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晚年的认知能力下降和抑郁症状与他汀类药物的使用有关:一项基于撒丁岛居家老人的人群研究的证据。

Cognitive decline and depressive symptoms in late-life are associated with statin use: evidence from a population-based study of Sardinian old people living in their own home.

作者信息

Mandas Antonella, Congiu Maria G, Abete Claudia, Dessi Sandra, Manconi Paolo E, Musio Monica, Columbu Silvia, Racugno Walter

出版信息

Neurol Res. 2014 Mar;36(3):247-54. doi: 10.1179/1743132813Y.0000000287.

Abstract

OBJECTIVES

This study was designed to provide further insights into the effects of dyslipidemia (Dys-y) and use of statins (St-y) on cognitive functions and mood in older people.

METHODS

Three hundred and twenty-nine subjects aged > or = 65 years were screened for cognitive dysfunction using mini mental state examination (MMSE). The geriatric depression scale (GDS) was used to detect depression. Interview questionnaires surveyed activities of daily living (ADL) and instrumental ADL (IADL), as well as other functional disabilities. The presence of neutral lipids (NLs) in cytoplasm of peripheral blood mononuclear cells (PBMCs) was determined with the Oil red O (ORO) staining.

RESULTS

There was no significant difference in MMSE and GDS scores between normal (Dys-n) and Dys-y. However, when Dys-y subjects were divided into St-y and non-statin users (St-n), significant differences emerged in the scores of MMSE and GDS: St-y had lower MMSE and higher GDS than St-n. Multiple correspondence analysis and logistic regression provided further evidence that elderly St-y were much more likely to suffer of cognitive impairment and depression than St-n. Another interesting finding was that the intensity of NL-PBMCs measured by ORO staining was greater in subjects with altered MMSE compared with cognitively normal subjects. In addition St-y had higher ORO score than St-n.

DISCUSSION

This is an observational study and cannot, therefore, prove a causal relationship between St-y in the elderly and a higher cognitive decline, nevertheless it provides substantial indications that caution should be exercised in the provision of statins in elderly subjects to avoid accelerated memory loss.

摘要

目的

本研究旨在进一步深入了解血脂异常(Dys-y)和他汀类药物使用(St-y)对老年人认知功能和情绪的影响。

方法

使用简易精神状态检查表(MMSE)对329名年龄≥65岁的受试者进行认知功能障碍筛查。采用老年抑郁量表(GDS)检测抑郁情况。通过访谈问卷调查日常生活活动(ADL)、工具性日常生活活动(IADL)以及其他功能障碍情况。采用油红O(ORO)染色法测定外周血单个核细胞(PBMCs)细胞质中中性脂质(NLs)的存在情况。

结果

正常组(Dys-n)和血脂异常组(Dys-y)在MMSE和GDS评分上无显著差异。然而,当将血脂异常组受试者分为他汀类药物使用者(St-y)和非他汀类药物使用者(St-n)时,MMSE和GDS评分出现了显著差异:St-y组的MMSE评分低于St-n组,GDS评分高于St-n组。多重对应分析和逻辑回归提供了进一步证据,表明老年St-y组比St-n组更易出现认知障碍和抑郁。另一个有趣的发现是,与认知正常的受试者相比,MMSE改变的受试者中通过ORO染色测量的NL-PBMCs强度更大。此外,St-y组的ORO评分高于St-n组。

讨论

这是一项观察性研究,因此无法证明老年人使用他汀类药物与更高的认知衰退之间存在因果关系,尽管如此,它提供了大量迹象表明,在为老年受试者提供他汀类药物时应谨慎,以避免加速记忆力丧失。

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