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Article(id=1324078356446184389, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508287, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1755619200000, receivedDateStr=2025-08-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614480363, onlineDateStr=2026-11-02, pubDate=1769270400000, pubDateStr=2026-01-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614480363, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614480363, creator=13701087609, updateTime=1793614480363, updator=13701087609, issue=Issue{id=1324078175000605624, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='2', pageStart='193', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='1769270400000', pubDateStr='2026-01-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614437103, creator='13701087609', updateTime=1793614526046, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078548130082942, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078548130082943, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078175000605624, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=280, endPage=286, ext={EN=ArticleExt(id=1324078358245540806, articleId=1324078356446184389, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on the trajectory of cognitive function changes and influencing factors of elderly groups relocated to new areas: Based on the empirical analysis of four cities and eight counties in Shanxi Province, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the dynamic trajectories of cognitive function and its influencing factors among elderly populations relocated through poverty alleviation resettlement programs.

Methods

A multistage stratified sampling approach was used to select 740 elderly individuals from 24 resettlement sites across four cities and eight counties in Shanxi Province for three rounds of follow-up surveys. Latent growth mixture models (LGMM) identified cognitive trajectory categories, and multivariable logistic regression analyzed influencing factors.

Results

The prevalence of cognitive impairment was 22.6%, with an overall upward trend in cognitive scores. LGMM identified two distinct trajectories: a “Peak-high cognitive function group” and a “Valley-low cognitive function group.” Advanced age (OR=2.914, 95% CI: 1.946-4.362), non-marital status (OR=2.551, 95% CI: 1.632-3.985), lack of regular physical exercise (OR=1.952, 95% CI: 1.327-2.873), and obesity (OR=2.652, 95% CI: 1.579-4.452) were significant risk factors for the low cognitive trajectory, while better basic functional ability was a protective factor (OR=0.723, 95% CI: 0.637-0.821).

Conclusion

While cognitive function showed overall improvement in the relocated elderly population, specific risk factors significantly increased the risk of cognitive decline. Recommendations include promoting early cognitive screening, expanding community sports facilities, and implementing family-based social support programs.

, authors=Hong-yu XIA, Hang LI, Xin-jing CAO, Le YANG, Qi YU, authorsList=Hong-yu XIA, Hang LI, Xin-jing CAO, Le YANG, Qi YU, authorCompany=null, correspAuthors=Le YANG, 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=1324078359000515529, articleId=1324078356446184389, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=易地搬迁老年群体认知功能变化轨迹与影响因素研究——基于山西省四市八县的实证分析, columnId=1228016573533847611, journalTitle=现代预防医学, columnName=基层卫生服务, runingTitle=null, highlight=null, articleAbstract=
目的

探究易地搬迁老年群体认知功能的动态演变轨迹及其影响因素，为搬迁后续健康干预提供参考。

方法

采用多阶段分层抽样，选取山西省四市八县24个安置点的740名老年人开展三轮追踪调查。采用潜变量增长混合模型（LGMM）识别认知轨迹类别，并通过多因素logistic回归分析影响因素。

结果

认知功能障碍检出率22.6%，认知功能得分总体呈上升趋势。LGMM识别出两类认知轨迹：“山峰型高认知功能组”和“谷底型低认知功能组”；多因素logistic回归分析显示，高龄（OR=2.914，95% CI：1.946~4.362）、非在婚（OR=2.551，95% CI：1.632~3.985）、无规律体育锻炼（OR=1.952，95% CI：1.327~2.873）和肥胖（OR=2.652，95% CI：1.579~4.452）是低认知轨迹的危险因素；基本活动能力与低认知轨迹风险呈负相关（OR=0.723，95% CI：0.637~0.821）。

结论

易地搬迁老年群体认知功能整体呈改善趋势，但高龄、非在婚、缺乏体育锻炼、肥胖及活动能力受限会显著增加认知衰退风险。建议推进早期认知筛查，增设社区体育设施，并开展以家庭为单位的社会支持。

, authors=夏宏宇, 李航, 曹馨婧, 杨乐, 于琦, authorsList=夏宏宇, 李航, 曹馨婧, 杨乐, 于琦, authorCompany=null, correspAuthors=杨乐, authorNote=

夏宏宇（2001—），女，硕士在读，研究方向：公共卫生

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杨乐，E-mail:
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Journal of the American Medical Directors Association, 2016, 17(2): 184.e9-184.14., articleTitle=Physical restraint and antipsychotic medication use among nursing home residents with dementia, refAbstract=null)], funds=[Fund(id=1324078364604105726, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, awardId=72204152, language=CN, fundingSource=国家自然科学基金青年基金项目(72204152), fundOrder=null, country=null), Fund(id=1324078364738323455, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, awardId=XD2042, language=CN, fundingSource=2020年度山西医科大学博士启动基金项目(XD2042), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324078359277339594, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, xref=null, ext=[AuthorCompanyExt(id=1324078359289922507, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, companyId=1324078359277339594, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Management, Shanxi Medical University, Taiyuan, Shanxi 030001, China), AuthorCompanyExt(id=1324078359298311116, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, companyId=1324078359277339594, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=山西医科大学管理学院，山西 太原 030001)])], figs=[ArticleFig(id=1324078363152876528, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=EN, label=Fig.1, caption=Average developmental trend diagram of cognitive function and its optimal models across dimensions for relocated elderly individuals, figureFileSmall=VEgLbnRmnzasxfleJ0qGmA==, figureFileBig=NJCbQ7+MLFQrPPOxGpWJdg==, tableContent=null), ArticleFig(id=1324078363228374001, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=CN, label=图1, caption=易地搬迁老年人认知功能及其各维度最优模型的平均发展趋势图, figureFileSmall=VEgLbnRmnzasxfleJ0qGmA==, figureFileBig=NJCbQ7+MLFQrPPOxGpWJdg==, tableContent=null), ArticleFig(id=1324078363450672114, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=EN, label=Table 1, caption=

