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认知障碍与心血管药物使用:爱尔兰老龄化纵向研究第一波的结果。

Cognitive impairment and cardiovascular medication use: Results from wave 1 of The Irish Longitudinal Study on Ageing.

机构信息

Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.

Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland.

出版信息

Cardiovasc Ther. 2017 Dec;35(6). doi: 10.1111/1755-5922.12300. Epub 2017 Sep 26.

Abstract

AIM

To explore the association between cardiovascular medication use and cognitive impairment in adults aged 50 years and over.

METHOD

This cross-sectional linked database study involved secondary quantitative analysis of 1903 participants from wave 1 of the Irish Longitudinal Study on Ageing with available pharmacy claims data. Cognitive impairment was assessed using a cut-off of ≤23 on the Montreal Cognitive Assessment. Cardiovascular medication use was calculated using the proportion of days covered for antihypertensive, antithrombotic, and lipid-modifying medications. For each class of cardiovascular medication, participants were categorized as belonging to one of three medication use groups: (1) not dispensed any medications (reference); (2) poor adherence (proportion of days covered <80%); and (3) good adherence (proportion of days covered ≥80%).

RESULTS

Controlling for demographic and health variables, there was no evidence of an independent association between impaired cognitive function and use of antihypertensives [good adherence OR (95% CI): 1.16 (0.88, 1.52), poor adherence OR (95% CI): 1.39 (0.95, 2.04)]; antithrombotics [good adherence OR (95% CI): 1.26 (0.93, 1.70), poor adherence OR 95% CI): 1.13 (0.80, 1.59)]; or lipid-modifying agents [good adherence OR (95% CI): 0.95 (0.71, 1.25), poor adherence OR (95% CI): 0.88 (0.64, 1.22)].

CONCLUSION

We found no evidence of an association between cardiovascular medication use and cognitive function. Future studies should investigate the prospective associations between cognition and use of cardiovascular medications using longitudinal data.

摘要

目的

探讨 50 岁及以上成年人心血管药物使用与认知障碍的关系。

方法

这是一项基于爱尔兰老龄化纵向研究(1 波)的横断面关联数据库研究,对 1903 名参与者进行二次定量分析,这些参与者有可用的药房报销数据。使用蒙特利尔认知评估的≤23 作为认知障碍的截断值进行评估。使用抗高血压、抗血栓和调脂药物的覆盖天数比例来计算心血管药物的使用情况。对于每一类心血管药物,参与者分为以下三种药物使用组之一:(1)未配给任何药物(参照组);(2)用药依从性差(覆盖天数比例<80%);(3)用药依从性好(覆盖天数比例≥80%)。

结果

在控制人口统计学和健康变量后,认知功能障碍与使用抗高血压药物之间没有独立的关联证据[用药依从性好的 OR(95%CI):1.16(0.88,1.52);用药依从性差的 OR(95%CI):1.39(0.95,2.04)];抗血栓药物[用药依从性好的 OR(95%CI):1.26(0.93,1.70);用药依从性差的 OR(95%CI):1.13(0.80,1.59)];或调脂药物[用药依从性好的 OR(95%CI):0.95(0.71,1.25);用药依从性差的 OR(95%CI):0.88(0.64,1.22)]。

结论

我们没有发现心血管药物使用与认知功能之间存在关联的证据。未来的研究应该使用纵向数据来调查认知功能与心血管药物使用之间的前瞻性关联。

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