The Elderly People With MCI In The Community Of Jinhua:Cross-sectional Study And Intervention Study

Objective:To investigate prevalence and the related factors of MCI among elderly people dwelling in the community of Jinhua. To develop the community interventions of MCI which includes cognitive intervention, exercise, psychological and social support by group education and individual instruction, and to explore the effect of community interventions on cognitive function of elderly with MCI and their quality of life.Method:This research project was carried on by two stages.The First Stage:In the cross-sectional study,916elderly people were recuited by Multistage cluster random sampling, and interviewed through questionnaires including Montreal cognitive assessment scale (MoCA), daily living skills scale (ADL) and self-designed questionnaire.154elderly people who were diagnosised MCI were interviewed by MCI related knowledge questionnaire and Quality of Life in Alzheimer’s Disease (QOL-AD).The Second Stage:90elderly people from the first stage who met the inclusion criteria were randomly assigned into ether the intervention group or the control group. In term of population sociology, disease conditions, cognitive level and quality of life, there were no significant differences between the two groups (P>0.05). Subjects of the intervention group received2collective education sessions and individual instructions (eg:telephone consultation). Two groups were evaluated by MCI related knowledge, daily living skills, cognitive function and quality of life before intervention, at1,3and6months after intervention.Results:The First Stage:①the prevalence and distribution of MCI among elderly people in Jinhua community:the prevalence of MCI was17.2%. In multiple logistic models, gender, educational level, the past professional, marital status, living conditions, economic status were related factors for MCI besides age (P<0.05).②logistic regression showed that age, education level, drinking tea, sleep, social activity and study were independent influencing factors of MCI.③the knowledge of MCI was lower among elderly MCI patients.The mean of disease knowledge score was5.51, and standard deviation was2.99. The rank of3subscale based on scores from low to high was risk factors dimension, disease knowledge dimension, and prevention and treatment dimension.In multiple regression model. educational level, learning habit, cognitive function were related factors of depression levels of elderly patients with MCI (F=69.276,P<0.001).④the score of the quality of life of MCI patients was39.49±7.935. In multiple regression models, economic conditions, ADL, MOCA was related factor of knowledge level except age (F=13.810, P<0.001).economic situation, cognitive function and daily activities were influence factors of the QOL of the patients with MCI.The Second Stage:①The repeated measures ANOVA showed that the scores of the cognitive function (MOCA), and delayed memory, attention, fluency and directional force demensions existed the interaction effect between time factor and group factor (P<0.001). As was indicated by multivariate ANOVA, the scores of MOCA and all demensions were not significantly different between intervention group and control goup before intervention (P>0.05). Executive ability、naming and abstract thinking dimensions were no significant difference between intervention group and control goup at1,3and6month after interventions (P>0.05). At the first month after intervention, the difference on the score of MOCA and scores of delayed memory, attention, fluency and directional force dimensions between two groups were not statistically significant (P>0.05), however, at3and6month after intervention, the total score of MOCA and scores of four dimensions in intervention group were significantly higher than those in the control group (P<0.01～0.001).②The repeated measures ANOVA showed that the scores of ADL existed the interaction effect between time factor and group factor (P<0.001).As was indicated by multivariate ANOVA. the ADL score were no significantly difference between the intervention group and the control goup at1,3month after intervention (P>0.05), but the intervention group were lower compared with the control goup at6month after intervention (P<0.001).③The repeated measures ANOVA showed that the total score of knowledge and scores of basic knowledge, risk factors, prevention and treatment t existed interaction effect between time factor and group factor (P<0.001).As was indicated by multivariate ANOVA.the scores of disease knowledge between the intervention group and the control group in baseline was no significant difference (P>0.05). However, there were significantly different between two groups at1,3and6month after intervention (P<0.001).④The repeated measures ANOVA showed that he score of QOL-AD existed the interaction effect between time factor and group factor (P<0.001),As was indicated by multivariate ANOVA, the score of QOL-AD were no significantly different at baseline (P>0.05), the score of QOL-AD of intervention group was higher than those of the control group at1,3and6month after intervention (P<0.01-0.001)Conclusion:MCI has become a common disease among elderly people in Jinhua community. It is harmful to the ADL, mental health and QOL. The community people have little knowledge about MCI. A community intervention which including group education and individual instruction was effective approach to improve cognitive function, ADL, mental health and QOL of old MCI patients dwelling in the community.