From the Department of Geriatrics (E.J.M.d.B., H.L.K.), Department of Radiology (R.K., W.P.T.M.M., J.H., P.A.d.J.), and Julius Center for Health Sciences and Primary Care, Department of Epidemiology (M.I.G.), University Medical Center Utrecht, Room B05.2.25, PO Box 85500, 3508 GA Utrecht, the Netherlands; and Departments of Neurology (J.J.C.), Geriatrics (A.d.J.), and Radiology (T.E.F.J.), Tergooi Hospital, Hilversum, the Netherlands.
Radiology. 2018 Sep;288(3):815-820. doi: 10.1148/radiol.2018172588. Epub 2018 Jun 12.
Purpose To identify risk factors for hippocampal calcifications and to investigate the association between hippocampal calcifications and cognitive function. Materials and Methods For this retrospective study, consecutive patients visiting a memory clinic at a Dutch general hospital between April 2009 and April 2015 were identified. All individuals underwent a standard diagnostic work-up including cognitive tests and brain CT. The following vascular risk factors were assessed: hypertension, diabetes mellitus, hyperlipidemia, and smoking. Cognitive screening consisted of the Cambridge Cognitive Examination, which includes the Mini-Mental State Examination. CT scans were analyzed for the presence and severity (absent, mild, moderate, severe) of hippocampal calcifications. One measure per patient, only the most severe score, was used. Logistic regression was used to identify risk factors for hippocampal calcifications, and linear regression was used for the association between hippocampal calcifications (patient level) and cognitive function. Results A total of 1991 patients (mean age, 78 years; range, 45-96 years) were included. The mean age of women was 79 years (range, 47-96 years), and the mean age of men was 77 years (range, 45-95 years). Of the 1991 patients, 380 (19.1%) had hippocampal calcifications. Older age (odds ratio [OR] per year, 1.05; 95% confidence interval [CI]: 1.03, 1.06), diabetes mellitus (OR, 1.50; 95% CI: 1.12, 2.00), and smoking (OR, 1.49; 95% CI: 1.05, 2.10) were associated with the presence of hippocampal calcifications. No associations were found between presence and severity of hippocampal calcifications and cognitive function. Conclusion Older age, diabetes mellitus, and smoking were associated with an increased risk of hippocampal calcifications. A greater degree of hippocampal calcifications was not associated with lower cognitive function in patients with memory complaints.
确定海马钙化的危险因素,并研究海马钙化与认知功能之间的关系。
本回顾性研究纳入了 2009 年 4 月至 2015 年 4 月期间在荷兰一家综合医院的记忆门诊就诊的连续患者。所有患者均接受了标准的诊断检查,包括认知测试和脑 CT。评估了以下血管危险因素:高血压、糖尿病、高脂血症和吸烟。认知筛查包括剑桥认知测验,其中包括简易精神状态检查。对 CT 扫描中是否存在海马钙化以及严重程度(无、轻度、中度、重度)进行了分析。每位患者使用一项测量指标,仅使用最严重的评分。采用逻辑回归确定海马钙化的危险因素,采用线性回归确定海马钙化(患者水平)与认知功能之间的关系。
共纳入 1991 例患者(平均年龄 78 岁,范围 45-96 岁)。女性的平均年龄为 79 岁(范围 47-96 岁),男性的平均年龄为 77 岁(范围 45-95 岁)。1991 例患者中,380 例(19.1%)有海马钙化。年龄较大(每年的优势比 [OR],1.05;95%置信区间 [CI]:1.03,1.06)、糖尿病(OR,1.50;95% CI:1.12,2.00)和吸烟(OR,1.49;95% CI:1.05,2.10)与海马钙化的存在相关。未发现海马钙化的存在和严重程度与认知功能之间存在关联。
年龄较大、糖尿病和吸烟与海马钙化的风险增加相关。在有记忆主诉的患者中,海马钙化程度较大与认知功能下降无关。