van den Berg Esther, Kloppenborg Raoul P, Kessels Roy P C, Kappelle L Jaap, Biessels Geert Jan
Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Biochim Biophys Acta. 2009 May;1792(5):470-81. doi: 10.1016/j.bbadis.2008.09.004. Epub 2008 Sep 23.
Vascular risk factors, such as type 2 diabetes mellitus, hypertension, dyslipidemia and obesity, have been associated with an increased risk of cognitive dysfunction, particularly in the elderly. The aim of this systematic review was to compare these risk factors with regard to the nature and magnitude of the associated cognitive decrements. Cross-sectional and longitudinal studies that assessed cognitive functioning in non-demented persons in relation to diabetes/impaired glucose metabolism (k = 36), hypertension (k = 24), dyslipidemia (k = 7) and obesity (k = 6) and that adjusted or matched for age, gender and education were included. When possible, effect sizes (Cohen's d) were computed per cognitive domain. Diabetes and hypertension were clearly associated with cognitive decrements; the results for obesity and dyslipidemia were less consistent. Effect sizes were moderate (median approximately -0.3) for all risk factors. Decline was found in all cognitive domains, although the effects on cognitive speed, mental flexibility and memory were most consistent. Methodological aspects of included studies and implications of these findings are discussed.
血管危险因素，如2型糖尿病、高血压、血脂异常和肥胖，与认知功能障碍风险增加有关，尤其是在老年人中。本系统评价的目的是比较这些危险因素在相关认知减退的性质和程度方面的差异。纳入了横断面研究和纵向研究，这些研究评估了非痴呆人群中与糖尿病/糖代谢受损（k = 36）、高血压（k = 24）、血脂异常（k = 7）和肥胖（k = 6）相关的认知功能，并对年龄、性别和教育程度进行了调整或匹配。尽可能针对每个认知领域计算效应量（科恩d值）。糖尿病和高血压与认知减退明显相关；肥胖和血脂异常的结果不太一致。所有危险因素的效应量均为中等（中位数约为-0.3）。在所有认知领域均发现有下降，尽管对认知速度、思维灵活性和记忆的影响最为一致。讨论了纳入研究的方法学方面以及这些发现的意义。
