研究使用LPA识别我国老年人的认知功能类别，并进一步研究其影响因素，以便为构建针对不同认知功能类别的干预方案提供理论依据。
1　对象与方法
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1.1　研究对象
本研究采用中国健康与养老追踪调查(CHARLS)2020年度的随访数据[5]。CHARLS 2020样本量为19 395人，剔除14 789人。排除标准：（1）年龄<60岁(n=8 741)；（2）患有与记忆相关的疾病(n=679)；（3）患有帕金森症(n=142) 或中风(n=845)；（4）患有情感及精神问题(n=200)；（5）认知功能评分不完整(n=4 182) 。最终纳入研究对象4 606人。2020年度调查已获北京大学生物医学伦理委员会批准(IRB00001052-11015)。
1.2　相关定义
1.2.1　慢性病共病和网络使用
慢性病共病[6]：同时存在2种或以上的慢性病；网络使用：过去一个月是否上网。
1.2.2　认知功能
通过认知状态电话访谈(TICS-10) 评估定向力、注意力，字词回忆和图形绘制评估回忆力(即时回忆力、延时回忆力)、视空间能力。分数越高代表认知功能越好。该量表在本研究中的Cronbach α 系数为0.806。
1.2.3　日常生活能力
采用基本日常生活能力(basic activities of daily living, BADL) 量表和工具性日常生活能力(instrumental activities of daily living,IADL) 量表评估研究对象的日常生活能力(activities of daily living, ADL)。若BADL量表6项(穿衣、洗澡、进食、上下床、上厕所、控制大小便)均为“没有困难”，视为BADL无损失。IADL量表(做家务、备餐、购物、使用电话、吃药、管钱)同理。若12项均为“没有困难”，视为ADL无损失。ADL量表在本研究中的Cronbach α系数是0.767。
1.2.4　抑郁症状
采用10项流调中心抑郁量表(Center for Epidemiologic Studies Depression Scale -10,CESD-10)来评估研究对象过去一周的抑郁症状。CESD-10≥10分认为存在抑郁症状[7]。该量表的Cronbach α系数是0.777。
1.3　统计学方法
以TICS-10、字词回忆和图形绘制共5维度的Z标准分作为外显变量，通过Mplus 8.0进行LPA分析。LPA有4类拟合指标[8]：（1）艾凯克信息标准(Akaike information criterion, AIC)、 贝叶斯信息标准(Baysian information criterion, BIC)、 调整贝叶斯信息准则(adjusted Baysian information criterion, aBIC)，数值越小代表模型拟合效果越好；（2）熵(Entropy)越接近1表明分类越准确；（3）罗-梦戴尔-鲁本校正似然比(Lo-Mendell-Rubin likelihood ratio,LMR) 、基于bootstrap的似然比(bootstrapped likelihood ratio, BLRT) 检验比较k-1个和k个类别模型之间的拟合差异，P<0.05表示第k个模型优于第k-1个模型；（4）每个类别人数大于总体的5%。
采用R 4.3.1进行统计分析。不符合正态分布的计量资料以［M（P25，P75）］表示，计数资料以频数(百分比) 表示。采用多元logistic回归分析老年人认知功能类别的影响因素。以百分位数P5、P35、P65、P95为节点，使用限制性立方样条(restricted cubic spline,RCS) 分析年龄、慢性病个数与认知功能类别的剂量-反应关系。双侧检验，检验水准α=0.05。
2　结果
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2.1　老年人一般资料
共纳入老年人4 606名，年龄为60～95 (67.34±5.54) 岁，其中男性2 718名(59.0%)。见表1。
2.2　老年人认知功能的潜在剖面分析结果
随着剖面类别数目的递增，AIC、BIC、aBIC值逐渐减小，模型4的熵值最大，且LMR和BLRT的P<0.001，因此模型4为最佳模型，见表2。基于模型4，各类别命名如下：类别1 (21%) 得分低于其他类别，且“注意力”表现较差，故命名为低认知功能-低注意力组；类别2(18.6%) 各维度得分较为均衡，命名为中等认知功能-均衡组；类别3 (47.7%) 得分最高，尤其是“注意力”维度，故命名为高认知功能-高注意力组；类别4(12.7%) 认知功能仅优于类别1，“视空间能力”得分较好，命名为低认知功能-高视空间能力组。见图1。
2.3　老年人认知功能潜在类别的单因素分析
老年人认知功能潜在类别在性别、受教育程度、居住地、午睡、网络使用、吸烟、饮酒、抑郁症状和IADL 受损方面的差异具有统计学意义(P<0.05) 。见表1。
2.4　老年人认知功能潜在类别的多因素分析
以认知功能潜在类别为因变量，采用逐步法进行多元logistic回归分析，赋值见表3。结果显示，非文盲、年龄<70岁、使用网络、不吸烟、无抑郁症状的男性老年人归属于高认知功能-高注意力组的可能性更大(P<0.05) 。见表4。
2.5　慢性病个数、年龄与老年人认知功能潜在类别的剂量-反应关系
