Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
Geriatr Gerontol Int. 2011 Apr;11(2):211-4. doi: 10.1111/j.1447-0594.2010.00669.x. Epub 2010 Dec 10.
To determine whether vascular risk factors such as hypertension, diabetes and hypercholesterolemia affect the progression of Alzheimer's disease (AD).
We followed up 150 consecutive outpatients with probable AD for 24-60 months. Severity of cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). We investigated the influence of vascular risk factors and other demographic and clinical conditions (including age, sex, education, initial MMSE score and follow-up time) on annual MMSE score changes.
Multiple regression analysis revealed that age, education and hypertension were significant variables associated with annual MMSE score changes. Younger, more educated patients with hypertension showed greater decline in annual MMSE scores. There were no significant correlations of annual MMSE score changes with other vascular factors or demographics, including sex, initial MMSE score, diabetes or hypercholesterolemia.
Younger, more educated patients are more likely to have faster cognitive decline. In addition, hypertension may also be associated with a greater rate of disease progression. Our results suggest the importance of prevention and treatment for hypertension in patients with AD.
确定高血压、糖尿病和高胆固醇血症等血管危险因素是否会影响阿尔茨海默病(AD)的进展。
我们对 150 例连续的可能患有 AD 的门诊患者进行了 24-60 个月的随访。使用 Mini-Mental State Examination(MMSE)评估认知障碍的严重程度。我们调查了血管危险因素以及其他人口统计学和临床状况(包括年龄、性别、教育程度、初始 MMSE 评分和随访时间)对 MMSE 评分年度变化的影响。
多元回归分析显示,年龄、教育程度和高血压是与 MMSE 评分年度变化相关的显著变量。患有高血压的年轻、教育程度较高的患者,其 MMSE 评分的年度下降幅度更大。MMSE 评分年度变化与其他血管因素或人口统计学因素(包括性别、初始 MMSE 评分、糖尿病或高胆固醇血症)之间没有显著相关性。
年轻、教育程度较高的患者更有可能出现认知功能衰退速度加快的情况。此外,高血压也可能与疾病进展的速度加快有关。我们的结果表明,在 AD 患者中预防和治疗高血压非常重要。