糖尿病和高血压与巴西中年成年人认知表现降低有关：纵向 Pro-Saúde 研究中的嵌套横断面分析。
Diabetes and hypertension are associated with lowered cognitive performance among middle-aged Brazilian adults: cross-sectional analyses nested in the longitudinal Pró-Saúde study.
机构信息
MD, PhD. Associate Professor, Postgraduate Program on Health Science, Faculdade de Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte (MG), Brazil.
IT, MSc. Doctoral Student, Instituto de Estudos em Saúde Coletiva (IESC), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro (RJ), Brazil.
出版信息
Sao Paulo Med J. 2021 Jan-Feb;139(1):46-52. doi: 10.1590/1516-3180.2020.0269.R1.30102020.
BACKGROUND
Cardiovascular risk factors are frequently associated with lowered cognitive performance among elderly people, but rarely among middle-aged adults.
OBJECTIVES
To investigate associations between cardiovascular risk factors (age, physical inactivity, smoking, alcohol use, hypertension and diabetes) and lower cognitive performance among middle-aged (45-64 years) Brazilian adults.
DESIGN AND SETTING
Cross-sectional study nested within the Pró-Saúde cohort. From 2,876 baseline study participants (1999), we randomly selected 488 participants and gave them validated and standardized cognitive tests (2012).
METHODS
We used multiple linear and logistic regression analyses to detect associations of cardiovascular risk factors with crude scores in cognitive tests on memory (word test) and executive function (verbal fluency tests), and with overall cognitive performance scores, respectively.
RESULTS
All cognitive test scores presented statistically significant inverse associations with age and direct associations with education. There was no association between lower cognitive performance and smoking or alcohol use. In both 1999 and 2012, after adjusting for sex, age and schooling, being physically active was inversely associated with lower performance regarding late memory. For individuals with diabetes in 1999, there was an association with lower performance regarding executive function, while there was a borderline association for those reporting it only in 2012. Having a diagnosis of hypertension since 1999 was associated with lower performance regarding both memory and executive functions, while reporting hypertension in 2012 was associated with lower performance regarding executive function.
CONCLUSIONS
Aging, low schooling and cardiovascular risk factors may represent life course disadvantages associated with cognitive decline even among middle-aged Brazilian adults.
背景
心血管危险因素常与老年人认知能力下降相关，但在中年人群中却很少见。
目的
调查心血管危险因素（年龄、体力活动不足、吸烟、饮酒、高血压和糖尿病）与巴西中年（45-64 岁）成年人认知能力下降之间的关系。
设计和设置
嵌套在 Pró-Saúde 队列中的横断面研究。从 2876 名基线研究参与者（1999 年）中，我们随机选择了 488 名参与者，并对他们进行了经过验证和标准化的认知测试（2012 年）。
方法
我们使用多元线性和逻辑回归分析来检测心血管危险因素与记忆（单词测试）和执行功能（言语流畅性测试）的认知测试的粗评分以及整体认知表现评分之间的关联。
结果
所有认知测试分数均与年龄呈显著负相关，与教育程度呈正相关。吸烟或饮酒与较低的认知表现之间没有关联。在 1999 年和 2012 年，在调整了性别、年龄和教育程度后，积极的体力活动与晚期记忆的表现呈负相关。对于 1999 年患有糖尿病的个体，与执行功能的表现呈负相关，而对于仅在 2012 年报告的个体，则存在边缘关联。自 1999 年以来患有高血压的个体与记忆和执行功能的表现均呈负相关，而在 2012 年报告高血压的个体与执行功能的表现呈负相关。
结论
衰老、低教育程度和心血管危险因素可能代表与认知能力下降相关的生命历程劣势，即使在巴西中年成年人中也是如此。
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