Variable settings and assignments

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
个人因素
性别男性=1；女性=2
年龄60~79岁=1；≥80岁=2
文化程度小学及以下=1；初中/中专=2；高中及以上=3
婚姻状况在婚=1；非在婚=2
居住安排独居=1；非独居=2
个人月均收入<=500元=1；501~1 000元=2；>1 000元=3
健康相关行为
吸烟是=1；否=2
饮酒是=1；否=2
体育锻炼是=1；否=2
睡眠质量好=1；差=2
健康状况
慢性病是=1；否=0
BMI肥胖=1；超重=2；正常体质量=3；低体质量=4
日常活动能力实测值
抑郁状况实测值
社会与环境评估
搬迁安置方式集中安置=1；分散安置=2
社会资本得分实测值
搬迁时长实测值
因变量
是否认知功能障碍无认知功能障碍=0；有认知功能障碍=1
认知功能障碍得分实测值
), ArticleFig(id=1324078363542946803, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=CN, label=表1, caption=

变量设置及赋值情况

, figureFileSmall=null, figureFileBig=null, tableContent=
变量赋值
个人因素
性别男性=1；女性=2
年龄60~79岁=1；≥80岁=2
文化程度小学及以下=1；初中/中专=2；高中及以上=3
婚姻状况在婚=1；非在婚=2
居住安排独居=1；非独居=2
个人月均收入<=500元=1；501~1 000元=2；>1 000元=3
健康相关行为
吸烟是=1；否=2
饮酒是=1；否=2
体育锻炼是=1；否=2
睡眠质量好=1；差=2
健康状况
慢性病是=1；否=0
BMI肥胖=1；超重=2；正常体质量=3；低体质量=4
日常活动能力实测值
抑郁状况实测值
社会与环境评估
搬迁安置方式集中安置=1；分散安置=2
社会资本得分实测值
搬迁时长实测值
因变量
是否认知功能障碍无认知功能障碍=0；有认知功能障碍=1
认知功能障碍得分实测值
), ArticleFig(id=1324078363605861364, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=EN, label=Table 2, caption=

Comparative analysis of cognitive impairment among relocated elderly with different characteristics in Shanxi Province

, figureFileSmall=null, figureFileBig=null, tableContent=
项目频数n(%)认知障碍检出率n(%)χ2P
性别男性374(50.5)76(20.3)2.1840.139
女性366(49.5)91(24.9)
年龄60~79621(83.9)125(20.1)13.143<0.001
≥80119(16.1)42(35.3)
受教育程度小学及以下530(71.6)108(20.4)5.9300.052
初中159(21.5)47(29.6)
高中及以上51(6.9)12(11.5)
婚姻状况在婚548(74.1)112(20.4)5.4820.019
非在婚192(25.9)55(28.6)
居住状况独居133(18)30(22.6)0.7130.398
共居607(82)137(22.6)
个人月均收入（元）≤500587(79.3)141(24)4.9970.082
501~1 000106(14.3)21(19.8)
>1 00047(6.4)21(10.6)
身体锻炼是559(75.5)100(17.9)28.626<0.001
否181(24.5)67(37)
睡眠质量好336(45.4)63(18.8)5.1330.023
差404(54.6)104(25.7)
吸烟是220(29.7)45(20.5)0.8000.371
否520(70.3)122(23.5)
饮酒是78(10.5)14(17.9)1.0640.302
否662(89.5)153(23.1)
慢性病是182(24.6)34(18.7)2.0860.149
否558(75.4)133(23.8)
搬迁安置方式集中安置716(96.8)163(22.8)0.4940.482
分散安置24(3.2)4(16.7)
BMI低体质量99(13.4)23(22.3)1.420.701
正常体质量357(48.2)83(23.2)
超重215(29.1)43(20.0)
肥胖69(9.3)18(26.1)
), ArticleFig(id=1324078363769439221, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=CN, label=表2, caption=

山西省不同特征易地搬迁老年人认知障碍现状比较

, figureFileSmall=null, figureFileBig=null, tableContent=
项目频数n(%)认知障碍检出率n(%)χ2P
性别男性374(50.5)76(20.3)2.1840.139
女性366(49.5)91(24.9)
年龄60~79621(83.9)125(20.1)13.143<0.001
≥80119(16.1)42(35.3)
受教育程度小学及以下530(71.6)108(20.4)5.9300.052
初中159(21.5)47(29.6)
高中及以上51(6.9)12(11.5)
婚姻状况在婚548(74.1)112(20.4)5.4820.019
非在婚192(25.9)55(28.6)
居住状况独居133(18)30(22.6)0.7130.398
共居607(82)137(22.6)
个人月均收入（元）≤500587(79.3)141(24)4.9970.082
501~1 000106(14.3)21(19.8)
>1 00047(6.4)21(10.6)
身体锻炼是559(75.5)100(17.9)28.626<0.001
否181(24.5)67(37)
睡眠质量好336(45.4)63(18.8)5.1330.023
差404(54.6)104(25.7)
吸烟是220(29.7)45(20.5)0.8000.371
否520(70.3)122(23.5)
饮酒是78(10.5)14(17.9)1.0640.302
否662(89.5)153(23.1)
慢性病是182(24.6)34(18.7)2.0860.149
否558(75.4)133(23.8)
搬迁安置方式集中安置716(96.8)163(22.8)0.4940.482
分散安置24(3.2)4(16.7)
BMI低体质量99(13.4)23(22.3)1.420.701
正常体质量357(48.2)83(23.2)
超重215(29.1)43(20.0)
肥胖69(9.3)18(26.1)
), ArticleFig(id=1324078363853325302, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=EN, label=Table 3, caption=

