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老年患者的认知功能:维生素 D 缺乏症是认知功能障碍和痴呆症的下一个标志物吗?

Cognitive Functioning of Geriatric Patients: Is Hypovitaminosis D the Next Marker of Cognitive Dysfunction and Dementia?

机构信息

Department of Geriatrics, Medical University of Bialystok, Fabryczna 27, 15-471 Bialystok, Poland.

Geriatric Ward, Hospital of the Ministry of Interior and Administration in Bialystok, Fabryczna 27, 15-471 Bialystok, Poland.

出版信息

Nutrients. 2018 Aug 16;10(8):1104. doi: 10.3390/nu10081104.

DOI:10.3390/nu10081104
PMID:30115862
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6115732/
Abstract

The study objective is to investigate whether vitamin D is associated with the cognitive function of geriatric patients. This cross-sectional study involved 357 patients hospitalized in the geriatric ward who complained of memory problems (mean age: 82.3 years). The level of cognitive function was measured with the Mini-Mental State Examination (MMSE) and the clinical diagnosis of dementia was established according to the International Classification of Diseases (ICD-10) criteria. The serum 25-hydroxy vitamin D was measured with liquid chromatography-tandem mass spectrometry. The iterative Bayesian model averaging (BMA) procedure was applied to linear and logistic regression models in order to identify the best set of factors describing cognitive dysfunction and dementia, respectively. According to BMA, there is strong evidence that higher vitamin D levels, higher body mass index (BMI), and higher mobility function measured with the Timed Up and Go (TUG) test are independently associated with better cognitive performance and lower risk of dementia. Additionally, there is strong evidence that fewer years of education and lower vitamin B12 plasma levels independently describe worse cognitive performance. However, vitamin B12 levels higher than 800 pg/mL is negatively associated with the MMSE performance. Hypovitaminosis D in geriatric patients is an underrated marker of cognitive dysfunction and dementia.

摘要

本研究旨在探讨维生素 D 是否与老年患者的认知功能有关。这项横断面研究纳入了 357 名因记忆问题而住院的老年病房患者(平均年龄:82.3 岁)。认知功能水平采用简易精神状态检查(MMSE)进行测量,痴呆的临床诊断根据国际疾病分类(ICD-10)标准确定。血清 25-羟维生素 D 采用液相色谱-串联质谱法进行测量。迭代贝叶斯模型平均(BMA)程序应用于线性和逻辑回归模型,以分别确定描述认知功能障碍和痴呆的最佳因素组合。根据 BMA,有强有力的证据表明,较高的维生素 D 水平、较高的体重指数(BMI)和使用计时起立行走(TUG)测试测量的较高的活动能力与更好的认知表现和较低的痴呆风险独立相关。此外,有强有力的证据表明,受教育年限较少和维生素 B12 血浆水平较低与认知表现较差独立相关。然而,维生素 B12 水平高于 800pg/mL 与 MMSE 表现呈负相关。老年患者的维生素 D 缺乏是认知功能障碍和痴呆的一个被低估的标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/352d/6115732/790f291f3a47/nutrients-10-01104-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/352d/6115732/77c4461aa4bc/nutrients-10-01104-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/352d/6115732/790f291f3a47/nutrients-10-01104-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/352d/6115732/77c4461aa4bc/nutrients-10-01104-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/352d/6115732/790f291f3a47/nutrients-10-01104-g002.jpg

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