Division of Health Science, Osaka University, Graduate School of Medicine, Osaka, Japan.
Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
Hypertens Res. 2017 Jul;40(7):665-670. doi: 10.1038/hr.2017.15. Epub 2017 Feb 23.
Both hypertension and diabetes in middle-aged individuals have been suggested to be predictive indicators of cognitive decline. However, the association of hypertension, diabetes and their combination with cognitive functioning is still controversial in older people. The purpose of this study was to investigate the association between cognitive decline and hypertension, diabetes, and their combination in 70-year-old people based on a 3-year longitudinal analysis. Four hundred and fifty-four people aged 70 (±1) years who participated in the Japanese longitudinal cohort study of Septuagenarians, Octogenarians and Nonagenarians Investigation with Centenarians (SONIC) were recruited randomly from a general population and were monitored for 3 years. The data, including most of the demographics, cognitive functioning measured by the Montreal Cognitive Assessment Japanese version (MoCA-J), blood pressure, blood chemistry and other medical histories, were collected at baseline and during the follow-up. The prevalence of hypertension noted in the follow-up survey was significantly higher than than noted at baseline. The mean MoCA-J score at follow-up was not significantly different from the score obtained at baseline. However, the participants with diabetes, especially combined with hypertension at baseline, had significantly lower MoCA-J scores than those without lifestyle-related diseases. The combination of hypertension and diabetes was still a significant risk factor for cognitive decline, considering the MoCA-J scores obtained during the follow-up after adjustments at baseline, relative to sex, body mass index, dyslipidemia, smoking, excessive alcohol intake, antihypertensive treatment and education level (β=-0.14; P<0.01). Our findings indicate that diabetes and the combination of hypertension and diabetes are clear risk factors for future cognitive decline in elderly individuals who are 70 years of age.
高血压和糖尿病都被认为是中年人认知能力下降的预测指标。然而，在老年人中，高血压、糖尿病及其组合与认知功能的关系仍存在争议。本研究旨在通过 3 年的纵向分析，探讨 70 岁人群中认知能力下降与高血压、糖尿病及其组合的关系。从一般人群中随机抽取 454 名年龄在 70（±1）岁的人参加日本 70、80 和 90 岁及以上人群纵向研究与百岁老人调查（SONIC），并对其进行 3 年的监测。在基线和随访期间收集了包括大多数人口统计学数据、蒙特利尔认知评估日本版（MoCA-J）评估的认知功能、血压、血液化学和其他病史在内的数据。在随访调查中，高血压的患病率明显高于基线时。随访时的 MoCA-J 平均得分与基线时的得分无显著差异。然而，患有糖尿病的参与者，尤其是基线时同时患有高血压的参与者，MoCA-J 得分明显低于没有生活方式相关疾病的参与者。考虑到基线调整后随访期间获得的 MoCA-J 评分，高血压和糖尿病的组合仍然是认知能力下降的一个显著危险因素，与性别、体重指数、血脂异常、吸烟、过量饮酒、降压治疗和教育程度有关（β=-0.14；P<0.01）。我们的研究结果表明，对于 70 岁的老年人，糖尿病和高血压与糖尿病的组合是未来认知能力下降的明确危险因素。
