Risk Factors and Protective Factors for the Progression of Mild Cognitive Impairment Towards Dementia

doi:10.12114/j.issn.1007-9572.2018.33.022

Abstract

Abstract: As the aging of the community population has progressed，the prevalence of dementia has increased every year.Because of the poor treatment efficacy for dementia in the middle and late stages，early recognition of cognitive dysfunction has become a focus of research in the field of gerontology.Previous studies on the causes of cognitive dysfunction have primarily focused on mild cognitive impairment （MCI） or dementia.This article focuses on the progression of MCI towards dementia and explores possible cognitive risks and protective factors in the advanced stages，to provide strategies to prevent or slow the progression of cognitive disorders.

Key words: Mild cognitive impairment, Dementia, Risk factors, Protective factors

摘要： 随着社会人口老龄化的进展，痴呆的患病率逐年增加。由于痴呆中晚期治疗效果欠佳，早期识别认知功能障碍已成为老年医学领域研究的焦点。既往认知功能障碍归因学研究多集中于轻度认知功能障碍（MCI）阶段或痴呆阶段，本文聚焦MCI向痴呆进展阶段，探索进展期可能的认知功能危险性因素及其保护性因素，以期为阻止或减缓认知功能障碍的进展提供公共预防策略。

关键词: 轻度认知障碍, 痴呆, 危险因素, 保护因素

ZHOU Yuanyuan,ZHOU Xianglian,WANG Jie, et al. Risk Factors and Protective Factors for the Progression of Mild Cognitive Impairment Towards Dementia[J]. Chinese General Practice, 2018, 21(33): 4149-4156. DOI: 10.12114/j.issn.1007-9572.2018.33.022.
周媛媛,周香莲,王杰等. 轻度认知功能障碍向痴呆进展的危险因素及保护因素研究[J]. 中国全科医学, 2018, 21(33): 4149-4156. DOI: 10.12114/j.issn.1007-9572.2018.33.022.

References

［1］Global Age Watch Index 2015［EB/OL］．（2015-09-09）［2017-09-06］．http：//www.helpage.org/newsroom/latest-news/page=4.
［2］民政部门户网站.2016年社会服务发展统计公报［EB/OL］．（2017-08-03）［2017-09-14］．http：//www.mca.gov.cn/article/sj/tjgb/201708/20170800005382.shtml.
［3］MARIANI E，MONASTERO R，MECOCCI P.Mild cognitive impairment：a systematic review［J］．J Alzheimers Dis，2007，12（1）：23-35.
［4］GROTHE M，HEINSEN H，TEIPEL S J.Atrophy of the cholinergic Basal forebrain over the adult age range and in early stages of Alzheimer's disease［J］．Biol Psychiatry，2012，71（9）：805-813．DOI：10.1016/j.biopsych.2011.06.019.
［5］SU X，SHANG L，XU Q，et al．Prevalence and predictors of mild cognitive impairment in Xi'an：a community-based study among the elders［J］．PLoS One，2014，9（1）：e83217．DOI：10.1371/journal.pone.0083217.
［6］WARD A，TARDIFF S，DYE C，et al．Rate of conversion from prodromal Alzheimer's disease to Alzheimer's dementia：a systematic review of the literature［J］．Dement Geriatr Cogn Dis Extra，2013，3（1）：320-332．DOI：10.1159/000354370.
［7］王鲁宁.老年人轻度认知功能障碍的研究进展［J］．中华老年医学杂志，2005，24（1）：6-8.
WANG L N.Research progress on mild cognitive impairment in the elderly［J］．Chinese Journal of Geriatrics，2005，24（1）：6-8.
［8］ROBERTS R，KNOPMAN D S.Classification and epidemiology of MCI［J］．Clin Geriatr Med，2013，29（4）：753-772．DOI：10.1016/j.cger.2013.07.003.
［9］WOOD H.Alzheimer disease：Meta-analysis finds high reversion rate from MCI to normal cognition［J］．Nat Rev Neurol，2016，12（4）：189．DOI：10.1038/nrneurol.2016.29.
［10］侯俊林，詹向红，闫国立，等．轻度认知障碍筛查方案研究进展［J］．中国老年学杂志，2013，33（10）：2464-2466．DOI：10.3969/j.issn.1005-9202.2013.10.129.
HOU J L，ZHAN X H，YAN G L，et al．Progress in screening programme for mild cognitive impairment ［J］．Chinese Journal of Gerontology，2013，33（10）：2464-2466．DOI：10.3969/j.issn.1005-9202.2013.10.129.
