Halling Anders, Berglund Johan
Blekinge Institute for Research and Development, Karlshamn, Sweden.
Eur J Gen Pract. 2006;12(3):114-9. doi: 10.1080/13814780600881128.
The aim of this study was to describe the association between ischaemic heart disease (IHD), diabetes mellitus (DM) and heart failure (HF) and the prevalence of cognitive impairment.
In a cross-sectional, community-based study in Karlskrona, Sweden, 1402 participants of the Swedish National Study on Ageing and Care (60-96 y) underwent a medical examination and psychological testing including the Mini Mental State Examination (MMSE). Of these, 58% stated that they were treated for hypertension, IHD, DM or HF, or had ECG abnormalities (positive screen).
The prevalence of cognitive impairment (MMSE score < 24) in patients treated for IHD, DM or HF was 28.5% compared to 16.1% in the population with a negative screen without cardiovascular disease or DM. After stratification by age, the difference was seen to be due to a higher prevalence of cognitive impairment in the age group 70-79 y, where 68.8% of the cognitively impaired came from the group treated for IHD, DM or HF. The odds ratio for cognitive impairment in this age group was 4.4 (95% CI 1.7-11.4), when compared to those with a negative screen as baseline.
This study has shown that the patient group treated for IHD, DM or HF has a higher prevalence of cognitive impairment and a higher risk of developing early cognitive impairment between the ages of 70 and 79 y. Although this study has not provided conclusive evidence that cardiovascular disease and DM are associated with the early development of cognitive impairment, it provides incentive for further studies.
本研究旨在描述缺血性心脏病(IHD)、糖尿病(DM)和心力衰竭(HF)之间的关联以及认知障碍的患病率。
在瑞典卡尔斯克鲁纳进行的一项基于社区的横断面研究中,瑞典全国老龄化与护理研究的1402名参与者(60 - 96岁)接受了医学检查和心理测试,包括简易精神状态检查表(MMSE)。其中,58%的人表示他们接受过高血压、IHD、DM或HF治疗,或有心电图异常(筛查阳性)。
接受IHD、DM或HF治疗的患者中,认知障碍(MMSE评分<24)的患病率为28.5%,而无心血管疾病或DM且筛查阴性的人群中这一患病率为16.1%。按年龄分层后,差异被认为是由于70 - 79岁年龄组中认知障碍的患病率较高,该组中68.8%的认知障碍患者来自接受IHD、DM或HF治疗的人群。与以筛查阴性者为基线相比,该年龄组认知障碍的优势比为4.4(95%CI 1.7 - 11.4)。
本研究表明,接受IHD、DM或HF治疗的患者组认知障碍患病率较高,且在70至79岁之间发生早期认知障碍的风险更高。尽管本研究未提供心血管疾病和DM与认知障碍早期发展相关的确凿证据,但它为进一步研究提供了动力。