张玉燕,左小芹

近年来，衰弱和认知功能障碍对老年慢性病患者的影响日益突出而逐渐受到临床医生和健康工作者的重视。在合并慢性阻塞性肺疾病的患者中，衰弱和认知功能障碍的现象更为普遍。衰弱和认知功能障碍与慢性阻塞性肺疾病的不良结局密切相关，并且衰弱和认知功能障碍的诊断和干预可以使慢性阻塞性肺疾病患者在综合管理中获益。因此，本综述主要论述慢性阻塞性肺疾病患者的常用衰弱和认知功能障碍评估工具及干预措施，以供临床医生参考。

慢性阻塞性肺疾病；衰弱；认知功能障碍

[1] VAN KAN G A,ROLLAND Y,BERGMAN H,等.The I.A.N.A.task force on frailty assessment of older people in clinical practice [J/OL].The Journal of nutrition,health and aging,2008,12(1):29-37. [2] VOGELMEIER C F,CRINER G J,MARTINEZ F J,等.Global Strategy for the Diagnosis,Management,and Prevention of Chronic Obstructive Lung Disease 2017 Report.GOLD Executive Summary[J/OL].American Journal of Respiratory and Critical Care Medicine, 2017,195(5):557-582. [3] MADDOCKS M,KON S S C,CANAVAN J L,等.Physical frailty and pulmonary rehabilitation in COPD:a prospective cohort study[J/OL].Thorax,2016,71(11):988-995. [4] MORLEY J E,MALMSTROM T K,MILLER D K.A simple frailty questionnaire(FRAIL)predicts outcomes in middle aged african americans[J/OL].Journal of Nutrition,Health&Aging,2012,16(7):601-608. [5] 万莹,申雪花.老年患者衰弱评估的研究进展[J].中国老年学杂志,2024(17):4349-4351. [6] DENT E,KOWAL P,HOOGENDIJK E O.Frailty measurement in research and clinical practice:A review[J/OL].European Journal of Internal Medicine,2016,31:3-10. [7] THEOU O,STATHOKOSTAS L,ROLAND K P,等.The effectiveness of exercise interventions for the management of frailty:a systematic review[J/OL].Journal of Aging Research,2011,2011:569194. [8] MORLEY J E,VELLAS B,VAN KAN G A,等.Frailty consensus:a call to action[J/OL].Journal of the American Medical Directors Association,2013,14(6):392-397. [9] APÓSTOLO J,COOKE R,BOBROWICZ-CAMPOS E,等.Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults:a systematic review[J/OL].JBI database of systematic reviews and implementation reports,2018,16(1):140-232. [10] 脑认知健康管理中国专家共识(2023) [11] PIKE K E,CAVUOTO M G,LI L,等.Subjective Cognitive Decline:Level of Risk for Future Dementia and Mild Cognitive Impairment,a Meta-Analysis of Longitudinal Studies[J/OL].Neuropsychology Review,2022,32(4):703-735. [12] SINGH B,PARSAIK A K,MIELKE M M,等.Chronic obstructive pulmonary disease and association with mild cognitive impairment:the mayo clinic study of aging[J/OL].Mayo Clinic Proceedings,2013,88(11):1222-1230. [13] 冯爱芳,王亮,李静,等.慢性阻塞性肺病诱导轻度认知功能障碍的回顾性队列研究[J].西安交通大学学报(医学版), 2016,37(6):867-871. [14] 常潇丹,黄丹辉,蔡绍曦.慢性阻塞性肺疾病合并症——认知障碍[J].中国临床新医学,2021,14(4):333-339. [15] FOLSTEIN M F,FOLSTEIN S E,MCHUGH P R.“mini-mental state”.A practical method for grading the cognitive state of patients for the clinician[J/OL].Journal of Psychiatric Research,1975,12(3):189-198. [16] 周源源,唐永刚,杨文,等.MMSE与CDR检测社区老年人认知障碍的有效性比较[J/OL].华夏医学,2024(5):76-81. [17] NASREDDINE Z S,PHILLIPS N A,BÉDIRIAN V,等.The montreal cognitive assessment,MoCA:a brief screening tool for mild cognitive impairment[J/OL].Journal of the American Geriatrics Society,2005,53(4):695-699. [18] 黄菲芸,王艳红,李娟娟,等.蒙特利尔认知评估量表在中国中老年人群筛查轻度认知功能障碍中的截断值的系统评价[J].中国循证医学杂志,2017,17(4):450-457. [19] VANFLETEREN L E,BEGHE B,ANDERSSON A,等.Multimorbidity in COPD,does sleep matter?[J/OL].European Journal of Internal Medicine,2020,73:7-15. [20] 陈树珍.稳定期慢性阻塞性肺疾病患者认知功能水平和影响因素分析及护理干预措施[J].护理实践与研究,2019(20):57-59. [21] GE Y L,LIU C H,FU A S,等.[correlation study between the levels of serum MCP-1,SAA and cognitive function in patients with COPD-OSAHS][J/OL].Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi=Journal of Clinical Otorhinolaryngology Head and Neck Surgery,2018,32(7):485-488. [22] MAASS A,DÜZEL S,BRIGADSKI T,等.Relationships of peripheral IGF-1,VEGF and BDNF levels to exercise-related changes in memory,hippocampal perfusion and volumes in older adults[J/OL].Neuroimage,2016,131:142-154. [23] 李玲玲,董通,郝淑云,等.不同运动方式对老年认知障碍患者干预效果的网状Meta分析[J].上海护理,2025,25(2):46-52. [24] 周香莲,周媛媛,王丽娜,等.老年性轻度认知功能障碍患者运动干预策略的研究进展[J].中国全科医学,2018,21(12):1408-1412.

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