Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Emergency and Critical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan; Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Exp Gerontol. 2020 Dec;142:111138. doi: 10.1016/j.exger.2020.111138. Epub 2020 Oct 26.
Handgrip strength is associated with mild cognitive impairment. Tumor necrosis factor [TNF]-α and interleukin [IL]-6 were pro-inflammatory cytokines influencing the severity of initial neurological deficit. Visfatin is a novel adipokine and has a strong correlation with inflammation. The relationships of TNF-α, IL-6 and visfatin are not consistent, and no study has investigated them in the elderly patients with cognitive impairment.
This study included patients aged ≥75 years at the emergency department from August 2018 to February 2019. All patients underwent comprehensive geriatric assessment and blood tests for fasting plasma TNF-α, IL-6 and visfatin levels.
We enrolled 106 elderly patients with a mean age of 87.3 years, including 62 (58.4%) patients in cognitive impairment group (Mini-Mental State Examination [MMSE] < 24) and 44 (41.5%) patients in the non-cognitive impairment group. Compared to the non-cognitive impairment group, the cognitive impairment group had significantly lower handgrip strength, and significantly higher TNF-α, IL-6 and visfatin levels. TNF-α positively correlated with IL-6. Both TNF-α and IL-6 negatively correlated with Barthel index and MMSE. Handgrip strength negatively correlated with TNF-α but positively correlated with Barthel index and MMSE scores. Backward and stepwise multiple logistic regression analyses showed that the independent predictor for cognitive impairment was handgrip strength and age.
The cognitive impairment group had significantly higher serum TNF-α, IL-6, and visfatin levels. The independent predictors of cognitive impairment were handgrip strength and age. Handgrip strength negatively correlated with TNF-α and IL-6 but positively with Barthel index and MMSE scores.
握力与轻度认知障碍有关。肿瘤坏死因子[TNF]-α和白细胞介素[IL]-6 是影响初始神经功能缺损严重程度的促炎细胞因子。内脏脂肪素是一种新型脂肪因子，与炎症有很强的相关性。TNF-α、IL-6 和内脏脂肪素之间的关系并不一致，并且没有研究在认知障碍的老年患者中对其进行研究。
本研究纳入了 2018 年 8 月至 2019 年 2 月期间急诊科年龄≥75 岁的患者。所有患者均接受了全面的老年评估和空腹血浆 TNF-α、IL-6 和内脏脂肪素水平的血液检查。
我们共纳入了 106 名年龄在 87.3 岁的老年患者，其中认知障碍组（简易精神状态检查[MMSE]＜24）有 62 名（58.4%）患者，非认知障碍组有 44 名（41.5%）患者。与非认知障碍组相比，认知障碍组的握力明显较低，TNF-α、IL-6 和内脏脂肪素水平明显较高。TNF-α与 IL-6 呈正相关。TNF-α和 IL-6 与 Barthel 指数和 MMSE 均呈负相关。握力与 TNF-α呈负相关，与 Barthel 指数和 MMSE 评分呈正相关。向后和逐步多元逻辑回归分析显示，认知障碍的独立预测因子是握力和年龄。
认知障碍组的血清 TNF-α、IL-6 和内脏脂肪素水平明显较高。认知障碍的独立预测因子是握力和年龄。握力与 TNF-α和 IL-6 呈负相关，与 Barthel 指数和 MMSE 评分呈正相关。
