Sakakura Kenichi, Hoshide Satoshi, Ishikawa Joji, Momomura Shin-ichi, Kawakami Masanobu, Shimada Kazuyuki, Kario Kazuomi
Cardiovascular Division, Department of Integrated Medicine I, Saitama Medical Center, Jichi Medical University School of Medicine, Saitama, Japan.
Am J Hypertens. 2008 Jun;21(6):627-32. doi: 10.1038/ajh.2008.157. Epub 2008 Apr 3.
As hypertension, obesity, and leanness are reported to be associated with poor cognitive function, it is possible that obesity or leanness in hypertensive patients may also be associated strongly with poor cognitive function.
We recruited 184 elderly hypertensive patients comprising 93 very elderly (aged >or=80 years) and 91 younger elderly (aged 61-79 years) subjects. A mini-mental state examination (MMSE) and 24-h ambulatory blood pressure monitoring (ABPM) were performed in all participants. Patients were classified as either lean, normal physique, or obese according to the body mass index (BMI) quartile. The prevalence of poor cognitive function, total MMSE score, and MMSE subscores were compared between the groups.
The prevalence of poor cognitive function, total MMSE score, and MMSE subscore attention/calculation were significantly different between the groups both in the total study population and in the very elderly patients. The multiple logistic regression model showed that leanness was a significant determinant of poor cognitive function in both the total study population (odds ratio (OR) 2.54, 95% confidence interval (CI) 1.13-5.73, P = 0.02) and the very elderly patients (OR 3.94, 95% CI 1.31-11.82, P = 0.01). Obesity was not a significant determinant in either the total study population, very elderly, or younger elderly groups.
While obesity in hypertensive elderly patients was not associated with poor cognitive function, leanness in hypertensive elderly patients was, especially in the very elderly.
据报道，高血压、肥胖和消瘦与认知功能差有关，因此高血压患者的肥胖或消瘦也可能与认知功能差密切相关。
我们招募了184名老年高血压患者，其中包括93名高龄（年龄≥80岁）和91名低龄（年龄61 - 79岁）受试者。所有参与者均进行了简易精神状态检查（MMSE）和24小时动态血压监测（ABPM）。根据体重指数（BMI）四分位数将患者分为消瘦、正常体型或肥胖。比较各组认知功能差的患病率、MMSE总分及MMSE各分项得分。
在整个研究人群和高龄患者中，各组认知功能差的患病率、MMSE总分及MMSE分项得分中的注意力/计算得分均存在显著差异。多因素logistic回归模型显示，消瘦是整个研究人群（比值比（OR）2.54，95%置信区间（CI）1.13 - 5.73，P = 0.02）和高龄患者（OR 3.94，95% CI 1.31 - 11.82，P = 0.01）认知功能差的重要决定因素。肥胖在整个研究人群、高龄或低龄患者组中均不是重要决定因素。
高血压老年患者的肥胖与认知功能差无关，而消瘦与认知功能差有关，尤其是在高龄患者中。
