Gunstad John, Bausserman Linda, Paul Robert H, Tate David F, Hoth Karin, Poppas Athena, Jefferson Angela L, Cohen Ronald A
Brown Medical School, Providence, Rhode Island, USA.
J Clin Neurosci. 2006 Jun;13(5):540-6. doi: 10.1016/j.jocn.2005.08.010. Epub 2006 May 24.
Cardiovascular disease (CVD) is a risk factor for cognitive impairment and dementia. Recent studies implicate homocysteine (HCY) and C-reactive protein (CRP) in this increased risk, as both are associated with cognitive dysfunction in demented and non-demented patients. However, it remains unclear whether they confer added risk in older adults with CVD. A total of 126 older CVD patients underwent blood and neuropsychological evaluation as part of a prospective examination of the neurocognitive consequences of CVD. A subset of these participants (n=37) also underwent neuroimaging to quantify the degree of white matter disease. After adjusting for demographic and medical factors, no significant relationship emerged between HCY and cognitive performance. In contrast, CRP showed significant independent relationships to test performance, including global cognitive performance, attention/psychomotor function, executive function, memory, and visuospatial abilities. Neither HCY nor CRP was related to extent of white matter disease or whole brain volume on magnetic resonance imaging. Further study is needed to identify mechanisms by which inflammatory processes impact on cognitive function and to determine whether reducing circulating levels of inflammatory markers results in improved cognition.
心血管疾病（CVD）是认知障碍和痴呆的一个风险因素。最近的研究表明，同型半胱氨酸（HCY）和C反应蛋白（CRP）与这种风险增加有关，因为它们在痴呆和非痴呆患者中均与认知功能障碍相关。然而，它们是否会给患有心血管疾病的老年人带来额外风险仍不清楚。作为对心血管疾病神经认知后果的前瞻性检查的一部分，共有126名老年心血管疾病患者接受了血液和神经心理学评估。这些参与者中的一部分（n = 37）还接受了神经影像学检查，以量化白质病变的程度。在对人口统计学和医学因素进行调整后，HCY与认知表现之间未出现显著关系。相比之下，CRP与测试表现存在显著的独立关系，包括整体认知表现、注意力/心理运动功能、执行功能、记忆和视觉空间能力。在磁共振成像上，HCY和CRP均与白质病变程度或全脑体积无关。需要进一步研究以确定炎症过程影响认知功能的机制，并确定降低循环炎症标志物水平是否会改善认知。
