2 型糖尿病对老年心力衰竭患者认知功能的附加影响。
The additive effects of type-2 diabetes on cognitive function in older adults with heart failure.
机构信息
Department of Psychology, Kent State University, Kent, OH 44242, USA.
出版信息
Cardiol Res Pract. 2012;2012:348054. doi: 10.1155/2012/348054. Epub 2012 Jun 3.
Background. Medical comorbidity has been theorized to contribute to cognitive impairment in heart failure (HF) patients. Specifically, type-2 diabetes mellitus (T2DM), a common coexisting condition among HF patients, may be an independent predictor of cognitive impairment. Nonetheless, the relationships between T2DM and other risk factors for cognitive impairment among persons with HF are unclear. Methods. Persons with HF (N = 169, 34.3% women, age 68.57 ± 10.28 years) completed neuropsychological testing within a framework of an ongoing study. History of T2DM, along with other medical characteristics, was ascertained through a review of participants' medical charts and self-report. Results. Many participants (34.9%) had a comorbid T2DM diagnosis. After adjustment for demographic and medical characteristics, HF patients with T2DM evidenced significantly greater impairments across multiple cognitive domains than HF patients without T2DM: λ = .92, F(5, 156) = 2.82, P = .018. Post hoc tests revealed significant associations between T2DM and attention (P = .003), executive function (P = .032), and motor functioning (P = .008). Conclusion. The findings suggest additive contributions of T2DM and HF to impairments in attention, executive function, and motor function. Future work is needed to elucidate the mechanisms by which T2DM exacerbates cognitive impairment in HF.
背景
医学合并症被认为是导致心力衰竭（HF）患者认知障碍的原因之一。具体来说，2 型糖尿病（T2DM）是 HF 患者常见的共存疾病，可能是认知障碍的独立预测因素。然而，HF 患者中 T2DM 与其他认知障碍风险因素之间的关系尚不清楚。方法：在一项正在进行的研究中，169 名 HF 患者（34.3%为女性，年龄 68.57±10.28 岁）完成了神经心理学测试。通过回顾参与者的病历和自我报告，确定了 T2DM 病史以及其他医疗特征。结果：许多参与者（34.9%）有合并 T2DM 的诊断。在调整了人口统计学和医疗特征后，患有 T2DM 的 HF 患者在多个认知领域的损伤明显大于没有 T2DM 的 HF 患者：λ=0.92，F（5, 156）=2.82，P=0.018。事后检验显示 T2DM 与注意力（P=0.003）、执行功能（P=0.032）和运动功能（P=0.008）之间存在显著关联。结论：这些发现表明 T2DM 和 HF 对注意力、执行功能和运动功能的损伤有叠加作用。需要进一步的研究来阐明 T2DM 如何加剧 HF 中的认知障碍的机制。
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