［11］尹昌浩，郭艳芹.轻度认知障碍的研究进展［J］．医学研究生学报，2012，25（9）：977-980．DOI：10.3969/j.issn.1008-8199.2012.09.021.
YIN C H，GUO Y Q.Progress of the research on mild cognitive impairment［J］．Journal of Medical Postgraduates，2012，25（9）：977-980．DOI：10.3969/j.issn.1008-8199.2012.09.021.
［12］MALEK-AHMADI M.Reversion from mild cognitive impairment to normal cognition：a meta-analysis ［J］．Alzheimer Dis Assoc Disord，2016，30（4）：324-330．DOI：10.1097/WAD.0000000000000145.
［13］PETERSEN R C.Mild cognitive impairment as a diagnostic entity［J］．J Intern Med，2004，256（3）：183-194．DOI：10.1111/j.1365-2796.2004.01388.x.
［14］WINBLAD B，PALMER K，KIVIPELTO M，et al．Mild cognitive impairment-beyond controversies，towards a consensus：report of the International Working Group on Mild Cognitive Impairment［J］．J Intern Med，2004，256（3）：240-246．DOI：10.1111/j.1365-2796.2004.01380x.
［15］ALBERT M S，DEKOSKY S T，DICKSON D，et al．The diagnosis of mild cognitive impairment due to Alzheimer's disease：recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease［J］．Alzheimers Dement，2011，7（3）：270-279．DOI：10.1016/j.jalz.2011.03.008.
［16］American Psychiatric Association.Diagnostic and statistical manual of mental disorders［M］．Washington DC：2013.
［17］PETERSEN R C，AISEN P S，BECKETT L A，et al．Alzheimer's Disease Neuroimaging Initiative （ADNI）：clinical characterization ［J］．Neurology，2010，74（3）：201-209．DOI：10.1212/WNL.0b013e3181cb3e25.
［18］PETERSEN R C，SMITH G E，WARING S C，et al．Mild cognitive impairment：clinical Characterization and outcome［J］．Arch Neurol，1999，56（3）：303-308．DOI：10.1001/archneur.56.3.303.
［19］PETERSEN R C，MORRIS J C.Mild Cognitive impairment as a clinical entity and treatment target ［J］．Arch Neurol，2005，62（7）：1160-1163．DOI：10.1001/archneur.62.7.1160.
［20］方创琳，刘海燕.快速城市化进程中的区域剥夺行为与调控路径［J］．地理学报，2007，62（8）：849-860．DOI：10.3321/j.issn：0375-5444.2007.08.007.
FANG C L，LIU H Y.the spatial privation and the corresponding controlling paths in China's urbanization process［J］．Acta Geographica Sinica，2007，62（8）：849-860．DOI：10.3321/j.issn：0375-5444.2007.08.007.
［21］陈敦鹏，叶阳.促进土地混合使用的思路与方法研究——以深圳为例［C］//中国城市规划年会，2011.
CHEN D P，YE Y.Research on the ways and means of promoting the use of land——taking Shenzhen as an example ［C］//Annual Conference of China Urban Planning，2011.
［22］焦春宝.河西区未来绿化空间分析［D］．天津：天津大学，2012.
JIAO C B.The analysis of future landscape space in Hexi district［D］．Tianjin：Tianjin University，2012.
［23］安思敏.基于数据挖掘的社区犯罪率分析与预测研究［D］．北京：北京交通大学，2017.
AN S M.Analysis and prediction of community crime rate based on data mining［D］．Beijing：Beijing Jiaotong University，2017.
［24］BASTA N E，MATTHEWS F E，CHATFIELD M D，et al．Community-level socio-economic status and cognitive and functional impairment in the older population［J］．Eur J Public Health，2008，18（1）：48-54．DOI：10.1093/eurpub/ckm076.
［25］NIE H，XU Y，LIU B，et al．The prevalence of mild cognitive impairment about elderly population in China：a meta-analysis［J］．Int J Geriatr Psychiatry，2011，26（6）：558-563．DOI：10.1002/gps.2579.
［26］WU Y T，PRINA A M，JONES A P，et al．Community environment，cognitive impairment and dementia in later life：results from the Cognitive Function and Ageing Study［J］．Age Ageing，2015，44（6）：1005-1011．DOI：10.1093/ageing/afv137.