以高认知功能-高注意力组为参照组，老年人慢性病个数与低认知功能-低注意力组(P总趋势=0.726, P非线性=0.685)、中等认知功能-均衡组(P总趋势= 0.505, P非线性=0.892)、 低认知功能-高视空间能力组(P总趋势=0.815, P非线性=0.699)的发生风险呈线性剂量-反应关系，见图2、3。年龄与低认知功能-低注意力组(P总趋势<0.001, P非线性<0.001)、中等认知功能-均衡组(P总趋势=0.016, P非线性=0.006)、 低认知功能-高视空间能力组(P总趋势=0.007, P非线性= 0.004) 发生风险之间存在非线性剂量-反应关系。66～73岁、66～75岁、66～74岁的老年人归属于这些组的可能性较小(OR<1)，当年龄≥70岁时(图形最低点)，随着年龄增加，3个认知功能组的发生风险变大，见图4。女性年龄与这些组的关联更强，呈正相关关系(OR>1)，见图5。
3　讨论
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3.1　老年人认知功能存在异质性
基于潜在剖面分析，本研究发现老年人认知功能可分为低认知功能-低注意力组、中等认知功能-均衡组、高认知功能-高注意力组和低认知功能-高视空间能力组4个类别，提示其认知功能水平存在异质性。这与其他学者[4]的研究结果相似。高认知功能-高注意力组(47.7%) 人数最多，其中注意力维度得分最高。说明我国老年人整体认知功能良好。可能与该群体老年人受教育程度较高、使用网络者较多有关，这些因素有助于获取健康知识，维护认知功能。中等认知功能-均衡组(18.6%)各维度得分较为均衡。低认知功能-高视空间能力组(12.7%) 老年人各维度得分较低，但“视空间能力”表现较好。可能与该组高龄老年人多，且大部分人有午睡习惯有关。研究表明午睡有助于改善老年人认知功能[9]。低认知功能-低注意力组(21%) 各维度得分与低认知功能-高视空间能力组相似，但“注意力”较差，可能与受教育程度低和吸烟有关。因此，应重点关注并识别老年人的认知功能类别，为不同群体提供有针对性的健康宣教和信息支持，以维持其认知功能。
3.2　<70岁、受教育程度较高的男性老年人归属于高认知功能-高注意力组的可能性较大
本研究显示，高龄(≥70岁)是老年人认知功能下降的危险因素，与Shen等[10]研究结果一致。原因可能是随着年龄的增长，海马体氧化应激和神经炎症反应增加，导致认知功能下降[11]。相比于女性，男性老年人归属于高认知功能-高注意力组的可能性更大，与先前研究结果一致[12]。然而Abulseoud等[13]发现女性在回忆、语言和注意力方面表现更好。同时，高受教育程度老年人更可能归属于高认知功能-高注意力组。原因可能是高受教育水平能提高老年人的认知储备，进而延缓认知下降[14]。综上，建议医护和社区保健人员关注高龄女性老年人的认知功能，尤其是文盲群体，定期评估并进行认知训练，以提升认知储备，延缓认知功能下降。
3.3　使用网络、无抑郁症状和不吸烟的老年人归属于高认知功能-高注意力组的可能性较大
本研究发现，使用网络、无抑郁症状和不吸烟的老年人具有更好的认知功能，与已有研究结果[15-18]一致。原因可能与网络使用能刺激认知功能区域[19]，提高社会参与度有关。同时有研究表明[20]，网络使用的技术困难会引发老年人的负面情绪，这可能不利于认知功能的维持。抑郁与认知功能下降密切相关，二者双向关联[17]，老年抑郁患者可通过提高认知储备或改善睡眠质量来缓解抑郁导致的认知功能下降[18]。吸烟是老年人认知功能下降的危险因素，其影响程度与吸烟时间和强度呈正相关[15]。因此，建议医护和社区保健人员加强健康宣教，鼓励老年人戒烟、积极参与社会活动。通过志愿者上门、定期开展培训会等措施，减小“数字鸿沟”，以改善认知功能。
3.4　老年人认知功能类别在是否慢性病共病、慢性病个数方面的差异无统计学意义
与以往研究[21]不同，本研究发现慢性病共病和慢性病个数与认知功能类别无关。原因可能与研究对象的年龄、慢性病种类和样本量有关。
我国老年人认知功能可分为低认知功能-低注意力组、中等认知功能-均衡组、高认知功能-高注意力组和低认知功能-高视空间能力组4个潜在类别，年龄<70岁、高受教育程度、男性、使用网络、不吸烟和无抑郁症状是高认知功能-高注意力组的保护因素。局限性：本研究为横断面研究，不能证明影响因素与老年人认知功能类别间的因果关系；其次，使用样本和剔除样本在多数变量上存在差异，尽管敏感性分析结果表明研究结论具有稳健性，但其对年龄<60岁及患特定疾病（帕金森等）人群的适用性仍需谨慎对待。今后可开展多中心的队列研究，进一步探索慢性病共病及种类等因素对老年人认知功能的影响，为认知功能下降的预防及个性化干预提供理论依据。
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2025年第52卷第5期
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doi: 10.20043/j.cnki.MPM.202409057
  • 接收时间：2024-09-05
  • 首发时间：2026-03-18
  • 出版时间：2025-03-10
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    广西医科大学第一附属医院，广西 南宁 530021

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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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