摘要
背景阿尔茨海默病与记忆力和认知功能下降有关的神经病理学改变早于临床症状多年,高血压是其危险因素之一。因此,在临床工作中,能在高血压患者中有效识别出痴呆高危人群,对于预防痴呆意义重大。目的对社区老年人进行调查,了解其认知功能变化情况,分析高血压有关的治疗情况、合并其他躯体疾病、血压控制状况等对轻度认知功能障碍(MCI)向痴呆转化的影响,为防止和延缓痴呆的发生提供依据。方法于2017年7-12月,对439例2011年经PPS(probability proportional to size)抽样法调查的MCI老年人进行简易智力状态检查,蒙特利尔认知评估量表、汉密尔顿抑郁量表、临床痴呆评定量表等量表测定,以及认知功能障碍诊断标准的再次测定。随访结局仍为MCI者为稳定型(MCIs),进展为痴呆者为进展型(MCIp),逆转为认知正常者为逆转型(MCIr)。比较不同高血压病史及其相关治疗等情况患者的MCI结局,采用Logistic回归分析MCI不恶化的影响因素。结果有高血压病史的社区MCI老年人入组时(2011年)的子女人数、BMI、高脂血症情况比较,差异有统计学意义(P<0.05);两组年龄、性别、单身情况、月收入、受教育年限、职业类型、个性倾向、家庭结构、酗酒史、吸烟史、记忆减退情况、2型糖尿病病史比较,差异无统计学意义(P>0.05)。新发高血压组和不治疗高血压组的年龄高于无高血压组,无高血压组的收缩压水平和舒张压水平低于新发高血压组、不治疗高血压组、持续高血压组,且持续高血压组的舒张压水平低于不治疗高血压组(P<0.05)。MCIp组的平均年龄高于MCIs组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,高龄是MCIp的危险因素(OR=0.856,P=0.011),月收入高则是保护因素(OR=2.288,P=0.045)。结论社区不治疗和新发高血压者可能会促进MCI进展为痴呆,高龄是危险因素,血压下降或升高是伴随神�
Background Hypertension is one of the risk factors for Alzheimer's disease,whose neuropathological changes associated with memory and cognitive function predate clinical symptoms for many years.Therefore,it is of great significance to effectively identify high-risk groups of dementia in patients with hypertension for its prevention clinically.Objective To investigate the changes of cognitive function of elderly people in community and analyze the effects of hypertension-related treatment,other combined physical diseases and blood pressure control on the transformation from mind cognitive impairment(MCI)to dementia,so as to provide a basis for preventing and delaying the occurrence of dementia.Methods From July to December 2017,439 elderly patients with MCI who had been sampled by probability proportional to size(PPS)in 2011 were examined for their simple mental state with the remeasurement by the Montreal Cognitive Assessment Scale,Hamilton Depression Scale,Clinical Dementia Assessment Scale and the criteria for the diagnosis of cognitive impairment.The outcomes of followup were divided into the stable type(MCIs),the progressive type(MCIp)for dementia and the reversed type(MCIr)for normal cognitive status.The follow-up outcomes of MCI was compared between different history of hypertension and its related treatment.And Logistic regression was used to analyze the related influencing factors of MCI without deterioration.Results There were significant differences in the number of children,BMI and hyperlipidemia among the elderly with hypertension history in 2011(P<0.05).There were no differences in age,gender,single status,monthly income,education level,occupation type,personality tendency,family structure,alcoholism history,smoking history,memory decline and type 2 diabetes history between the two groups(P>0.05).The age of new-onset and untreated hypertension group was higher than that of nonhypertension group,and the systolic and diastolic blood pressure levels of non-hypertension group were lower than those of new
作者
秦虹云
诸秉根
王玲
郭祎
曹志城
胡承平
QIN Hongyun;ZHU Binggen;WANG Ling;GUO Yi;CAO Zhicheng;HU Chengping(Shanghai Pudong New Area Mental Health Center/Mental Health Center Affiliated to Tongji University,Shanghai 200124,China)
出处
《中国全科医学》
CAS
北大核心
2020年第13期1640-1646,1653,共8页
Chinese General Practice
基金
上海市浦东新区卫生和计划生育委员会资助项目(PWRd2017-05)
上海市卫生和计划生育委员会资助项目(201640298)。
关键词
轻度认知功能障碍
高血压
痴呆
影响因素分析
社区
Mild cognitive impairment
Hypertension
Dementia
Root cause analysis
Community
