空巢老人居住环境与认知障碍关联的贝叶斯网络分析
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男,硕士在读,学生,1930910293@qq.com

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湖南省自然科学基金医卫联合基金项目(2026JJ81979);湖南省自然科学基金面上项目(2023JJ31019);2023年度湖南省教育厅优秀青年项目(23B0517)


Bayesian network analysis of the effect of living environment on cognitive impairment in empty-nest older adults
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    摘要:

    目的 探讨居住环境多层次因素对空巢老人认知障碍的关联路径,识别关键直接与间接预测因子,为针对性环境干预提供依据。方法 基于社会生态模型,采用中国老年健康影响因素跟踪调查(CLHLS)2018年数据,共纳入5 961名空巢老人。通过单因素分析和LASSO回归筛选潜在预测变量,利用R语言bnlearn包构建贝叶斯网络结构,采用禁忌搜索算法进行结构学习,基于贝叶斯估计算法进行参数学习,并使用Netica软件进行概率预测。结果 空巢老人认知障碍发生率为18.7%。经LASSO回归筛选,11个变量被纳入贝叶斯网络模型,其结果显示:是否吸烟、医疗服务可及性、房间是否有霉味、杀虫剂使用频率与认知障碍直接相关;夏季开窗通风频率、是否使用管道天然气、厨房是否通风、居住地、驱蚊剂使用频率、冬季开窗通风频率、社区是否提供健康教育与认知障碍间接连接。吸烟、房间有霉味、医疗服务不可及、经常使用杀虫剂的空巢老人发生认知障碍的风险最大(71.0%)。结论 居住环境相关因素可通过多路径影响空巢老人认知功能,其认知障碍预防策略需采取多因素、整合性的社区和居家干预模式。

    Abstract:

    Objective To explore the pathways linking residential environmental factors with cognitive impairment among empty-nest older adults, aiming to identify key direct and indirect predictors and provide a basis for targeted environmental interventions. Methods Based on the theoretical framework of the socio-ecological model, data were obtained from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), including a total of 5,961 empty-nest older adults. Potential predictors were initially screened through univariate analysis and LASSO regression. The Bayesian network structure was constructed using the R bnlearn package, with the Tabu search algorithm applied for structure learning and Bayesian estimation for parameter learning. Probability predictions were performed using Netica software.Results The incidence of cognitive impairment among empty-nest older adults was 18.7%. After LASSO regression screening, 11 variables were included in the Bayesian network model. The Bayesian network model identified four factors directly associated with cognitive impairment:smoking, accessibility of healthcare services, presence of mold smell in the room, and frequency of pesticide use. Seven factors were indirectly linked to cognitive impairment: frequency of window ventilation in summer, use of pipeline natural gas, kitchen ventilation, residential location, frequency of mosquito repellent use, frequency of window ventilation in winter, and availability of community health education. The subgroup with all four risk factors:smoking, presence of mold smell in the room, lack of accessible healthcare services, and frequent pesticide use had the highest risk of cognitive impairment, reaching 71.0%. Conclusion Residential environmental factors are associated with cognitive function in empty-nest older adults through multiple pathways. Prevention strategies for cognitive impairment should adopt a multi-factorial and integrated intervention model involving both community and household approaches.

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张世纪,田艳珍,李金秀,邓力邦,张涛,付建军.空巢老人居住环境与认知障碍关联的贝叶斯网络分析[J].护理学杂志,2026,41(10):1-7

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  • 收稿日期:2025-12-01
  • 最后修改日期:2026-02-06
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  • 在线发布日期: 2026-06-15