Goodness-of-fit indices for the linear latent growth mixture models of cognitive function among the relocated elderly population

, figureFileSmall=null, figureFileBig=null, tableContent=
类别数目LLAICBICaBICEntropyLMRBLRT类别概率
2-6 602.92913 227.85913 278.53213 243.6030.9430.020 6<0.0010.93/0.07
3-6 558.56713 145.13413 209.62813 165.1730.8800.444 7<0.0010.03/0.79/0.18
4-6 487.54013 009.08013 087.39313 033.4120.9290.010 3<0.0010.05/0.67/0.27/0.01
), ArticleFig(id=1324078363962377207, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=CN, label=表3, caption=

易地搬迁老年群体认知功能潜变量增长线性模型拟合结果

, figureFileSmall=null, figureFileBig=null, tableContent=
类别数目LLAICBICaBICEntropyLMRBLRT类别概率
2-6 602.92913 227.85913 278.53213 243.6030.9430.020 6<0.0010.93/0.07
3-6 558.56713 145.13413 209.62813 165.1730.8800.444 7<0.0010.03/0.79/0.18
4-6 487.54013 009.08013 087.39313 033.4120.9290.010 3<0.0010.05/0.67/0.27/0.01
), ArticleFig(id=1324078364042068984, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=EN, label=Table 4, caption=

Goodness-of-fit indices for the linear latent growth mixture models across cognitive domains among the relocated elderly population

, figureFileSmall=null, figureFileBig=null, tableContent=
类别数目LLAICBICaBICEntropyLMRBLRT类别概率
时间/地点定向力
2-2 445.4204 918.8394 983.3324 938.8770.9910.006 5<0.0010.90/0.10
3-2 326.2964 680.5934 745.0864 700.6310.9930.101 2<0.0010.03/0.76/0.22
4-1 816.6433 667.2863 745.5993 691.6181.0000.346 7<0.0010.76/0.08/0.02/0.14
食物命名能力
2-4 396.8788 815.7558 866.4288 831.5000.934<0.001<0.0010.18/0.82
3-4 205.4218 438.8428 503.3358 458.8800.9930.012 8<0.0010.09/0.75/0.16
4-4 008.5498 051.0988 129.4118 075.4300.999<0.001<0.0010.03/0.10/0.70/0.17
即刻记忆力
2-1 073.1972 174.3952 238.8882 194.4331.000<0.001<0.0010.91/0.90
3-528.3611 084.7231 149.2161 104.7611.0000.764 3<0.0010.02/0.03/0.95
4-270.072574.144652.457598.4761.0000.524 0<0.0010.02/0.03/0.93/0.02
注意力和计算能力
2-3 898.5397 819.0777 869.7517 834.8220.997<0.001<0.0010.19/0.81
3-3 571.4647 170.9287 235.4217 190.9661.000<0.001<0.0010.77/0.08/0.15
4-3 179.2106 402.4216 503.7676 433.9091.0000.018 9<0.0010.11/0.14/0.05/0.70
延迟记忆力
2-3 133.8766 289.7516 340.4246 305.4961.000<0.001<0.0010.23/0.77
3-2 922.9585 873.9155 938.4095 893.9540.9990.003 5<0.0010.22/0.08/0.70
4-2 821.2235 676.4455 754.7585 700.7770.999<0.001<0.0010.62/0.16/0.06/0.15
图形复制与语言能力
2-3 189.1336 400.2676 450.9406 416.0110.9950.001<0.0010.05/0.95
3-3 044.8046 117.6096 182.1026 137.6470.9690.253 4<0.0010.06/0.08/0.86
4-2 856.5805 747.1615 825.4745 771.4931.0000.199 6<0.0010.65/0.04/0.01/0.30
), ArticleFig(id=1324078364146926585, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=CN, label=表4, caption=

