On Target Health Data LLC, Suffield, CT, USA.
Wyoming Department of Health, Cheyenne, WY, USA.
Public Health Rep. 2020 Jan;135(1):132-140. doi: 10.1177/0033354919893030.
Cognitive difficulties or impairment may be an early step in the development of dementia. Several modifiable risk factors for cardiovascular disease (CVD) may also increase the risk of dementia. The objective of our study was to compare adults with subjective cognitive impairment (SCI), using the Behavioral Risk Factor Surveillance System (BRFSS) cognitive disability measure, with adults who reported CVD.
We examined data on 3 key outcomes among 302 008 adult respondents aged ≥45 in the 2017 BRFSS: respondents with SCI only, respondents with CVD only, and respondents with both conditions. We compared measures of disability, quality of life, access to health care, and a composite measure of the following 7 risk factors: current smoking, diabetes, high cholesterol, hypertension, inadequate fruit and vegetable consumption, obesity, and sedentary lifestyle. We also estimated population-attributable risk (PAR).
Among respondents, 7.9% reported SCI only, 11.1% reported CVD only, and 3.2% reported both conditions, with differences by age and sex. Adults with SCI only were more likely than adults with CVD only to report other disability, worse access to health care, and poorer quality of life, even though adults with CVD were older. Compared with adults with neither condition, adults with any of the 3 outcomes were more likely to report having each of the 7 risk factors; we found a linear association with an increasing number of risk factors. Five or 6 risk factors contributed to PARs for each of the 3 key outcomes. PARs for SCI only were highest for ever smoking (17.2%) and sedentary lifestyle (12.8%), whereas for CVD only, PARs were highest for hypertension (35.5%) and high cholesterol (22.9%).
Despite differences between adults with SCI and adults with CVD in several demographic and health-related measures, the overall similarity in PARs for SCI and CVD suggests potential benefits from using effective CVD interventions to address SCI.
认知障碍或损害可能是痴呆症发展的早期阶段。几种可改变的心血管疾病（CVD）风险因素也可能增加痴呆症的风险。我们的研究目的是比较使用行为风险因素监测系统（BRFSS）认知障碍测量的有主观认知障碍（SCI）的成年人与报告有 CVD 的成年人。
我们检查了 2017 年 BRFSS 中 302008 名≥45 岁的成年受访者的 3 个关键结果数据：仅有 SCI 的受访者、仅有 CVD 的受访者以及同时患有这两种疾病的受访者。我们比较了残疾、生活质量、获得医疗保健的机会以及以下 7 个风险因素的综合指标：当前吸烟、糖尿病、高胆固醇、高血压、水果和蔬菜摄入不足、肥胖和久坐的生活方式。我们还估计了人群归因风险（PAR）。
在受访者中，7.9%报告仅有 SCI，11.1%报告仅有 CVD，3.2%报告同时患有这两种疾病，差异与年龄和性别有关。仅有 SCI 的成年人比仅有 CVD 的成年人更有可能报告其他残疾、更差的医疗保健获取机会和更差的生活质量，尽管 CVD 成年人年龄更大。与没有任何一种情况的成年人相比，任何一种 3 种结果的成年人更有可能报告有 7 个风险因素中的每一个；我们发现，随着风险因素数量的增加，存在线性关联。对于 SCI 仅有的每个结果，5 个或 6 个风险因素促成了 PAR；而对于 CVD 仅有的每个结果，PAR 最高的是高血压（35.5%）和高胆固醇（22.9%）。
尽管 SCI 成年人和 CVD 成年人在几个人口统计学和健康相关指标上存在差异，但 SCI 和 CVD 的 PAR 总体相似表明，使用有效的 CVD 干预措施来解决 SCI 可能具有潜在的益处。