［27］CASSARINO M，O'SULLIVAN V，KENNY R A，et al．Environment and cognitive aging：a cross-sectional study of place of residence and cognitive performance in the Irish longitudinal study on aging ［J］．Neuropsychology，2016，30（5）：543-557．DOI：10.1037/neu0000253.
［28］WU Y T，PRINA A M，JONES A，et al．The built environment and cognitive disorders：results from the cognitive function and ageing study Ⅱ［J］．Am J Prev Med，2017，53（1）：25-32．DOI：10.1016/j.amepre.2016.11.020.
［29］BLAIR A，ROSS N A，GARIEPY G，et al．How do neighborhoods affect depression outcomes? A realist review and a call for the examination of causal pathways［J］．Soc Psychiatry Psychiatr Epidemiol，2014，49（6）：873-887．DOI：10.1007/s00127-013-0810-z.
［30］SACHDEV P S，LIPNICKI D M，CRAWFORD J，et al．Risk profiles for mild cognitive impairment vary by age and sex：the Sydney Memory and Ageing study［J］．Am J Geriatr Psychiatry，2012，20（10）：854-865．DOI：10.1097/JGP.0b013e31825461b0.
［31］WARD A，ARRIGHI H M，MICHELS S，et al．Mild cognitive impairment：disparity of incidence and prevalence estimates［J］．Alzheimers Dement，2012，8（1）：14-21．DOI：10.1016/j.jalz.2011.01.002.
［32］UNVERZAGT F W，OGUNNIYI A，TALER V，et al．Incidence and risk factors for cognitive impairment no dementia and mild cognitive impairment in African Americans［J］．Alzheimer Dis Assoc Disord，2011，25（1）：4-10．DOI：10.1097/WAD.0b013e3181f1c8b1.
［33］LIN F V，WANG X，WU R，et al．Identification of successful cognitive aging in the Alzheimer's disease neuroimaging initiative study［J］．J Alzheimers Dis，2017，59（1）：101-111．DOI：10.3233/JAD-161278.
［34］BAE J B，KIM Y J，HAN J W，et al．Incidence of and risk factors for Alzheimer's disease and mild cognitive impairment in Korean elderly［J］．Dement Geriatr Cogn Disord，2015，39（1/2）：105-115．DOI：10.1159/000366555.
［35］AU B，DALE-MCGRATH S，TIERNEY M C.Sex differences in the prevalence and incidence of mild cognitive impairment：a meta-analysis［J］．Ageing Res Rev，2017，35：176-199．DOI：10.1016/j.arr.2016.09.005.
［36］梁小妞，罗剑锋，赵倩华，等．不同认知功能量表评估受低教育程度老年人认知功能的分析［J］．中国临床神经科学，2015，23（4）：423-427.
LIANG X N，LUO J F，ZHAO Q H，et al．The effects of education levels on cognition impairment assessed by MMSE and MoCA ［J］．Chinese Journal of Clinical Neurosciences，2015，23（4）：423-427.
［37］DARTIGUES J F，GAGNON M，LETENNEUR L，et al．Principal lifetime occupation and cognitive impairment in a French elderly cohort （Paquid）［J］．Am J Epidemiol，1992，135（9）：981-988.
［38］GRACIA REBLED A C，SANTABARBARA S J，LóPEZ ANTóN R L，et al．Occupation and risk of cognitive impairment and dementia in people in over 55 years：a systematic review，spain［J］．Rev Esp Salud Publica，2016，90：e1-5.
［39］SMALL G W，LA RUE A，KOMO S，et al．Predictors of cognitive change in middle-aged and older adults with memory loss［J］．Am J Psychiatry，1995，152（12）：1757-1764．DOI：10.1176/ ajp.152.12.1757.
［40］YOSHITAKE T，KIYOHARA Y，KATO I，et al．Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population：the Hisayama Study［J］．Neurology，1995，45（6）：1161-1168.
［41］ANTTIlA T，HELKALA E L，VIITANEN M，et al．Alcohol drinking in middle age and subsequent risk of mild cognitive impairment and dementia in old age：a prospective population based study［J］．BMJ，2004，329（7465）：539-542．DOI：10.1136/bmj.38181.418958.BE.
［42］ZHAO X，YUAN L，FENG L，et al．Association of dietary intake and lifestyle pattern with mild cognitive impairment in the elderly［J］．J Nutr Health Aging，2015，19（2）：164-168．DOI：10.1007/s12603-014-0524-2.
