Gussekloo J, de Craen A J, van Exel E, Bootsma-van der Wiel A, Westendorp R G
Leids Universitair Medisch Centrum, afd. Algemene Interne Geneeskunde, sectie Gerontologie en Geriatrie, Postbus 9600, 2300 RC Leiden.
Ned Tijdschr Geneeskd. 2004 May 15;148(20):979-83.
In view of the absolute and relative increase in the number of oldest old, it is important to identify the causes and consequences of disease in this group. One of the areas of focus in the 'Leiden 85-plus Study', a population-based prospective study amongst 85-year-olds in the Dutch town of Leiden, is therefore to study the causes and consequences of cognitive decline in the very elderly. Cognitive impairment is the main threat to independence in the oldest old; 85-year-old people with impaired cognitive function (prevalence: 35%) have a ten times greater risk of being limited in their activities of daily life. If this cognitive impairment could be prevented, a large proportion of the independence limitations in the general population could be prevented (population attributable risk: 70%). Limitations in cognitive functioning are strongly associated with the incidence of cardiovascular disease, as well as with a lower average HDL-cholesterol concentration and signs of inflammation. Vascular factors appear to be closely related to development of cognitive impairment in very elderly. Therefore, future therapeutic research will have to demonstrate to what extent influencing the cardiovascular risk factors can lead to the prevention of cognitive decline in the very elderly.
鉴于高龄老人数量的绝对和相对增长，确定该群体疾病的病因和后果非常重要。因此，在荷兰莱顿市针对85岁及以上老人开展的一项基于人群的前瞻性研究“莱顿85岁及以上老人研究”中，重点关注的领域之一是研究高龄老人认知能力下降的病因和后果。认知障碍是高龄老人独立生活的主要威胁；认知功能受损的85岁老人（患病率：35%）日常生活活动受限的风险要高十倍。如果能够预防这种认知障碍，那么普通人群中很大一部分的独立生活受限情况都可以得到预防（人群归因风险：70%）。认知功能受限与心血管疾病的发病率密切相关，也与较低的平均高密度脂蛋白胆固醇浓度及炎症迹象有关。血管因素似乎与高龄老人认知障碍的发展密切相关。因此，未来的治疗研究将必须证明，在何种程度上影响心血管危险因素能够预防高龄老人的认知能力下降。
