Jefferson Angela L, Poppas Athena, Paul Robert H, Cohen Ronald A
Department of Neurology, Alzheimer's Disease Center, Boston University School of Medicine, Robinson Complex, Suite 7800, 715 Albany Street, Boston, MA 02118-2526, USA.
Neurobiol Aging. 2007 Mar;28(3):477-83. doi: 10.1016/j.neurobiolaging.2006.01.001. Epub 2006 Feb 15.
The present study examines the relationship between systemic hypoperfusion via cardiac output (CO) and neuropsychological performances emphasizing executive function in an aging cohort. Geriatric outpatients with treated, stable cardiovascular disease (CVD) and no history of neurological illness (n=72, ages 56-85) were administered cognitive measures with an emphasis on executive functioning. Echocardiogram findings were used to stratify participants into two groups: low CO (<4.0 L/min) and normal CO (> o r=4.0 L/min). Between-group comparisons were made using ANCOVAs adjusting for systolic blood pressure. The low CO group performed significantly worse than the normal CO group on DKEFS Tower Test and DKEFS Trail Making Test. No significant between-group differences were noted for any of the other cognitive indices. Findings suggest that reduced CO is associated with poorer executive functioning among geriatric outpatients with stable CVD, as the cognitive profile emphasizes a relationship between systemic hypoperfusion and problems with sequencing and planning. The executive dysfunction profile may be secondary to reduced blood flow to vulnerable subcortical structures implicated in frontal-subcortical circuitry.
本研究探讨了老年人群中心输出量（CO）导致的全身灌注不足与强调执行功能的神经心理表现之间的关系。对患有已治疗的稳定心血管疾病（CVD）且无神经疾病史的老年门诊患者（n = 72，年龄56 - 85岁）进行了以执行功能为重点的认知测量。超声心动图检查结果用于将参与者分为两组：低心输出量组（<4.0升/分钟）和正常心输出量组（≥4.0升/分钟）。使用协方差分析（ANCOVA）对收缩压进行调整后进行组间比较。在德克萨斯儿童执行功能成套测验（DKEFS）塔楼测试和DKEFS连线测验中，低心输出量组的表现明显差于正常心输出量组。其他任何认知指标在组间均未发现显著差异。研究结果表明，在患有稳定CVD的老年门诊患者中，心输出量降低与较差的执行功能相关，因为认知概况强调了全身灌注不足与序列和计划问题之间的关系。执行功能障碍概况可能继发于涉及额叶 - 皮质下回路的易损皮质下结构血流量减少。