易地搬迁老年群体认知功能各维度潜变量增长线性模型拟合结果

, figureFileSmall=null, figureFileBig=null, tableContent=
类别数目LLAICBICaBICEntropyLMRBLRT类别概率
时间/地点定向力
2-2 445.4204 918.8394 983.3324 938.8770.9910.006 5<0.0010.90/0.10
3-2 326.2964 680.5934 745.0864 700.6310.9930.101 2<0.0010.03/0.76/0.22
4-1 816.6433 667.2863 745.5993 691.6181.0000.346 7<0.0010.76/0.08/0.02/0.14
食物命名能力
2-4 396.8788 815.7558 866.4288 831.5000.934<0.001<0.0010.18/0.82
3-4 205.4218 438.8428 503.3358 458.8800.9930.012 8<0.0010.09/0.75/0.16
4-4 008.5498 051.0988 129.4118 075.4300.999<0.001<0.0010.03/0.10/0.70/0.17
即刻记忆力
2-1 073.1972 174.3952 238.8882 194.4331.000<0.001<0.0010.91/0.90
3-528.3611 084.7231 149.2161 104.7611.0000.764 3<0.0010.02/0.03/0.95
4-270.072574.144652.457598.4761.0000.524 0<0.0010.02/0.03/0.93/0.02
注意力和计算能力
2-3 898.5397 819.0777 869.7517 834.8220.997<0.001<0.0010.19/0.81
3-3 571.4647 170.9287 235.4217 190.9661.000<0.001<0.0010.77/0.08/0.15
4-3 179.2106 402.4216 503.7676 433.9091.0000.018 9<0.0010.11/0.14/0.05/0.70
延迟记忆力
2-3 133.8766 289.7516 340.4246 305.4961.000<0.001<0.0010.23/0.77
3-2 922.9585 873.9155 938.4095 893.9540.9990.003 5<0.0010.22/0.08/0.70
4-2 821.2235 676.4455 754.7585 700.7770.999<0.001<0.0010.62/0.16/0.06/0.15
图形复制与语言能力
2-3 189.1336 400.2676 450.9406 416.0110.9950.001<0.0010.05/0.95
3-3 044.8046 117.6096 182.1026 137.6470.9690.253 4<0.0010.06/0.08/0.86
4-2 856.5805 747.1615 825.4745 771.4931.0000.199 6<0.0010.65/0.04/0.01/0.30
), ArticleFig(id=1324078364218229754, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=EN, label=Table 5, caption=

Parameter estimates for the linear latent growth models of cognitive function and its domains among the relocated elderly population

, figureFileSmall=null, figureFileBig=null, tableContent=
项目均值方差/协方差
估计值标准误估计值标准误
认知功能1类模型截距5.134a2.271
截距25.296b0.188斜率0.2001.077
斜率1.064b0.123截距与斜率-1.5621.299
2类
截距22.105b1.639
斜率-3.766b0.973
时间/地点定向力1类模型截距0.0290.056
截距4.593b0.026斜率-0.070a0.032
斜率0.107b0.018截距与斜率0.0030.034
2类
截距3.959b0.235
斜率-0.748b0.143
食物命名能力1类模型截距0.3560.359
截距5.826b0.186斜率0.0790.097
斜率-0.567b0.093截距与斜率-0.1520.180
2类
截距5.314b0.083
斜率0.818b0.042
3类
截距5.892b0.209
斜率-1.823b0.113
即刻记忆力1类模型截距0.0130.038
截距3.420b0.329斜率-0.0010.012
斜率-1.494b0.158截距与斜率0.0000.019
2类
截距2.8020.025
斜率0.0870.012
注意力和计算能力1类模型截距0.639b0.260
截距3.481b0.252斜率0.154a0.067
斜率-1.732b0.126截距与斜率-0.319a0.131
2类
截距3.683b0.235
斜率-0.0790.124
3类
截距4.103b0.063
斜率0.448b0.031
4类
截距4.344b0.255
斜率-1.373b0.133
延迟记忆力1类模型截距0.132a0.064
截距1.907b0.049斜率-0.271a0.126
斜率0.546b0.025截距与斜率-0.0630.033
2类
截距1.870b0.115
斜率-0.146a0.065
3类
截距2.275b0.115
斜率-1.132b0.058
图形复制与语言能力1类模型截距-0.650b0.208
截距6.653b0.030斜率-0.191b0.066
斜率0.0020.916截距与斜率0.385b0.100
2类
截距6.679b0.312
斜率-1.939b0.158
3类
截距3.847b0.146
斜率1.386b0.085
), ArticleFig(id=1324078364302115835, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=CN, label=表5, caption=

易地搬迁老年群体认知功能及各维度潜变量增长线性模型参数估计

, figureFileSmall=null, figureFileBig=null, tableContent=
项目均值方差/协方差
估计值标准误估计值标准误
认知功能1类模型截距5.134a2.271
截距25.296b0.188斜率0.2001.077
斜率1.064b0.123截距与斜率-1.5621.299
2类
截距22.105b1.639
斜率-3.766b0.973
时间/地点定向力1类模型截距0.0290.056
截距4.593b0.026斜率-0.070a0.032
斜率0.107b0.018截距与斜率0.0030.034
2类
截距3.959b0.235
斜率-0.748b0.143
食物命名能力1类模型截距0.3560.359
截距5.826b0.186斜率0.0790.097
斜率-0.567b0.093截距与斜率-0.1520.180
2类
截距5.314b0.083
斜率0.818b0.042
3类
截距5.892b0.209
斜率-1.823b0.113
即刻记忆力1类模型截距0.0130.038
截距3.420b0.329斜率-0.0010.012
斜率-1.494b0.158截距与斜率0.0000.019
2类
截距2.8020.025
斜率0.0870.012
注意力和计算能力1类模型截距0.639b0.260
截距3.481b0.252斜率0.154a0.067
斜率-1.732b0.126截距与斜率-0.319a0.131
2类
截距3.683b0.235
斜率-0.0790.124
3类
截距4.103b0.063
斜率0.448b0.031
4类
截距4.344b0.255
斜率-1.373b0.133
延迟记忆力1类模型截距0.132a0.064
截距1.907b0.049斜率-0.271a0.126
斜率0.546b0.025截距与斜率-0.0630.033
2类
截距1.870b0.115
斜率-0.146a0.065
3类
截距2.275b0.115
斜率-1.132b0.058
图形复制与语言能力1类模型截距-0.650b0.208
截距6.653b0.030斜率-0.191b0.066
斜率0.0020.916截距与斜率0.385b0.100
2类
截距6.679b0.312
斜率-1.939b0.158
3类
截距3.847b0.146
斜率1.386b0.085
), ArticleFig(id=1324078364386001916, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=EN, label=Table 6, caption=