［43］TRICHOPOULOU A，COSTACOU T，BAMIA C，et al．Adherence to a Mediterranean diet and survival in a Greek population［J］．N Engl J Med，2003，348（26）：2599-2608．DOI：10.1056/NEJMoa 025039.
［44］WILLETT W C，SACKS F，TRICHOPOULOU A，et al．Mediterranean diet pyramid：a cultural model for healthy eating［J］．Am J Clin Nutr，1995，61（6 Suppl）：1402S-1406.
［45］GARDENE S L，RAINEY-SMITH S R，BARNES M B，et al．Dietary patterns and cognitive decline in an Australian study of ageing［J］．Mol Psychiatry，2015，20（7）：860-866．DOI：10.1038/ mp.2014.79.
［46］LU Y，AN Y，GUO J，et al．Dietary intake of nutrients and lifestyle affect the risk of mild cognitive impairment in the Chinese elderly population：a cross-sectional study［J］．Front Behav Neurosci，2016，10：229．DOI：10.3389/fnbeh.2016.00229.
［47］LI F J，SHEN L，JI H F.Dietary intakes of vitamin E，vitamin C，and β-carotene and risk of Alzheimer's disease：a meta-analysis［J］．J Alzheimers Dis，2012，31（2）：253．DOI：10.3233/ JAD-2012-120349.
［48］FORD A H，FLICKER L，ALFONSO H，et al．Vitamins B12，B6 and folic acid in older men［J］．Neurology，2010，75：1-8．DOI：10.1212/WNL.0b013e3181f962c4.
［49］ZHANG D M，YE J X，MU J S，et al．Efficacy of Vitamin B supplementation on cognition in elderly patients with cognitive-related diseases［J］．J Geriatr Psychiatry Neurol，2017，30（1）：50-59．DOI：10.1177/0891988716673466.
［50］JIA J，ZHOU A，WEI C，et al．The prevalence of mild cognitive impairment and its etiological subtypes in elderly Chinese［J］．Alzheimers Dement，2014，10（4）：439-447．DOI：10.1016/j.jalz.2013.09.008.
［51］TERVO S，KIVIPELTO M，H?NNINEN T，et al．Incidence and risk factors for mild cognitive impairment：a population-based three-year follow-up study of cognitively healthy elderly subjects［J］．Dement Geriatr Cogn Disord，2004，17（3）：196-203．DOI：10.1159/000076356.
［52］HOTTMAN D A，CHERNICK D，CHENG S，et al．HDL and cognition in neurodegenerative disorders［J］．Neurobiol Dis，2014，72：22-36．DOI：10.1016/j.nbd.2014.07.015.
［53］GONS R A，VAN ORDEN A G，DE LAAT K F，et al．Cigarette smoking is associated with reduced microstructural integrity of cerebral white matter［J］．Brain，2011，134（7）：2116-2124．DOI：10.1093/brain/awr145.
［54］NEWHOUSE P，KELLAR K，AISEN P，et al．Nicotine treatment of mild cognitive impairment：a 6-month double-blind pilot clinical trial［J］．Neurology，2012，78（2）：91-101．DOI：10.1212/WNL.0b013e31823efcbb.
［55］SUTHERLAND M T，RIEDEL M C，FLANNERY J S，et al．Chronic cigarette smoking is linked with structural alterations in brain regions showing acute nicotinic drug-induced functional modulations［J］．Behav Brain Funct，2016，12（1）：16．DOI：10.1186/s12993-016-0100-5.
［56］ANTTILA T，HELKALA E L，VIITANEN M，et al．Alcohol drinking in middle age and subsequent risk of mild cognitive impairment and dementia in old age：a prospective population based study［J］．BMJ，2004，329（7465）：539．DOI：10.1136/bmj.38181.418958.BE.
［57］GANGULI M，VANDER BILT J，SAXTON J A，et al．Alcohol consumption and cognitive function in late life：a longitudinal community study［J］．Neurology，2005，65（8）：1210-1217．DOI：10.1212/01.wnl.0000180520.35181.24.
［58］DRY M J，BURNS N R，NETTELBECK T，et al．Dose-related effects of alcohol on cognitive functioning［J］．PLoS One，2012，7（11）：e50977．DOI：10.1371/journal.pone.0050977.
［59］HINDMARCH I，KERR J S，SHERWOOD N.The effects of alcohol and other drugs on psychomotor performance and cognitive function［J］．Alcohol Alcohol，1991，26（1）：71-79.
