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在老年人群中使用脑磁共振成像发现的无症状性卒中的功能和认知后果。

Functional and cognitive consequences of silent stroke discovered using brain magnetic resonance imaging in an elderly population.

作者信息

Schmidt Wolf-Peter, Roesler Andreas, Kretzschmar Konrad, Ladwig Karl-Heinz, Junker Ralf, Berger Klaus

机构信息

Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.

出版信息

J Am Geriatr Soc. 2004 Jul;52(7):1045-50. doi: 10.1111/j.1532-5415.2004.52300.x.

Abstract

OBJECTIVES

To evaluate the prevalence of silent stroke and its associated consequences on physical, cognitive, and emotional functioning in an elderly population.

DESIGN

Population-based cross-sectional survey.

SETTING

The Memory and Morbidity in Augsburg Elderly project in the Augsburg region of southern Germany.

PARTICIPANTS

Two hundred sixty-seven community-dwelling persons aged 65 to 83.

MEASUREMENTS

The presence of silent stroke was determined using magnetic resonance imaging brain scan and a single question asking for physician-diagnosed stroke in each participant. The health effect of silent stroke was assessed using rating scales for self-perceived health status (36-item short-form health survey), activities of daily living (ADLs) and instrumental ADLs, cognitive function, and depression (Center for Epidemiologic Studies Depression scale).

RESULTS

Just fewer than 13% (12.7%) of participants were affected by silent stroke. Silent stroke was associated with a history of hypertension, heart surgery, and elevated C-reactive protein. Individuals with silent stroke showed impairments on the Mini-Mental State Examination test and in the cognitive domains of memory, procedural speed, and motor performance.

CONCLUSION

The presence of silent stroke has a considerable effect on cognitive performance in those affected. Determining the presence of silent stroke using brain imaging may contribute to identifying individuals at risk for developing gradual neurological deficits.

摘要

目的

评估老年人群中无症状性卒中的患病率及其对身体、认知和情感功能的相关影响。

设计

基于人群的横断面调查。

地点

德国南部奥格斯堡地区的奥格斯堡老年人记忆与发病率项目。

参与者

267名年龄在65至83岁的社区居住者。

测量方法

通过磁共振成像脑部扫描以及询问每位参与者是否有医生诊断的卒中的单一问题来确定无症状性卒中的存在。使用自我感知健康状况评定量表(36项简短健康调查问卷)、日常生活活动(ADL)和工具性ADL、认知功能和抑郁评定量表(流行病学研究中心抑郁量表)评估无症状性卒中的健康影响。

结果

略少于13%(12.7%)的参与者受到无症状性卒中的影响。无症状性卒中与高血压病史、心脏手术史和C反应蛋白升高有关。有无症状性卒中的个体在简易精神状态检查表测试以及记忆、程序速度和运动表现的认知领域存在损害。

结论

无症状性卒中的存在对受影响者的认知表现有相当大的影响。使用脑成像确定无症状性卒中的存在可能有助于识别有逐渐发展为神经功能缺损风险的个体。

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