Multivariate logistic regression analysis of factors influencing cognitive function trajectories among relocated elderly populations

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βSEWald χ2POR95%CI
下限上限
性别（以“男性”为参照）
女0.2020.2180.8570.3551.2240.7981.877
年龄（以“60~79岁”为参照）
≥801.0690.20626.963<0.0012.9141.9464.362
文化程度（以“高中及以上”为参照）
小学及以下0.9330.6092.3480.1252.5420.7718.388
初中0.0220.6640.0010.9731.0220.2783.756
婚姻状况（以“在婚”为参照）
非在婚0.9360.22816.902<0.0012.5511.6323.985
个人月收入（以“<500”为参照）
501~1 000-0.5190.3282.5070.1130.5950.3131.131
>1 000-0.3840.4920.6090.4350.6810.2601.786
居住安排（以“非独居”为参照）
独居-0.3690.2751.7990.1800.6910.4031.186
吸烟（以“否”为参照）
是-0.1330.2440.2990.5840.8750.5431.411
饮酒（以“否”为参照）
是-0.9090.5402.8340.0920.4030.1401.161
体育锻炼（以“是”为参照）
否0.6690.19711.5130.0011.9521.3272.873
睡眠质量（以“好”为参照）
差-0.2070.1971.1040.2930.8130.5531.196
慢性病（以“无慢性病”为参照）
有慢性病0.0070.2220.0010.9761.0070.6511.556
BMI（以“正常体质量”为参照）
肥胖0.9750.26413.607<0.0012.6521.5794.452
超重-0.3840.2791.8890.1690.6810.3941.178
低体质量0.3560.2452.1130.1461.4270.8832.306
基本活动能力总分
基本活动能力-0.3240.06524.940<0.0010.7230.6370.821
抑郁总分
抑郁0.0310.0173.2580.0711.0320.9971.067
搬迁方式（以“集中安置”为参照）
分散安置0.5760.4371.7390.1871.7790.7564.189
社会资本总分
社会资本总分-0.0080.0160.2380.6260.9920.9621.024
搬迁时长0.0550.0461.3920.2381.0560.9651.156
常量-2.4250.8607.9530.0050.088
), ArticleFig(id=1324078364482470909, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078356446184389, language=CN, label=表6, caption=

易地搬迁老年群体认知功能轨迹影响因素的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βSEWald χ2POR95%CI
下限上限
性别（以“男性”为参照）
女0.2020.2180.8570.3551.2240.7981.877
年龄（以“60~79岁”为参照）
≥801.0690.20626.963<0.0012.9141.9464.362
文化程度（以“高中及以上”为参照）
小学及以下0.9330.6092.3480.1252.5420.7718.388
初中0.0220.6640.0010.9731.0220.2783.756
婚姻状况（以“在婚”为参照）
非在婚0.9360.22816.902<0.0012.5511.6323.985
个人月收入（以“<500”为参照）
501~1 000-0.5190.3282.5070.1130.5950.3131.131
>1 000-0.3840.4920.6090.4350.6810.2601.786
居住安排（以“非独居”为参照）
独居-0.3690.2751.7990.1800.6910.4031.186
吸烟（以“否”为参照）
是-0.1330.2440.2990.5840.8750.5431.411
饮酒（以“否”为参照）
是-0.9090.5402.8340.0920.4030.1401.161
体育锻炼（以“是”为参照）
否0.6690.19711.5130.0011.9521.3272.873
睡眠质量（以“好”为参照）
差-0.2070.1971.1040.2930.8130.5531.196
慢性病（以“无慢性病”为参照）
有慢性病0.0070.2220.0010.9761.0070.6511.556
BMI（以“正常体质量”为参照）
肥胖0.9750.26413.607<0.0012.6521.5794.452
超重-0.3840.2791.8890.1690.6810.3941.178
低体质量0.3560.2452.1130.1461.4270.8832.306
基本活动能力总分
基本活动能力-0.3240.06524.940<0.0010.7230.6370.821
抑郁总分
抑郁0.0310.0173.2580.0711.0320.9971.067
搬迁方式（以“集中安置”为参照）
分散安置0.5760.4371.7390.1871.7790.7564.189
社会资本总分
社会资本总分-0.0080.0160.2380.6260.9920.9621.024
搬迁时长0.0550.0461.3920.2381.0560.9651.156
常量-2.4250.8607.9530.0050.088
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易地搬迁老年群体认知功能变化轨迹与影响因素研究——基于山西省四市八县的实证分析
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夏宏宇 , 李航 , 曹馨婧 , 杨乐 , 于琦
现代预防医学 | 基层卫生服务 2026,53(2): 280-286
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现代预防医学 |基层卫生服务 2026 , 53 (2) : 280 -286
易地搬迁老年群体认知功能变化轨迹与影响因素研究——基于山西省四市八县的实证分析
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夏宏宇, 李航, 曹馨婧, 杨乐 , 于琦
作者信息
  • 山西医科大学管理学院，山西 太原 030001
通讯作者:
杨乐，E-mail:
作者简介:

