A Study On The Frailty Status And Clinical Characteristics Between The Patients With Different Tcm Syndromes Of Mild Cognitive Impairment

Objective:The purpose of this study is to explore the prevalence of frailty and the characteristics of various frailty indicators in elderly patients with mild cognitive impairment(MCI),and to provide evidence for the relationship between frailty and cognitive impairment in elderly patients;and to study the distribution characteristics of TCM syndromes in elderly patients with MCI,the incidence of frailty of different TCM syndromes and the characteristics of various debilitating indicators,to provide clinical evidence for further research on the prevention and treatment strategies of cognitive frailty with different TCM syndromes of MCI.Methods:444 patients(aged≥60)years to the Geriatrics Department of the Hubei Provincial Hospital of Traditional Chinese Medicine were selected in case-control study from November 2018 to December 2019,and the patients were evaluated by professional doctors and researchers for TCM dialectics,cognitive function and frailty.Collected the general clinical data of all subjects,and used the Mini-mental State Examination(MMSE)scale for cognitive function assessment,used the Fried Frailty Phenotype(FP)to assess the frailty status and the Short Physical Performance Battery(SPPB),Short-Form Mini Nutritional Assessment(MNA-SF)to assess physical fitness and overall nutritional status.According to whether they meet the diagnosis and acceptance criteria for MCI,they were divided into MCI group(n=97)and normal cognitive function group(n=347).Through the application of TCM syndrome diagnostic criteria and the determination of TCM syndrome types in the diagnostic scale of clinical research guidelines for mild cognitive impairment(draft)for 97 MCI subjects,to investigate the occurrence and characteristics of frailty in patients with different TCM syndromes of MCI.Results:1.There were no statistically significant differences between the MCI group and the normal cognitive function group in gender compo-sition,education level,marital status,BMI value,smoking history,alcohol consumption history,visual loss,empty nest,fall history in the past year,cumulative total disease score,comorbidities,multiple medication,GDS-15 score,and depression status(P>0.05);but two groups had significant differences in terms of age,MMSE scores,hearing impairment,postural hypotension,PSQI score(P<0.05).A further binary Logistic regression model showed that age(P=0.030,95%CI:1.006,1.112)and MMSE core(P<0.001,95%CI:0.520,0.653)were independent risk factors for MCI.2.There was no statistically significant difference in activity ability between the MCI group and the normal cognitive function group(P>0.05).The total MNA-SF score of MCI patients was lower than that of the normal cognitive function group(P<0.01),and the diffe-rence in nutritional status was statistically significant(P<0.01).3.The difference of frailty between the MCI group and the normal cognitive function group was statistically significant(P<0.05),and the occurrence of MCI was also associated with decreased step speed(P<0.01)or decreased grip strength(P<0.001)in the frailty phenotype,a further binary Logistic regression model sho-wed that the presence of reduced grip strength was an independent risk factor for MCI(P=0.002,95%CI:0.234,0.713).In the assessment of cognitive function,orientation(P<0.01)and language function(P<0.05)have a certain correlation with the occurrence of frailty.4.In this study,there were 49 cases(50.5%)of spleen and kidney deficiency syndrome in the MCI group,20 cases(20.6%)of qi-blood deficiency,17 cases(17.5%)of phlegm-turbidity and obo-qiao syn-drome,6 cases(6.2%)of blood-stasis brain collatusion syndrome,5 cases(5.2%)of Yin deficiency and Yang hyperactivity.5.There are statistically significant differences in the MNA-SF score(P<0.05)and FP score(P<0.001)of different TCM syndrome types of MCI;The difference of frailty between the different TCM syndrome types of MCI was statistically significant(P<0.001);in each sub-item of FP,there is a statistically significant difference between the different TCM syndrome types of MCI whether there is a decrease in pace(P<0.01)and whether there is a decrease in activity level(P<0.01).