老年人酒精相关问题的流行情况及其与认知障碍和痴呆的关系。
Prevalence of alcohol-related problems in an elderly population and their association with cognitive impairment and dementia.
机构信息
School of Medicine of Ribeirão Preto, University of São Paulo Hospital of Clinics, Ribeirão Preto, SP, Brazil.
出版信息
Alcohol Clin Exp Res. 2010 Apr;34(4):726-33. doi: 10.1111/j.1530-0277.2009.01142.x. Epub 2010 Jan 26.
BACKGROUND
Studies investigating the association between alcohol use and cognitive disorders in the elderly population have produced divergent results. Moreover, the role of alcohol in cognitive dysfunction is not clear. The aims of this study were to estimate the prevalence of alcohol-related problems in an elderly population from Brazil and to investigate their association with cognitive and functional impairment (CFI) and dementia.
METHODS
A community-based cross-sectional study was performed. A sample of 1,145 elderly people was examined in 2 phases. Several instruments were utilized in the first phase: the CAGE questionnaire was used to identify potential cases of alcohol-related problems, and a screening test for dementia was used to estimate CFI. The CAMDEX interview (Cambridge Examination) and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) criteria were used for the clinical diagnosis of dementia in the second phase.
RESULTS
"Heavy alcohol use" (CAGE > or = 2) was found in 92 subjects (prevalence: 8.2%). It was associated with gender (males, p < 0.001), low education (only in females, p = 0.002), and low socioeconomic level (p = 0.001, in females; p = 0.002, in males). The Mini Mental State Examination exhibited a nonlinear relationship with alcohol-related problems in females; "mild-moderate alcohol use" (CAGE < 2) presented the highest score. A significant association between alcohol-related problems and cognitive dysfunction was found only in females. "Heavy alcohol use" was associated with higher CFI and dementia rates compared to "mild-moderate alcohol use" (p = 0.003 and p < 0.001, respectively). "Mild-moderate alcohol use" had a tendency of association with lower CFI and dementia rates when compared to "no alcohol use" (p = 0.063 and 0.050, respectively).
CONCLUSION
Our findings suggest that alcohol use does not have a linear relationship with cognitive decline.
背景
研究发现，酒精使用与老年人认知障碍之间存在关联，但结果存在差异。此外，酒精在认知功能障碍中的作用尚不清楚。本研究旨在评估巴西老年人群中与酒精相关问题的患病率，并探讨其与认知和功能障碍（CFI）及痴呆的关系。
方法
本研究为基于社区的横断面研究。在两个阶段共检查了 1145 名老年人。第一阶段使用了多种工具：CAGE 问卷用于识别与酒精相关问题的潜在病例，以及痴呆筛查测试用于评估 CFI。在第二阶段使用 CAMDEX 访谈（剑桥检查）和 DSM-IV（精神障碍诊断和统计手册，第 4 版）标准进行痴呆的临床诊断。
结果
92 名受试者（患病率：8.2%）存在“大量饮酒”（CAGE≥2）。其与性别相关（男性，p<0.001），与受教育程度较低相关（仅女性，p=0.002），与社会经济水平较低相关（女性，p=0.001；男性，p=0.002）。简易精神状态检查在女性中与酒精相关问题呈非线性关系；“轻度至中度饮酒”（CAGE<2）得分最高。仅在女性中发现酒精相关问题与认知功能障碍之间存在显著相关性。与“轻度至中度饮酒”相比，“大量饮酒”与更高的 CFI 和痴呆发生率相关（p=0.003 和 p<0.001）。与“不饮酒”相比，“轻度至中度饮酒”与较低的 CFI 和痴呆发生率呈趋势相关（p=0.063 和 0.050）。
结论
本研究结果表明，酒精使用与认知能力下降之间并非呈线性关系。
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