夏宏宇（2001—），女，硕士在读，研究方向：公共卫生

Study on the trajectory of cognitive function changes and influencing factors of elderly groups relocated to new areas: Based on the empirical analysis of four cities and eight counties in Shanxi Province
Hong-yu XIA, Hang LI, Xin-jing CAO, Le YANG , Qi YU
Affiliations
  • School of Management, Shanxi Medical University, Taiyuan, Shanxi 030001, China
出版时间: 2026-01-25 doi: 10.20043/j.cnki.MPM.202508287
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摘要
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目的

探究易地搬迁老年群体认知功能的动态演变轨迹及其影响因素，为搬迁后续健康干预提供参考。

方法

采用多阶段分层抽样，选取山西省四市八县24个安置点的740名老年人开展三轮追踪调查。采用潜变量增长混合模型（LGMM）识别认知轨迹类别，并通过多因素logistic回归分析影响因素。

结果

认知功能障碍检出率22.6%，认知功能得分总体呈上升趋势。LGMM识别出两类认知轨迹：“山峰型高认知功能组”和“谷底型低认知功能组”；多因素logistic回归分析显示，高龄（OR=2.914，95% CI：1.946~4.362）、非在婚（OR=2.551，95% CI：1.632~3.985）、无规律体育锻炼（OR=1.952，95% CI：1.327~2.873）和肥胖（OR=2.652，95% CI：1.579~4.452）是低认知轨迹的危险因素；基本活动能力与低认知轨迹风险呈负相关（OR=0.723，95% CI：0.637~0.821）。

结论

易地搬迁老年群体认知功能整体呈改善趋势，但高龄、非在婚、缺乏体育锻炼、肥胖及活动能力受限会显著增加认知衰退风险。建议推进早期认知筛查，增设社区体育设施，并开展以家庭为单位的社会支持。

易地搬迁  /  认知功能  /  老年人  /  轨迹识别  /  影响因素
Objective

To investigate the dynamic trajectories of cognitive function and its influencing factors among elderly populations relocated through poverty alleviation resettlement programs.

Methods

A multistage stratified sampling approach was used to select 740 elderly individuals from 24 resettlement sites across four cities and eight counties in Shanxi Province for three rounds of follow-up surveys. Latent growth mixture models (LGMM) identified cognitive trajectory categories, and multivariable logistic regression analyzed influencing factors.

Results

The prevalence of cognitive impairment was 22.6%, with an overall upward trend in cognitive scores. LGMM identified two distinct trajectories: a “Peak-high cognitive function group” and a “Valley-low cognitive function group.” Advanced age (OR=2.914, 95% CI: 1.946-4.362), non-marital status (OR=2.551, 95% CI: 1.632-3.985), lack of regular physical exercise (OR=1.952, 95% CI: 1.327-2.873), and obesity (OR=2.652, 95% CI: 1.579-4.452) were significant risk factors for the low cognitive trajectory, while better basic functional ability was a protective factor (OR=0.723, 95% CI: 0.637-0.821).

Conclusion

While cognitive function showed overall improvement in the relocated elderly population, specific risk factors significantly increased the risk of cognitive decline. Recommendations include promoting early cognitive screening, expanding community sports facilities, and implementing family-based social support programs.

