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酒精摄入与轻度认知障碍向痴呆症的转变

Alcohol consumption and transition of mild cognitive impairment to dementia.

作者信息

Xu Gelin, Liu Xinfeng, Yin Qin, Zhu Wusheng, Zhang Renliang, Fan Xiaobing

机构信息

Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China.

出版信息

Psychiatry Clin Neurosci. 2009 Feb;63(1):43-9. doi: 10.1111/j.1440-1819.2008.01904.x.

Abstract

AIM

Mild cognitive impairment (MCI) is a prodrome for dementia. Alcohol drinking patterns may affect cognitive functions and the effects may accumulate to a significant level at an advanced age. This study investigated the relationship between alcohol consumption and risks for dementia in a cohort of elderly patients with MCI.

METHODS

Patients with suspected cognitive impairment were screened. One hundred and seventy-six patients who met the MCI criteria were enrolled. Lifetime and daily alcohol consumptions were assessed at baseline using a self-report questionnaire answered by patients and their caregivers. Patients were classified according to alcohol consumptions as abstainers, light-moderate and heavy drinkers. Global cognitive functions were assessed periodically with Mini-Mental State Examination (MMSE). Enrolled patients were followed for 2 years.

RESULTS

Of the 176 patients diagnosed as having MCI, 15 (8.5%) died, 13 (7.4%) were lost to follow up, and 66 (37.5%) developed dementia during follow up. Light-moderate alcohol drinkers had better MMSE performance than abstainers (P < 0.05) and heavy drinkers (P < 0.01) 2 years after MCI diagnosis. Patients who consumed a total of <or=300 kg alcohol prior to MCI diagnosis had less cognitive decline than patients who consumed no (P < 0.05) or >300 kg alcohol (P < 0.01). Heavy drinkers had a higher risk for dementia than abstainers (P < 0.05) and light-moderate drinkers (P < 0.05) 2 years after MCI diagnosis.

CONCLUSIONS

A J-shaped relationship may exist between alcohol consumption and cognitive decline in MCI patients. Light-moderate alcohol drinking may be associated with decreased risks for dementia in elderly patients with MCI.

摘要

目的

轻度认知障碍(MCI)是痴呆的前驱症状。饮酒模式可能会影响认知功能,且这种影响在老年时可能累积到显著程度。本研究调查了老年MCI患者队列中饮酒与痴呆风险之间的关系。

方法

对疑似认知障碍患者进行筛查。纳入176例符合MCI标准的患者。在基线时使用患者及其照料者回答的自我报告问卷评估终生饮酒量和每日饮酒量。根据饮酒量将患者分为戒酒者、轻度 - 中度饮酒者和重度饮酒者。定期用简易精神状态检查表(MMSE)评估整体认知功能。对纳入患者随访2年。

结果

在176例被诊断为MCI的患者中,15例(8.5%)死亡,13例(7.4%)失访,66例(37.5%)在随访期间发展为痴呆。MCI诊断2年后,轻度 - 中度饮酒者的MMSE表现优于戒酒者(P < 0.05)和重度饮酒者(P < 0.01)。MCI诊断前饮酒总量≤300千克的患者比未饮酒(P < 0.05)或饮酒量>300千克(P < 0.01)的患者认知衰退更少。MCI诊断2年后,重度饮酒者患痴呆的风险高于戒酒者(P < 0.05)和轻度 - 中度饮酒者(P < 0.05)。

结论

MCI患者饮酒与认知衰退之间可能存在J形关系。轻度 - 中度饮酒可能与老年MCI患者患痴呆风险降低有关。

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