Hayakawa Tomoaki, McGarrigle Christine A, Coen Robert F, Soraghan Christopher J, Foran Tim, Lawlor Brian A, Kenny Rose Anne
Mercer's Institute of Successful Ageing, St James's Hospital, Dublin, Ireland.
The Irish Longitudinal Study on Ageing, Trinity College Dublin, The University of Dublin, Dublin, Ireland.
J Am Geriatr Soc. 2015 Sep;63(9):1868-73. doi: 10.1111/jgs.13596. Epub 2015 Aug 27.
To compare the patterns of blood pressure (BP) behavior during orthostasis in individuals with mild cognitive impairment (MCI) with those of controls and to investigate whether orthostatic BP behavior differs between individuals with MCI who convert to dementia and those who do not.
Longitudinal study with 3 years of follow-up.
Memory clinic in Dublin, Ireland, between 2007 and 2012.
Community-dwelling individuals with MCI (n = 150) and controls (n = 75).
Orthostatic BP was examined using the active standing test with a beat-to-beat continuous BP monitoring device in addition to neuropsychological testing. Hazard ratios (HRs) from parametric survival models were used to determine whether conversion to dementia was independently associated with baseline orthostatic BP variables.
Individuals with MCI were more likely than controls to have a systolic BP (SBP) deficit of greater than 30% 30 seconds after standing (P = .01). Thirty percent of participants with MCI (n = 43) converted to dementia within the 3-year follow-up period. Individuals with MCI with a SBP deficit greater than 30% 30 seconds after standing were twice as likely to convert to dementia as those without the deficit (HR = 2.77, 95% confidence interval = 1.02-7.50).
Human beings have evolved an elaborate neurological control system to maintain cerebral perfusion during orthostatic challenge. In people with MCI, this response is impaired and renders them twice as likely to convert to dementia.
比较轻度认知障碍（MCI）个体与对照组在直立位时的血压（BP）行为模式，并调查转化为痴呆症的MCI个体与未转化者之间的直立位血压行为是否存在差异。
为期3年随访的纵向研究。
2007年至2012年期间爱尔兰都柏林的记忆诊所。
社区居住的MCI个体（n = 150）和对照组（n = 75）。
除了神经心理学测试外，使用带有逐搏连续血压监测设备的主动站立测试来检查直立位血压。参数生存模型的风险比（HRs）用于确定转化为痴呆症是否与基线直立位血压变量独立相关。
MCI个体比对照组更有可能在站立30秒后出现收缩压（SBP）下降超过30%（P = 0.01）。30%的MCI参与者（n = 43）在3年随访期内转化为痴呆症。站立30秒后SBP下降超过30%的MCI个体转化为痴呆症的可能性是未出现下降者的两倍（HR = 2.77，95%置信区间 = 1.02 - 7.50）。
人类进化出了一套复杂的神经控制系统，以在直立位挑战期间维持脑灌注。在MCI患者中，这种反应受损，使他们转化为痴呆症的可能性增加一倍。
