Division of General Medicine, University of Michigan Health System, and Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan; Veterans Affairs Health Services Research and Development Center of Excellence, Ann Arbor, Michigan; The Stroke ProgramUniversity of Michigan, Ann Arbor, Michigan.
J Stroke Cerebrovasc Dis. 2013 Oct;22(7):1038-45. doi: 10.1016/j.jstrokecerebrovasdis.2012.05.004. Epub 2012 Jun 27.
Poststroke cognitive decline (PSCD) is an important consequence of stroke that may be more severe in women than in men. The existence of any gender differences in PSCD among Mexican Americans, and their potential mechanisms, such as blood pressure (BP), remain unknown. We assessed PSCD stratified on gender in older Mexican Americans and explored the influence of pre- and poststroke systolic BP on PSCD.
Among 1576 nondemented, stroke-free adults 60 years of age or older when recruited between 1998 and 1999 in the Sacramento Area Latino Study on Aging (SALSA) cohort, we examined pre- and poststroke longitudinal changes in Spanish English Verbal Learning test scores (WL), a verbal memory test, and errors on the Modified Mini Mental State Examination (3MSE) scores, a global cognition test, stratified by gender, adjusting for baseline and time-varying covariates with linear mixed effects models.
We identified 151 adults (mean age 72 ± 8 years) with incident first-ever stroke during 10 years of follow-up. After adjustment for age, education, and time-varying depressive symptoms, 3MSE errors increased by 22% per year (95% confidence interval [CI] 6.8-36.7%) in men and 13.2% per year (95% CI 3.5-22.9%) in women over the poststroke period. Poststroke WL scores improved by 0.05 words per year (95% CI -0.24 to 0.33) in men and by 0.09 words per year (95% CI -0.16 to 0.34) in women. Results persisted after adjustment for time-varying systolic BP.
Among this population of older Mexican Americans, PSCD did not differ by gender. We found no evidence that systolic BP influenced PSCD in women or men.
卒中后认知衰退（PSCD）是卒中的一个重要后果，女性的认知衰退可能比男性更严重。墨西哥裔美国人中是否存在 PSCD 的性别差异，以及他们潜在的机制，如血压（BP），目前尚不清楚。我们评估了老年墨西哥裔美国人中按性别分层的 PSCD，并探讨了卒中前和卒中后收缩压对 PSCD 的影响。
在 1998 年至 1999 年招募的 1576 名无痴呆、无卒中的 60 岁或以上的萨克拉门托拉丁裔老龄化研究（SALSA）队列的非痴呆成年人中，我们检查了西班牙-英语词汇学习测试（WL）、一项语言记忆测试和改良的 Mini-Mental State 检查（3MSE）的得分在性别分层的情况下，在卒中前后的纵向变化，调整了线性混合效应模型的基线和时变协变量。
我们确定了 151 名成年人（平均年龄 72 ± 8 岁）在 10 年的随访期间发生了首次首发卒中。在调整年龄、教育和时变抑郁症状后，男性每年 3MSE 错误增加 22%（95%置信区间 [CI] 6.8-36.7%），女性每年增加 13.2%（95% CI 3.5-22.9%）。男性每年的 WL 分数增加 0.05 个单词（95% CI -0.24 到 0.33），女性每年增加 0.09 个单词（95% CI -0.16 到 0.34）。在调整时变收缩压后，结果仍然存在。
在这一老年墨西哥裔美国人人群中，PSCD 不分性别。我们没有发现收缩压对女性或男性 PSCD 有影响的证据。
