摘要
目的了解社区老年人代谢性心血管疾病患病情况及其对痴呆的影响,为痴呆防控提供参考。方法收集2018-2023年中国多中心痴呆调查(CMDS)和湖北省老年记忆队列(HAMCS)中14803名≥65岁老年人人口学、疾病及认知功能评估相关数据,采用多因素Logistic回归分析代谢性心血管疾病及其共病对痴呆的影响。结果14803名≥65岁老年人中痴呆1119人(7.6%),代谢性心血管疾病(高血压、糖尿病、心脏病及脑血管疾病)共病4096人(27.7%),其中高血压共病糖尿病、心脏病和脑血管疾病分别为788人(6.7%)、981人(8.3%)和876人(7.4%)。不同居住地、性别、年龄、受教育年限、婚姻状况组老年人痴呆患病率有统计学差异,体质量指数、吸烟、社交活动、罹患高血压、心脏病、脑血管疾病、自主神经功能紊乱对老年人痴呆患病均有影响。调整混杂因素后多因素Logistic回归结果显示,与未患代谢性心血管病老年人相比,患1~4种代谢性心血管疾病老人患痴呆风险分别为1.509倍(95%CI:1.161~1.960),1.869倍(95%CI:1.389~2.516),2.399倍(95%CI:1.618~3.557)和2.684倍(95%CI:1.257~5.730);高血压共病糖尿病患痴呆风险最高(OR=2.157;95%CI:1.377~3.379);按性别和年龄分层后分析发现,痴呆风险随着代谢性心血管疾病共病种类增加而增加;男性高血压共病脑血管病患痴呆风险最高(OR=4.400,95%CI:2.154~8.989),女性高血压共病糖尿病患痴呆风险最高(OR=2.022,95%CI:1.189~3.442);<75岁组高血压共病脑血管病患痴呆的风险最高(OR=2.140,95%CI:1.141~4.014),≥75岁组高血压共病糖尿病患痴呆风险最高(OR=2.530,95%CI:1.402~4.563)。结论中国老年人代谢性心血管疾病患病率较高,代谢性心血管疾病共病患者患痴呆风险显著增加。
Objective To understand the prevalence of metabolic cardiovascular in the elderly in the community and its impact on dementia,so as to provide a reference for for dementia prevention and control.Methods Data of the demographic,disease and cognitive function of 14803≥65-year-old elderly people in the China Multicenter Dementia Survey(CMDS)and the Hubei Aging and Memory Cohort Study(HAMCS)from 2018 to 2023 were collected,and the multivariate logistic regression model was used to analyze the impact of metabolic cardiovascular and its comorbidities on the prevalence of dementia.Results Among 14803 participants,1119(7.6%)had dementia,9688(65.4%)had metabolic cardiovascular disease and its comorbidities.Of whom,788(6.7%),981(8.3%),and 876(7.4%)had comorbidities of hypertension,heart disease,cerebrovascular disease and hypertension,respectively.There were significant differences in the prevalence of dementia among the elderly in different groups of residence,gender,age,education level,and marital status.Body mass index,smoking,social activities,hypertension,heart disease,cerebrovascular disease,and autonomic nerve dysfunction had an impact on the prevalence of dementia in the elderly.After adjusting for confounding factors,multivariate logistic regression models showed that the risk of dementia in the elderly with 1-4 metabolic cardiovascular diseases was 1.509 times(95%CI:1.161-1.960),1.869 times(95%CI:1.389-2.516),2.399 times(95%CI:1.618-3.557)and 2.684 times(95%CI:1.257-5.730)of that in old persons who were disease-free,respectively.The risk of dementia in participants with hypertension and diabetes was the highest(OR=2.157;95%CI:1.377-3.379).After stratified by sex and age,men with both hypertension and cerebrovascular disease had the highest risk of developing dementia(OR=4.400,95%CI:2.154-8.989),and the women with hypertension and diabetes had the highest risk(OR=2.022,95%CI:1.189-3.442).Persons who were<75-year-old with both hypertension and cerebrovascular disease had the highest risk(OR=2.140,95%CI:1.141-4.01
作者
聂倩倩
程桂荣
曾燕
鄢华
Nie Qianqian;Cheng Guirong;Zeng Yan;Yan Hua(Department of Medicine,Wuhan University of Science and Technology,Wuhan 430081,China;Department of Cardiology,Asia Heart Hospital affiliated to Wuhan University of Science and Technology,Wuhan 430022,China)
出处
《中华脑血管病杂志（电子版）》
2024年第1期27-32,共6页
Chinese Journal of Cerebrovascular Diseases(Electronic Edition)
基金
国家自然科学基金面上项目(82371444)
科技创新2030-“脑科学和类脑研究”重大项目课题(2022ZD0211604)。
关键词
代谢性心血管疾病
痴呆
共病
优势比
老年人
Metabolic cardiovascular diseases
Dementia
Comorbidities
Odds Ratio
Community-dwelling old population