Relocation  /  Cognitive Function  /  Older adults  /  Trajectory recognition  /  Influencing factors
夏宏宇, 李航, 曹馨婧, 杨乐, 于琦. 易地搬迁老年群体认知功能变化轨迹与影响因素研究——基于山西省四市八县的实证分析. 现代预防医学, 2026 , 53 (2) : 280 -286 . DOI: 10.20043/j.cnki.MPM.202508287
Hong-yu XIA, Hang LI, Xin-jing CAO, Le YANG, Qi YU. Study on the trajectory of cognitive function changes and influencing factors of elderly groups relocated to new areas: Based on the empirical analysis of four cities and eight counties in Shanxi Province[J]. Modern Preventive Medicine, 2026 , 53 (2) : 280 -286 . DOI: 10.20043/j.cnki.MPM.202508287
正文
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在人口老龄化的背景下，认知衰退与痴呆症高发形成重大公共卫生负担[1]。以往研究表明，移民搬迁是影响老年群体认知功能的关键因素之一[2-3]。我国的易地搬迁作为国家级重大民生工程，成功改善了960多万贫困人口的生活[4]。
现有研究普遍显示灾害性移民搬迁对老年认知功能有负面影响[2,5]。然而，作为政府主导、配套设施完备的迁移，易地搬迁的本质是人民对美好生活诉求的主动响应[6]，这种政策干预理论上应形成认知保护的正向循环。但搬迁过程伴随的社会网络断裂、环境适应与生活方式改变等问题，也可能带来认知衰退的风险[7]。因此，易地搬迁对老年认知的影响呈现出双重性特征：积极效应与消极效应进行着复杂的互动与交织。
本研究采用潜变量增长混合模型和多因素logistic回归分析，以揭示易地搬迁老年群体认知功能的轨迹变化与关键影响因素。旨在为易地搬迁老年群体认知功能领域的研究提供数据支持，也为具有移民搬迁经历老年群体的认知功能改善的相关政策制定和实践干预提供参考，助力健康老龄化以及易地搬迁后续健康教育与促进工作的开展。
1　对象与方法
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1.1　对象
本研究采用多阶段分层抽样，选取太原、吕梁、忻州、临汾4市（按地理位置及经济特征），每市随机抽取2县，每县抽取4个（不足则全部抽取）易地搬迁安置点，共24个安置点。第一次数据采集（T1）为2023年6月至8月，共发放问卷1 882份，回收有效问卷1 853份；第二次数据采集（T2）为2024年3月至4月，647人因失访（包括死亡、外出、拒绝参与等）未参与问卷的填写，获得有效问卷1 206份；第三次数据采集（T3）为2024年11月，908人因失访未参与问卷的填写，获得有效问卷945份。最终，依据本论文的研究内容与研究目的，三次问卷调查均完成的有效被试者共740人。纳入标准：年龄≥60岁、属易地搬迁人群、具备理解与应答能力，并自愿签署知情同意书；排除标准：身体状况不适合参与调查或应答呈现明显规律性。
采用自行设计的问卷，部分变量基于成熟量表进行测量，由经过统一培训的调查员进行面对面访问填写。调查过程使用统一指导语，向老年人说明调查目的、意义及填写方法。受访者可根据意愿自行填写或由调查人员协助填写，问卷当场收回，如有错漏及时更正。本研究经山西医科大学伦理委员会审批（批号：2022GLL012），所有受访者均签署知情同意书。
1.2　研究方法
问卷内容基于前期研究，并结合易地搬迁政策及人群特点，涵盖性别、年龄、身高、体重、文化程度、婚姻状况、个人月收入、吸烟饮酒情况、体育锻炼、睡眠时间、认知功能、日常活动能力、社会资本水平、搬迁安置方式及搬迁时长等方面。受访老年人认知功能状况采用中文版简易精神状态筛查量表(Chinese Version of the Mini-mental State Examination，CMMSE)进行评估；抑郁状况采用10条目流行病学中心抑郁量表（CESD-10）评估；日常活动能力采用Katz指数（Katz Index of Activities of Daily Living）进行评估；社会资本采用课题组自行研制的《易地搬迁老年人社会资本量表》进行评估。问卷内容效度分析显示，量表各条目的内容效度指数（I-CVI）为 0.800~1.000，量表水平的内容效度指数（S-CVI/Ave）为 0.953，表明量表内容具有良好的相关性；信度分析结果显示，总量表的 Cronbach α系数为 0.926，分半信度系数为 0.660，表明量表具有较好的内部一致性。
本研究纳入相关变量赋值情况如表1。婚姻状况中非在婚包括离异、丧偶和未婚；睡眠质量根据变量分布情况，进一步划分为好（包括“比较好”和“非常好”）和不好（包括“非常差”“比较差”“一般”）；BMI采用受访对象自我报告身高和体质量计算，BMI<18.5 kg/m2 为低体质量，18.5~23.9 kg/m2为正常体质量，24.0~27.9 kg/m2为超重，≥28.0 kg/m2为肥胖；是否认知功能障碍根据受教育程度，小学及以下组>22分为无认知障碍；初中/中专及以上组>26分为无认知障碍。
1.3　统计方法
所有分析基于完成三轮调查的740名受访者，采用SPSS 27.0与Stata 17.0软件进行数据处理与统计分析。计量资料以均数±标准差表示，组间比较采用单因素方差分析或独立样本t检验；计数资料以频数与百分比（%）描述，组间比较采用χ2检验。采用二元logistic回归分析认知功能轨迹的影响因素，使用Enter法将所有自变量一次性纳入模型，检验水准α设定为0.05。
采用Mplus 8.3软件构建潜变量增长混合模型，识别易地搬迁老年人认知功能的潜在异质性轨迹。LGMM在传统潜变量增长模型基础上引入类别潜变量，可识别数据中未被观测的异质性亚群及其发展轨迹[8-9]。模型筛选依据以下标准：似然比检验（LMR与BLRT）需显著（P <0.05）；在此基础上，结合 AIC、BIC、aBIC（数值越小拟合越好）及Entropy（>0.60表明分类准确性较高）等指标综合判断[10-11]；同时，为保障模型实际意义，各类别概率均需大于5%[12]。该流程旨在平衡模型拟合优度与分类实效性，避免过度拟合。相较于传统增长模型，LGMM能够有效捕捉纵向数据中存在的异质亚群及其动态演变规律。本研究通过该方法系统揭示易地搬迁老年群体认知功能的多样轨迹模式，为实施精准化健康干预提供依据。
2　结果
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2.1　基本状况