［60］PIAZZA-GARDNER A K，GAFFUD T J，BARRY A E.The impact of alcohol on Alzheimer's disease：a systematic review［J］．Aging Ment Health，2013，17（2）：133-146．DOI：10.1080/13607863.2012.742488.
［61］刘伯源，王久玲，肖义泽.中国60岁及以上人群老年期痴呆患病率Meta分析［J］．中华流行病学杂志，2016，37（11）：1541-1545．DOI：10.3760/cma.j.issn.0254-6450.2016.11.021.
LIU B Y，WANG J L，XIAO Y Z.Prevalence of senile dementia in people aged ≥60 years in China：a Meta-analysis ［J］．Chinese Journal of Epidemiology，2016，37（11）：1541-1545．DOI：10.3760/cma.j.issn.0254-6450.2016.11.021.
［62］WILLIAMS J W，PLASSMAN B L，BURKE J，et al．Preventing Alzheimer's disease and cognitive decline［J］．Evid Rep Technol Assess （Full Rep），2010（193）：1-727.
［63］BRENOWITZ W D，KUKULL W A，BERESFORD S A，et al．Social relationships and risk of incident mild cognitive impairment in U.S.Alzheimer's disease centers［J］．Alzheimer Dis Assoc Disord，2014，28（3）：253-260．DOI：10.1097/WAD.0000000000000020.
［64］HUGHES T F，FLATT J D，FU B，et al．Engagement in social activities and progression from mild to severe cognitive impairment：the MYHAT study［J］．Int Psychogeriatr，2013，25（4）：587-595．DOI：10.1017/S1041610212002086.
［65］JAMES B D，WILSON R S，BARNES L L，et al．Late-life social activity and cognitive decline in old age［J］．J Int Neuropsychol Soc，2011，17（6）：998-1005．DOI：10.1017/S1355617711000531.
［66］VERGHESE V，LIPTON R B，KATZ M J，et al．Leisure activities and the risk of dementia in the elderly［J］．N Engl J Med，2003，348（25）：2508-2516．DOI：10.1056/NEJMoa022252.
［67］VAN DER LINDE R，STEPHAN B C，MATTHEWS F E，et al．Behavioural and psychological symptoms in the older population without dementia-relationship with socio-demographics，health and cognition［J］．BMC Geriatr，2010，10：87．DOI：10.1186/1471-2318-10-87.
［68］BUBU O M，BRANNICK M，MORTIMER J，et al．Sleep，cognitive impairment and Alzheimer's disease：a systematic review and meta-analysis［J］．Sleep，2017，40（1）：1-18．DOI：10.1093/sleep/zsw032.
［69］YAFFE K，FALVEY C M，HOANG T.Connections between sleep and cognition in older adults［J］．Lancet Neurol，2014，13（10）：1017-1028．DOI：10.1016/S1474-4422（14）70172-3.
［70］SOFI F，VALECCHI D，BACCI D，et al．Physical activity and risk of cognitive decline：a meta-analysis of prospective studies［J］．J Intern Med，2011，269（1）：107-117．DOI：10.1111/j.1365-2796.2010.02281.x.
［71］TEN BRINKE L F，BOLANDZADEH N，NAGAMATSU L S，et al．Aerobic exercise increases hippocampal volume in older women with probable mild cognitive impairment：a 6-month randomised controlled trial［J］．Br J Sports Med，2015，49（4）：248-254．DOI：10.1136/bjsports-2013-093184.
［72］LEPOUSEZ G，NISSANT A，LLEDO P M.Adult neurogenesis and the future of the rejuvenating brain circuits［J］．Neuron，2015，86（2）：387-401．DOI：10.1016/j.neuron.2015.01.002.
［73］GOMES DA SILVA S，UNSAIN N，MASCó D H，et al．Early exercise promotes positive hippocampal plasticity and improves spatial memory in the adult life of rats［J］．Hippocampus，2012，22（2）：347–358．DOI：10.1002/hipo.20903.
［74］SUMIYOSHI A，TAKI Y，NONAKA H，et al．Regional gray matter volume increases following 7 days of voluntary wheel running exercise：a longitudinal VBM study in rats［J］．Neuroimage，2014，98（9）：82-90．DOI：10.1016/j.neuroimage.2014.04.075.

[1]	XIN Gongkai, CONG Xin, YUAN Lei, CHENG Yuetong, NI Cuiping, ZHANG Weiwei, ZHANG Pingping, LIU Yu. Research Progress on Comprehensive Assessment Tools for the Elderly with Dementia [J]. Chinese General Practice, 2023, 26(33): 4103-4109.
