Maugeri D, Testaì M, Santangelo A, Abbate S, Bennati E, Bonanno M R, Lo Giudice F, Mamazza C, Panebianco P
Department of Senescent, Urological and Neurological Sciences, School of Specialization in Geriatrics, Cannizzaro Hospital, University of Catania, Via Messina, 829, I-95124 Catania, Italy.
Arch Gerontol Geriatr. 2005 Jan-Feb;40(1):1-5. doi: 10.1016/j.archger.2004.05.003.
Aging of the Italian population resulted in a net increase of the cardiovascular pathologies, and the correlated disabilities. In addition, the cardiovascular diseases represent actually in Italy the most frequent cause of death. With advancing age, both the heart and the blood vessels undergo numerous morphological and functional modifications, which are reducing the functional reserves of these organs. The present study looked for correlation between the cardiac functionality and the cognitive, as well as affective functions. Furthermore, we evaluated the functional variations of the autonomy and autosufficiency of the same patients. We had 171 enrolled subjects (108 women and 63 men), all above the age of 70 years. Based on the classification of the New York Heart Association (NYHA), 85 of these patients (35 men and 50 women) had a II class (Group A), and 86 of them (28 men and 58 women) a III NYHA class of heart function (Group B). We included only patients who did not have any cerebrovascular event yet, and were not bed-ridden. The psychometric performance has been evaluated by using the mini-mental state examination (MMSE), the geriatric depression scale (GDS), the activities of daily living (ADL) and the instrumental activities of daily living (IADL) scales. Cardiac functions have been measured by Doppler echocardiography, in M-mode. The Group A (of mean age 71 +/- 3 years) displayed ventricular ejection fraction (VEF) values in average of 43 +/- 4%, MMSE scores 27 +/- 2; GDS scores 14 +/- 3; IADL 6 +/- 1, and ADL = 6, i.e., maintained a complete autosufficiency. The Group B (mean age 74 +/- 4 years) displayed VEF values in average of 26 +/- 3%, MMSE scores 23 +/- 4; GDS scores 22 +/- 3; IADL 4 +/- 2, and ADL = 4 +/- 1, i.e., had a reduced autosufficiency. These results confirm that also the heart pays a toll for aging: the myocardial contractility becomes significantly altered, meaning the loss of cardiac functions itself. These morpho-functional heart alterations are accompanied by decreased psychometric performances during aging, with consequent reductions of cognitivity, affectivity, autosufficiency and autonomy, involving a complex decrease of the quality of life.
意大利人口老龄化导致心血管疾病及其相关残疾的净增加。此外，心血管疾病目前是意大利最常见的死亡原因。随着年龄的增长，心脏和血管都会经历许多形态和功能上的改变，这会降低这些器官的功能储备。本研究旨在寻找心脏功能与认知功能以及情感功能之间的相关性。此外，我们评估了同一患者自主能力和自理能力的功能变化。我们招募了171名受试者（108名女性和63名男性），均为70岁以上。根据纽约心脏协会（NYHA）的分类，其中85名患者（35名男性和50名女性）属于II级（A组），另外86名患者（28名男性和58名女性）属于NYHA心功能III级（B组）。我们仅纳入了尚未发生任何脑血管事件且非卧床不起的患者。通过简易精神状态检查表（MMSE）、老年抑郁量表（GDS）、日常生活活动（ADL）量表和工具性日常生活活动（IADL）量表来评估心理测量表现。通过M型多普勒超声心动图测量心脏功能。A组（平均年龄71±3岁）的心室射血分数（VEF）平均值为43±4%，MMSE评分27±2；GDS评分14±3；IADL为6±1，ADL = 6，即保持完全自理能力。B组（平均年龄74±4岁）的VEF平均值为26±3%，MMSE评分23±4；GDS评分22±3；IADL为4±2，ADL = 4±1，即自理能力下降。这些结果证实，心脏也会因衰老而受损：心肌收缩力明显改变，意味着心脏功能本身的丧失。这些心脏形态功能改变伴随着衰老过程中心理测量表现的下降，进而导致认知、情感（功能）、自理能力和自主能力的降低，包括生活质量的复杂下降。