本研究共纳入740名易地搬迁老年人。单因素分析显示，年龄、婚姻状况、体育锻炼和睡眠质量在认知障碍组间差异中具有统计学意义（P<0.05）。
2.2　认知功能轨迹特征
本文先后拟合2、3、4个潜在亚类的线性潜类别增长模型（LGMM），以探索易地搬迁老年人认知功能的异质性。结果显示，4类模型的LL、AIC、BIC、aBIC值均低于2类和3类模型，但最小一类的占比仅为1%，可能存在过拟合风险。3类模型的Entropy值（0.880）低于2类（0.943）和4类（0.929），且LMR检验不显著（P=0.444 7），分类优势有限。2类模型在信息准则（AIC=13 227.859, BIC=13 278.532）和Entropy（0.943）上表现均衡，LMR（P=0.020 6）与BLRT（P<0.001）均显著，统计性能更优。结合类别概率分布的合理性（0.93/0.07），最终确定2个潜在亚类为最优模型，拟合结果见表3。
认知功能各维度的轨迹分析显示，最优模型类别因维度而异：时间/地点定向力和即刻记忆力为2类最优；食物命名、延迟记忆力、图形复制与语言能力为3类最优；注意力和计算能力则为4类最优。结果详见表4。
认知功能总分及各维度轨迹呈现显著的群体异质性和个体差异。认知功能总分分为两个亚类：93%初始较低，先降后升（第三次高于第一次）；7%初始较高，先升后降，总体上升（差异均显著）。时间/地点定向力90%初始较低，先降后升，总体上升。食物命名能力分三类：75%先降后升、16%初始高且缓升、9%初始低且先升后降；75%群体第三次优于第一次。即刻记忆力91%初始高且稳定，9%初始低且先升后平。注意力和计算能力分四类：70%初始高且先降后升，11%和14%初始高且先升后降，5%初始低且先降后稳；70%群体第三次优于第一次。延迟记忆力分三类初始相近：70%先降后升，22%和8%分别先降后升或先升后降；70%第三次优于第一次。图形复制与语言能力86%初始高且先升后降，第三次与第一次持平；6%和8%分别先降后升和先升后降。
2.3　认知功能轨迹的影响因素分析
本研究将认知功能轨迹分为“山峰型高认知功能组”（赋值=1）和“谷底型低认知功能组”（赋值=2）作为因变量。山峰型高认知功能组截距显著更高（β=25.296, SE=0.188, P<0.01），斜率为正（β=1.064, SE=0.123,P<0.01）；谷底型低认知功能组截距显著较低（β=22.105, SE=1.639, P<0.01），斜率为负（β=-3.766, SE=0.973, P<0.01）。多重共线性诊断显示VIF为1.008~1.633，容忍度为0.612~0.992，这表明模型中自变量之间不存在严重的多重共线性问题。
logistic 回归结果显示，高龄（OR=2.914, 95% CI:1.946~4.362）、非在婚（OR=2.551, 95% CI:1.632~3.985）、无体育锻炼（OR=1.952, 95% CI:1.327~2.873）和肥胖（OR=2.652, 95% CI:1.579~4.452）是低功能组的危险因素，而基本活动能力得分高为保护因素（OR=0.723, 95% CI:0.637~0.821）。详见表6。
3　讨论
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本研究基于三轮追踪调查，揭示了易地搬迁老年群体认知功能的异质性变化轨迹及其影响因素。结果显示，该群体认知功能障碍检出率为 22.6%，略高于一般老年人[13]。潜类别增长模型识别出“山峰型高认知功能组”与“谷底型低认知功能组”两类轨迹，整体呈上升趋势，提示搬迁可能对认知功能有积极影响。各认知维度变化不一：时间/地点定向力提升明显，而图形复制与语言能力则呈现先升后降趋势，反映搬迁环境与自然老化对不同认知功能的差异化影响。
研究结果显示，高龄（OR=2.914）、非在婚（OR=2.551）、缺乏规律体育锻炼（OR=1.952）和肥胖（OR=2.652）是低认知轨迹的危险因素，而基本活动能力（OR=0.723）为其保护因素。具体而言，与60~79岁人群相比，80岁及以上老年人的认知功能显著下降，说明年龄增长尤其是进入高龄阶段后，认知衰退风险显著升高，可能与神经退行性病变加速有关[14]。在婚状态作为认知保护因素，可能通过配偶情感支持与家庭互动延缓认知衰退进程[15]，凸显社会关系网络在维护老年认知健康中的重要作用。肥胖对认知功能的负面影响与既往研究一致，其可能通过影响记忆、注意力和信息处理速度等高级认知功能加剧认知下降[16]，提示在易地搬迁老年群体中应重视体重管理，结合营养指导与体育锻炼以降低认知风险。缺乏体育锻炼作为痴呆的明确危险因素[17-18]，在本研究中再次得到验证，规律运动对认知保护具有普遍意义。此外，基本活动能力作为保护因素，可能通过维持日常生活功能独立性促进神经激活，从而有助于认知功能的维持[19]。
本研究结果表明，针对易地搬迁老年群体的认知功能后续政策，需加强对特定高风险人群的精准扶持。建议重点开展对高龄、低教育水平等群体的早期认知筛查，在集中安置社区增设体育设施，鼓励规律锻炼，同时，应推动以婚姻和家庭为单位的社会支持干预，以提升整体干预措施的针对性和有效性。然而，研究存在一定的局限性：三次追踪调查的时间跨度可能不足以捕捉认知功能的长期演变规律，且未控制搬迁前基线认知水平的潜在混杂效应。建议后续研究进一步深化对长期干预效果的探索。
基金
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  • 国家自然科学基金青年基金项目(72204152)
  • 2020年度山西医科大学博士启动基金项目(XD2042)
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2026年第53卷第2期
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doi: 10.20043/j.cnki.MPM.202508287
  • 接收时间：2025-08-20
  • 首发时间：2026-11-02
  • 出版时间：2026-01-25
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  • 收稿日期：2025-08-20
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国家自然科学基金青年基金项目(72204152)
2020年度山西医科大学博士启动基金项目(XD2042)
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    山西医科大学管理学院，山西 太原 030001

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
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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