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德国普通人群中的贫血与轻度认知障碍

Anemia and Mild Cognitive Impairment in the German General Population.

作者信息

Dlugaj Martha, Winkler Angela, Weimar Christian, Dürig Jan, Broecker-Preuss Martina, Dragano Nico, Moebus Susanne, Jöckel Karl-Heinz, Erbel Raimund, Eisele Lewin

机构信息

Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.

Department of Hematology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.

出版信息

J Alzheimers Dis. 2016;49(4):1031-42. doi: 10.3233/JAD-150434.

Abstract

There is increasing evidence that anemia is associated with cognitive impairment. Therefore, the aim of the study was to examine the cross-sectional association of anemia as well as the persistence of anemia over the last five years with mild cognitive impairment (MCI) and MCI subtypes (amnestic/non-amnestic MCI (aMCI/naMCI)). Out of 4,157 participants (50% men, 50-80 years) of the second examination (t1) of a cohort study (baseline (t0) 2000-2003), we included 4,033 participants with available hemoglobin information and complete cognitive assessment. Anemia was defined as hemoglobin <13 g/dl in men (n = 84) and <12 g/dl in women (n = 79). Group comparisons were used to compare the cognitive subtests. To determine the association of MCI with anemia at t1, with anemia five years prior to the cognitive assessment (t0) and anemia at both time points, we used logistic regression models and included 579 participants with MCI and 1,438 cognitively normal participants out of the total cohort. Anemic participants showed lower performances in verbal memory and executive functions. The fully adjusted odds ratios (OR) for MCI, aMCI, and naMCI in anemic versus non-anemic participants were 1.92 (95% -CI, 1.09-3.39), 1.96 (1.00-3.87), and 1.88 (0.91-3.87). Anemia at both times points showed a non-significant association with naMCI (OR 3.74, 0.94-14.81, fully adjusted). Our results suggest that anemia is associated with an increased risk of MCI independent of traditional cardiovascular risk factors. The association of anemia and MCI has important clinical relevance, because many causes of anemia can be treated effectively.

摘要

越来越多的证据表明贫血与认知障碍有关。因此,本研究的目的是探讨贫血的横断面关联以及过去五年中贫血的持续性与轻度认知障碍(MCI)及其亚型(遗忘型/非遗忘型MCI(aMCI/naMCI))之间的关系。在一项队列研究的第二次检查(t1)(基线(t0)为2000 - 2003年)的4157名参与者(50%为男性,年龄50 - 80岁)中,我们纳入了4033名有可用血红蛋白信息且认知评估完整的参与者。贫血定义为男性血红蛋白<13 g/dl(n = 84),女性血红蛋白<12 g/dl(n = 79)。采用组间比较来比较认知子测试。为了确定t1时MCI与贫血、认知评估前五年(t0)的贫血以及两个时间点的贫血之间的关联,我们使用了逻辑回归模型,在总队列中纳入了579名MCI参与者和1438名认知正常的参与者。贫血参与者在言语记忆和执行功能方面表现较差。贫血与非贫血参与者相比,MCI、aMCI和naMCI的完全调整优势比(OR)分别为1.92(95%可信区间,1.09 - 3.39)、1.96(1.00 - 3.87)和1.88(0.91 - 3.87)。两个时间点均贫血与naMCI的关联无统计学意义(完全调整后OR为3.74,0.94 - 14.81)。我们的结果表明,贫血与MCI风险增加相关,且独立于传统心血管危险因素。贫血与MCI的关联具有重要的临床意义,因为许多贫血病因可以得到有效治疗。

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