Objective: To analyze the spatial distribution of the prevalence of cognitive dysfunction and its risk factors in Chinese population aged 45 years and above to provide evidence for formulating regional prevention and control strategies.
Methods: The study subjects with complete cognitive function data were selected from the follow-up data of the China Health and Retirement Longitudinal Study (CHARLS) Phase IV. ArcGis 10.4 software was used for spatial analysis of the prevalence of cognitive dysfunction in the population aged 45 years and above for each province based on the geographic information system (GIS) technology.
Results: In 2018, the overall prevalence of cognitive dysfunction was 33.59% (5951/17716) in individuals aged 45 and above in China. Global spatial autocorrelation analysis indicated a spatial clustering and a positive autocorrelation (P < 0.001) of the prevalence of cognitive dysfunction in the study subjects, with a Moran's I value of 0.333085. The results of local spatial autocorrelation analysis showed that the southwestern region of China was the main aggregation area of patients with cognitive dysfunction. Geographically weighted regression analysis suggested that a male gender, an advanced age, and illiteracy were the major risk factors for cognitive dysfunction (P < 0.05). These 3 risk factors showed a spatial distribution heterogeneity with greater impact in the northern, western, and northwestern regions of China, respectively.
Conclusion: The prevalence of cognitive dysfunction is relatively high in individuals aged 45 years and above in China. A male gender, an advanced age, and illiteracy are the major risk factors for cognitive dysfunction and show different spatial distribution patterns, with the northern, western and northwestern regions of China as the key areas for prevention and control, where the prevention and control measures should be designed based on local conditions.
目的: 了解我国45岁及以上的中老年人认知功能障碍患病现状的空间分布及其影响因素，为区域化制定中老年人群认知功能障碍防控策略和措施提供理论依据。
方法: 利用中国健康与养老追踪调查（CHARLS）第4期追访数据，选取认知功能数据完整的研究对象进行研究，基于地理信息系统（GIS）技术，以省级作为空间分析单位，采用ArcGis 10.4软件对中老年人认知功能障碍情况进行空间统计分析。
结果: 2018年，我国45岁及以上人群的认知功能障碍患病率为33.59%（5951/17716），全局空间自相关分析结果显示，患病率的Moran'I值=0.333085，表明认知功能障碍患病率存在空间聚集性，且为正自相关（P < 0.001）。局部空间自相关分析结果显示，认知功能障碍患者的聚集区域主要在我国西南部。地理加权回归分析显示，男性、高龄、文盲是认知功能障碍患病的主要危险因素（P < 0.05），且存在空间分布异质性，分别对我国北部、西部和西北部影响更大。
结论: 我国45岁及以上人群认知功能障碍患病率较高，男性、高龄、文盲是认知功能障碍患病的主要危险因素，且空间分布存在差异，重点防控地区集中于我国北部、西部和西北部，不同地区的认知功能障碍防控措施应结合其地域特点，具备一定针对性。
Keywords: cognitive dysfunction; influencing factors; spatial distribution.