[2]	LIU Weina, GE Haiyan, MA Jing, CAO Qinying, BAI Xingyu, CUI Shifang, QIAO Yanxia. A Study on the Relationship of Vitamin A and E Levels in Umbilical Cord Blood with Respiratory Distress Syndrome in Preterm Infants [J]. Chinese General Practice, 2023, 26(33): 4152-4158.
[3]	LI Jixin, QIU Linjie, REN Yan, WANG Wenru, LI Meijie, ZHANG Jin. The Correlation of Dietary Inflammatory Index with Overweight, Obesity and Abdominal Obesity: a Meta-analysis [J]. Chinese General Practice, 2023, 26(32): 4089-4097.
[4]	MA Liyuan, WANG Zengwu, FAN Jing, HU Shengshou. Interpretation of Report on Cardiovascular Health and Diseases in China 2022 [J]. Chinese General Practice, 2023, 26(32): 3975-3994.
[5]	LI Yujing, JIN Yichao, CHEN Xing, JI Mengying, DAI Huihua. Risk Factors for Endometrial Lesions Detected by Hysteroscopy in Breast Cancer Patients Taking Tamoxifen [J]. Chinese General Practice, 2023, 26(32): 4026-4030.
[6]	ZHOU Sijing, LUO Bangan, CAO Hui, ZHANG Xi, WANG Dongxin. Epidemiological Characteristics of Dementia and Its Correlation with Multimorbidity among Residents Aged 65 and Above [J]. Chinese General Practice, 2023, 26(29): 3616-3621.
[7]	LIU Yue, LIU Qi, DONG Hui, LIU Yaling. Neuropsychological Changes of Cognitive Reverters after Stroke Based on the Montreal Cognitive Assessment (MoCA) with a Double Threshold [J]. Chinese General Practice, 2023, 26(27): 3417-3422.
[8]	LI Zimeng, WANG Rong, CHEN Shuai, ZHAO Caili, WANG Xiaocong, WEN Yalu, LIU Long. Application of metaPRS and APOEε4 to Optimize Genetic Risk Prediction Modeling Strategy for Mild Cognitive Impairment [J]. Chinese General Practice, 2023, 26(25): 3104-3111.
[9]	REN Yuanyuan, CHENG Gong, JIANG Hongying, WANG Yiyang, CHEN Liang, ZHAO Hui, LIANG Chenyuan. Analysis of Influencing Factors of Coronary Artery Calcification and Its Severity in Patients with Coronary Heart Disease [J]. Chinese General Practice, 2023, 26(24): 2980-2985.
[10]	WANG Xinyuan, LIU Yanli, ZHOU Lijun, ZHANG Qi, WEI Qifei, YAN Xingyu, LUO Jiao, LIU Xiaofei. Advances in Resistance to Care in Patients with Dementia [J]. Chinese General Practice, 2023, 26(22): 2809-2815.
[11]	WANG Xinyuan, WANG Xiaolei, LIU Yanli, AN Ran, LUO Jiao, LIU Xiaofei, LI Yangyang, HU Chongdie, HOU Fuwen. Advances in Evaluation Tools for Resistiveness to Care in Patients with Dementia [J]. Chinese General Practice, 2023, 26(22): 2816-2822.
[12]	YU Yanxue, BAI Ruyu, YU Wenlong, GUO Xia, WU Li'e. Occurrence Status and Influencing Factors of Cognitive Dysfunction in Population Aged 60 and Above [J]. Chinese General Practice, 2023, 26(21): 2581-2588.
[13]	HE Manlan, YUAN Ping, HE Lei, CHEN Lu. Meta-analysis of Risk Factors for Urinary Tract Infection in Neurogenic Bladder [J]. Chinese General Practice, 2023, 26(21): 2659-2665.
[14]	FENG Shuidong, LI Junyan, DENG Shuxiang, CHEN Limou, CAO Mengyue, TANG Yan, TANG Peng, LIU Jun, SHEN Minxue, YANG Fei. Association between Air Pollutant Exposure and Dyslipidemia in Middle-aged and Elderly People in Mining Areas [J]. Chinese General Practice, 2023, 26(18): 2238-2244.
[15]	XUE Jingru, SUN Suzhen. Clinical Characteristics and Risk Factors for Unfavourble Prognosis of Mycoplasma Pneumoniae Encephalitis in Children [J]. Chinese General Practice, 2023, 26(17): 2125-2131.