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首页> 美国卫生研究院文献>British Medical Journal >Christmas 2009: Young and old: Lying obliquely—a clinical sign of cognitive impairment: cross sectional observational study
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Christmas 2009: Young and old: Lying obliquely—a clinical sign of cognitive impairment: cross sectional observational study

机译：2009年圣诞节：年轻人和老人：倾斜躺着-认知障碍的临床表现：横断面观察研究

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>Objective To determine if failure to spontaneously orient the body along the longitudinal axis of a hospital bed when asked to lie down is associated with cognitive impairment in older patients.>Design Cross sectional observational study.>Setting Neurology department of a university hospital in Germany.>Participants Convenience sample of 110 older (≥60 years) inpatients with neurological conditions and 23 staff neurologists.>Main outcome measures The main outcome measure was the association between the angle of the body axis and the results of three cognitive screening tests (mini-mental state examination, DemTect, and clock drawing test). Staff doctors were shown photographs of a model taken at a natural viewing able to determine their subjective perspective of what constitutes oblique.>Results 110 neurological inpatients (mean age 70.9 (SD 6.8) years) were included after exclusions. Evidence of cognitive impairment was found in 34, with scores indicating dementia in eight, according to the mini-mental state examination, and in 11 according to the DemTect. Across all patients, the mean angular deviation of the body axis from the longitudinal axis of the bed (range 0-23°) correlated linearly with the mini-mental state examination (r=−0.480), DemTect (r=−0.527), and the clock drawing test (r=−0.552) scores (P<0.001 for all), even after removing age as a covariate. Overall, 90% of staff neurologists considered a minimal body angle of 7° to be oblique. Angular deviation of at least 7° predicted cognitive impairment according to the three different tests, with specificities between 89% and 96% and sensitivities between 27% and 50%.>Conclusion Clinicians might suspect cognitive impairment in mobile older inpatients with neurological disorders who spontaneously position themselves obliquely when asked to lie on a bed.
机译：>目标：确定在要求躺下时未能自发地沿病床纵轴定向身体是否与老年患者的认知功能障碍有关。>设计横截面观察>设置德国某大学医院的神经科。>参与者 110名年龄在60岁以上（含60岁）以上神经系统疾病的住院患者和23名工作人员的神经科医师的便利性样本。>主要结局指标：主要结局指标是体轴角度与三种认知筛查测试（迷你精神状态检查，DemTect和钟表测试）的结果之间的关联。向职员医生展示了通过自然观察拍摄的模型照片，这些照片能够确定其主观视角是什么构成斜肌。>结果将排除后的110名神经科住院患者（平均年龄70.9（SD 6.8）岁）包括在内。根据小精神状态检查，发现认知障碍的证据为34个，其中得分表示痴呆的占8个，根据DemTect的得分为11个。在所有患者中，体轴与床纵轴的平均角度偏差（范围为0-23°）与小精神状态检查（r = -0.480），DemTect（r = -0.527），甚至删除年龄作为协变量后，时钟绘图测试（r = -0.552）得分（所有P均<0.001）。总体而言，90％的职员神经科医生认为最小体角为7°是倾斜的。根据三种不同的测试，至少有7°的角度偏差预测了认知障碍，特异性在89％至96％之间，敏感性在27％至50％之间。>结论有神经系统疾病的住院病人，当被要求躺在床上时会自然地倾斜自己。

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