Chen Guei-Chiuan, Chen Pei-Ya, Su Yu-Chin, Hsiao Cheng-Lun, Yang Fu-Yi, Hsu Po-Jen, Lin Shinn-Kuang
Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Front Neurol. 2019 Jan 10;9:1176. doi: 10.3389/fneur.2018.01176. eCollection 2018.
Stroke and dementia represent frequent causes of psychophysical and socioeconomic burdens. We conducted a vascular, cognitive, and psychomental survey involving elderly volunteers at community-based recycling stations in Northern Taiwan. Recycling volunteers aged ≥60 years were surveyed. We recorded seven parameters, namely (1) body mass index (BMI), (2) fasting glucose, (3) fasting cholesterol, (4) ankle-brachial index (ABI), (5) carotid duplex sonography, (6) five-item Brief Symptom Rating Scale (BSRS-5) score, and (7) eight-item Interview to Differentiate Aging and Dementia (AD8). During the carotid duplex study, we measured the carotid intima-media thickness (CIMT) and the carotid total plaque score (CTPS) of the common and internal carotid arteries. In total, 985 subjects (mean age: 70.8 years) participated in this study. Among these, 81% were women, and 52% were vegetarians. The average ABI, CIMT, and CTPS were higher in men, whereas women had higher cholesterol levels and BSRS-5 scores. Obesity, hypertension, hyperglycemia, and hyperlipidemia were present in 21, 38, 9, and 27% of all subjects, respectively. Carotid plaques with mild (CTPS 1-5), moderate (CTPS 5.1-10), and severe (CTPS > 10) atherosclerosis were detected in 45, 16, and 7% of the subjects, respectively. Mild cognitive impairment (AD8 > 2) was observed in 13% of the subjects, whereas moderate mood disorder (BSRS-5≧10) was observed in only 1% of subjects. Vegetarians had a lower BMI, systolic blood pressure (SBP), cholesterol, CIMT, and CTPS than did non-vegetarians. Substantial predictors of severe atherosclerosis were advanced age (>70 years), male sex, history of heart disease, hyperlipidemia, and currently elevated SBP and cholesterol levels. Predictors of mild cognitive impairment were illiteracy, history of hypertension, hyperlipidemia, and moderate mood disorder. Subclinical carotid atherosclerosis was common in elderly recycling volunteers, with 23% having moderate to severe stenosis. Vegetarians had a reduced risk of atherosclerosis. The low incidence of moderate mood disorder might indicate that recycling work enhances psychomental health. In addition, a healthier lifestyle, better mood condition, and vegetarian diet might contribute to lower incidence of mild cognitive impairment.
中风和痴呆是导致身心负担和社会经济负担的常见原因。我们在台湾北部社区回收站对老年志愿者进行了一项血管、认知和心理调查。对年龄≥60岁的回收志愿者进行了调查。我们记录了七个参数,即(1)体重指数(BMI),(2)空腹血糖,(3)空腹胆固醇,(4)踝臂指数(ABI),(5)颈动脉双功超声检查,(6)五项简明症状评定量表(BSRS - 5)评分,以及(7)八项衰老与痴呆鉴别访谈(AD8)。在颈动脉双功超声检查中,我们测量了颈总动脉和颈内动脉的颈动脉内膜中层厚度(CIMT)和颈动脉总斑块评分(CTPS)。共有985名受试者(平均年龄:70.8岁)参与了本研究。其中,81%为女性,52%为素食者。男性的平均ABI、CIMT和CTPS较高,而女性的胆固醇水平和BSRS - 5评分较高。所有受试者中,肥胖、高血压、高血糖和高脂血症的发生率分别为21%、38%、9%和27%。分别有45%、16%和7%的受试者检测到轻度(CTPS 1 - 5)、中度(CTPS 5.1 - 10)和重度(CTPS > 10)动脉粥样硬化的颈动脉斑块。13%的受试者出现轻度认知障碍(AD8 > 2),而只有1% 的受试者出现中度情绪障碍(BSRS - 5≧10)。素食者的BMI、收缩压(SBP)、胆固醇、CIMT和CTPS均低于非素食者。严重动脉粥样硬化的重要预测因素是高龄(>70岁)、男性、心脏病史、高脂血症以及目前升高的SBP和胆固醇水平。轻度认知障碍的预测因素是文盲、高血压病史、高脂血症和中度情绪障碍。亚临床颈动脉粥样硬化在老年回收志愿者中很常见,23%的人有中度至重度狭窄。素食者患动脉粥样硬化的风险降低。中度情绪障碍的低发生率可能表明回收工作能增强心理健康。此外,更健康的生活方式、更好的情绪状态和素食饮食可能有助于降低轻度认知障碍的发生率。