Umegaki Hiroyuki, Iimuro Satoshi, Kaneko Tetsuji, Araki Atsushi, Sakurai Takashi, Ohashi Yasuo, Iguchi Akihisa, Ito Hideki
Department of Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-Cho, Showa-Ku, Nagoya, Aichi 466-8550, Japan.
Neurobiol Aging. 2008 Jul;29(7):1022-6. doi: 10.1016/j.neurobiolaging.2007.02.004. Epub 2007 Apr 16.
Cognitive impairment in elderly diabetic patients has generated considerable interest recently; however, the mechanism of the impairment remains to be elucidated. In the current study, factors associated with cognitive dysfunction in old diabetic patients were explored. A Mini Mental State Examination (MMSE) was performed on 907 of 1173 registered elderly Japanese diabetic subjects. To characterize the clinical features of diabetes, we examined indices of glycemic control, lipid metabolism, blood pressure and complications. Single regression analysis adjusted for age showed that shorter height, higher GDS 15 scores, lower serum albumin, history of cerebrovascular disease, the existence of diabetic nephropathy, no smoking habit, no drinking habit, and no occupation were associated with lower MMSE scores. Multiple regression analysis demonstrated that age (odds ratio (OR)=1.079; 95% confidence interval (CI)=1.011-1.150), GDS 15 scores (OR=1.139; 95% CI=1.045-1.243), serum albumin (OR=0.336; 95% CI=0.174-0.745), and history of cerebrovascular disease (OR=3.011; 95% CI=1.578-5.748) were the variables significantly associated with having lower MMSE scores.
老年糖尿病患者的认知障碍近来引起了广泛关注；然而，这种障碍的机制仍有待阐明。在本研究中，我们探讨了老年糖尿病患者认知功能障碍的相关因素。对1173名登记在册的日本老年糖尿病受试者中的907人进行了简易精神状态检查表（MMSE）测试。为了描述糖尿病的临床特征，我们检查了血糖控制、脂质代谢、血压及并发症等指标。校正年龄后的单因素回归分析显示，身高较矮、老年抑郁量表15项（GDS 15）得分较高、血清白蛋白水平较低、有脑血管疾病史、存在糖尿病肾病、无吸烟习惯、无饮酒习惯及无职业与较低的MMSE得分相关。多因素回归分析表明，年龄（比值比（OR）=1.079；95%置信区间（CI）=1.011 - 1.150）、GDS 15得分（OR = 1.139；95% CI = 1.045 - 1.243）、血清白蛋白（OR = 0.336；95% CI = 0.174 - 0.745）及脑血管疾病史（OR = 3.011；95% CI = 1.578 - 5.748）是与较低MMSE得分显著相关的变量。
