Service of Internal Medicine B, AP-HP, Hôpital Lariboisière, University Paris 7 Denis-Diderot, Paris, France.
Diabetes Metab. 2013 Oct;39(5):418-23. doi: 10.1016/j.diabet.2013.02.008. Epub 2013 May 2.
This study aimed to assess the relationship between blood pressure and cognitive function in elderly patients with diabetes mellitus (DM).
A total of 32 patients with DM aged ≥ 65 years (seven women and 25 men; mean ± SD age: 74.3 ± 6.4 years) were included in this cross-sectional study. Relationships between blood pressure and neuropsychological tests were determined using Spearman's rank correlations (ρ) and multivariable linear regression models.
Lower diastolic blood pressure was associated with lower scores on the Frontal Assessment Battery (ρ=0.32, P=0.02), longer times to complete the Trail Making Test Part B (ρ=0.51, P=0.003), lower scores for the Finger Tapping Test (ρ=0.36, P=0.046) and less verbal fluency (ρ=0.36, P=0.047). In multivariable models, these relationships were attenuated after adjusting for levels of education.
There was an association between lower diastolic blood pressure and poorer executive function in this cohort of elderly DM patients. These results underline the importance of systematic cognitive evaluation in elderly patients with DM, and suggest that a too-low diastolic blood pressure may have deleterious effects on mental function. Larger studies in the future are required to confirm these preliminary results.
本研究旨在评估老年糖尿病（DM）患者的血压与认知功能之间的关系。
这项横断面研究共纳入 32 名年龄≥65 岁的 DM 患者（7 名女性和 25 名男性；平均±标准差年龄：74.3±6.4 岁）。使用 Spearman 秩相关系数（ρ）和多变量线性回归模型来确定血压与神经心理学测试之间的关系。
较低的舒张压与额叶评估量表（Frontal Assessment Battery，ρ=0.32，P=0.02）得分较低、完成 Trail Making Test 部分 B 的时间更长（ρ=0.51，P=0.003）、手指敲击测试（Finger Tapping Test，ρ=0.36，P=0.046）得分较低以及言语流畅性（Verbal Fluency，ρ=0.36，P=0.047）较低有关。在多变量模型中，在校正教育程度后，这些关系减弱。
在这组老年 DM 患者中，较低的舒张压与较差的执行功能之间存在关联。这些结果强调了对老年 DM 患者进行系统认知评估的重要性，并表明舒张压过低可能对精神功能产生有害影响。未来需要更大规模的研究来证实这些初步结果。
