Tu Qiuyun, Ding Binrong, Yang Xia, Bai Song, Tu Junshi, Liu Xiao, Wang Ranran, Tao Jinghua, Jin Hui, Wang Yiqun, Tang Xiangqi
Department of Geriatrics, The Third Xiangya Hospital of Central South University, Changsha 410013, China.
Department of Rehabilitation Therapy, Zhongshan School of Medicine in Sun Yat-Sen University, 510080, China.
Arch Gerontol Geriatr. 2014 Mar-Apr;58(2):236-47. doi: 10.1016/j.archger.2013.09.006. Epub 2013 Oct 6.
The objectives of the study were to explore the prevalence and effects of vascular cognitive impairment (VCI) among ischemic stroke patients and to provide a basis for prevention and treatment strategies. A stratified cluster random sampling method was performed, and 689 ischemic stroke patients (over 40 years of age) were enrolled. All of the patients had received a neuropsychological assessment battery to assess cognitive function and self-designed questionnaires to collect relevant information. According to the cognitive status, the patients were divided into two groups, a case group and a control group. The caregivers of the patients were given a questionnaire concerning the awareness of and attitudes toward VCI. In this study, we determined that the prevalence of VCI was 41.8%. Aging, paraventricular white matter lesion (WML), macroangiopathy, high levels of alcohol, a lack of hobbies, and excessive sleep were risk factors for vascular cognitive impairment no dementia (VCIND). A high level of education, manual-work, low level of alcohol use, regular health checks, a vegetable-based diet, and more fruit and milk were protective factors for VCIND. Living alone, hyperlipidemia, transient ischemic attack, a family history of stroke, and brain atrophy were risk factors of vascular dementia (VD). A high educational level, a vegetable-based diet, and tea were protective factors for VD. The general public awareness of VCI was found to be insufficient, and there was a prejudice toward and lack of funding for the care of VCI patients. The prevalence of VCI is high in ischemic stroke patients, and there are different impact factors at different stages. Despite the high prevalence of VCI, the general public awareness is limited. Appropriate prevention measures should be developed to reduce the prevalence of VCI.
本研究的目的是探讨缺血性脑卒中患者血管性认知障碍(VCI)的患病率及其影响因素,为预防和治疗策略提供依据。采用分层整群随机抽样方法,纳入689例年龄超过40岁的缺血性脑卒中患者。所有患者均接受了神经心理评估量表以评估认知功能,并通过自行设计的问卷收集相关信息。根据认知状态,将患者分为病例组和对照组。同时向患者的照料者发放了关于VCI认知及态度的问卷。本研究确定VCI的患病率为41.8%。年龄、脑室旁白质病变(WML)、大血管病变、大量饮酒、缺乏爱好以及睡眠过多是无痴呆血管性认知障碍(VCIND)的危险因素。高学历、体力劳动、少量饮酒、定期体检、以蔬菜为主的饮食以及更多的水果和牛奶是VCIND的保护因素。独居、高脂血症、短暂性脑缺血发作、脑卒中家族史以及脑萎缩是血管性痴呆(VD)的危险因素。高学历、以蔬菜为主的饮食以及饮茶是VD的保护因素。研究发现公众对VCI的认知不足,对VCI患者的照料存在偏见且资金投入不足。缺血性脑卒中患者中VCI的患病率较高,且在不同阶段有不同的影响因素。尽管VCI患病率较高,但公众认知有限。应制定适当的预防措施以降低VCI的患病率。