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目的：探讨2015年至2023年间厦门市仙岳医院住院痴呆患者日常生活活动能力（ADL）轨迹的潜在类别及其影响因素。方法：收集该医院2015至2023年住院痴呆患者在院期间的Barthel量表数据、社会人口学及相关临床特征，采用潜在类别分析模型拟合Barthel量表数据以识别痴呆患者ADL的发展轨迹，并利用多因素Logistic分析探索社会人口学和临床特征对患者ADL轨迹的影响。结果：共纳入188例住院痴呆患者，当ADL轨迹被分为两个类别时，潜在类别分析模型的拟合效果最佳，根据轨迹特征分别命名为高基线迟发性加速衰退组（103例，54.8%）和中基线早发性缓进衰退组（85例，45.2%）。婚姻状况、居住地、职业类型、痴呆类型和是否患有糖尿病在类别间分布具有差异（均P<0.05）。进行Logistic分析后，发现非变性病痴呆患者（OR=0.387,95%CI:0.192～0.782）及不合并糖尿病的痴呆患者（OR=0.290,95%CI:0.100～0.844）处于高基线迟发性加速衰退组的可能性更高。结论：高基线迟发性加速衰退组和中基线早发性缓进衰退组的痴呆患者具有异质性，变性病痴呆患者和痴呆合并糖尿病者整体ADL水平较低，呈早发性衰退现象。
Abstract：Objective:To explore the latent classes of the trajectory of activities of daily living(ADL)in hospitalized patients with dementia and identify the influencing factors.Methods:Data on ADL measurements during hospitalization for patients with dementia from a tertiary psychiatric hospital between 2015 and 2023 were collected.Latent class analysis(LCA)was employed to fit Barthel index data for identifying the developmental trajectories of ADL in dementia patients,and multivariate logistic regression analysis was conducted to explore the effects of sociodemographic and clinical characteristics.Results:A total of 188 hospitalized dementia patients were enrolled in this study. The LCA model yielded the optimal fit when the ADL trajectories were classified into two subgroups,which were named according to their characteristics as the high-baseline delayed accelerated decline group(103 cases,54.8%)and the moderate-baseline early-onset gradual decline group(85 cases,45.2%). Significant differences were observed between the two groups in marital status,place of residence,occupation type,type of dementia,and the presence of diabetes(all P<0.05). Further logistic regression analysis revealed that patients with non-degenerative dementia(OR=0.387,95%CI:0.192 – 0.782)and those without comorbid diabetes(OR=0.290,95%CI:0.100 –0.844) had a higher probability of being classified into the high-baseline delayed accelerated decline group.Conclusions:Dementia patients in the high-baseline delayed accelerated decline group and the moderate-baseline early-onset gradual decline group had significant heterogeneity. Patients with degenerative dementia and those with dementia complicated by diabetes mellitus presented with lower ADL levels and manifested an early-onset decline pattern.
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基本信息:
中图分类号:R749.1
引用信息:
[1]薛计慧.住院痴呆患者日常生活活动能力轨迹的潜在类别分析[J].广州医科大学学报,2026,54(01):16-22.
基金信息:
厦门市自然科学基金项目(3502Z202372102)
2026-02-03
2026-02-03