认知功能下降与心血管疾病首发事件风险的相关性：来自立陶宛队列研究的结果。

Lowered cognitive function and the risk of the first events of cardiovascular diseases: findings from a cohort study in Lithuania.

机构信息

Laboratory of Population Studies of the Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50162, Kaunas, Lithuania.

Department of Environmental and Occupational Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-47181, Kaunas, Lithuania.

出版信息

BMC Public Health. 2021 Apr 24;21(1):792. doi: 10.1186/s12889-021-10843-4.

DOI:10.1186/s12889-021-10843-4

PMID:33894765

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8070287/

Abstract

BACKGROUND

The purpose of this prospective cohort study was to examine whether the level of cognitive function at the baseline expressed as a cognitive function composite score and score of specific domains predict the risk of first cardiovascular disease (CVD) events in middle-aged and older populations.

METHODS

Seven thousand eighty-seven participants, men and women aged 45-72 years, were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006-2008 in the city of Kaunas, Lithuania. During 10 years of follow-up, the risk of first non-fatal events of CVD and death from CVD (excluding those participants with a documented history of CVD and/or ischemic heart disease (IHD) diagnosed at the baseline survey) was evaluated. Cox proportional hazards regression models were applied to examine how cognitive function predicts the first events of CVD.

RESULTS

During the follow-up, there were 156 deaths from CVD (49 women and 107 men) and 464 first non-fatal CVD events (195 women and 269 men) registered. The total number of first CVD events was 620 (11.5%). After adjustment for sociodemographic factors, biological and lifestyle risk factors and illnesses, a decrease per 1 standard deviation in different cognitive function scores significantly increased the risk of a first event of CVD (immediate verbal recall score - by 17% in men and 32% in women; delayed verbal recall score - by 17% in men and 24% in women; and a composite score of cognitive function - by 15% in men and 29% in women). Kaplan-Meier survival curves for the probability of a first cardiovascular event according to the categories of a composite score of cognitive function, revealed that a lowered cognitive function predicts a higher probability of the events compared to normal cognitive function (p < 0.05).

CONCLUSIONS

The findings of this follow-up study suggest that men and women with lower cognitive functions have an increased risk for a first event of CVD compared to participants with a higher level of cognitive functions.

摘要

背景

本前瞻性队列研究的目的是探讨基线时的认知功能水平（用认知功能综合评分和特定领域评分表示）是否可预测中年及以上人群首次心血管疾病（CVD）事件的风险。

方法

在立陶宛考纳斯市于 2006-2008 年进行的健康、酒精、心理社会因素在东欧（HAPIEE）研究的基线调查中，评估了 7087 名 45-72 岁的男性和女性参与者。在 10 年的随访期间，评估了首次非致命性 CVD 事件和 CVD 死亡的风险（不包括那些在基线调查时已确诊有 CVD 和/或缺血性心脏病（IHD）病史的参与者）。应用 Cox 比例风险回归模型来检验认知功能如何预测 CVD 的首次事件。

结果

在随访期间，有 156 人死于 CVD（49 名女性和 107 名男性），464 人发生首次非致命性 CVD 事件（195 名女性和 269 名男性）。首次 CVD 事件总数为 620 例（11.5%）。在校正了社会人口学因素、生物和生活方式危险因素及疾病后，不同认知功能评分每降低 1 个标准差，显著增加了首次 CVD 事件的风险（即时言语回忆评分 - 男性增加 17%，女性增加 32%；延迟言语回忆评分 - 男性增加 17%，女性增加 24%；认知功能综合评分 - 男性增加 15%，女性增加 29%）。根据认知功能综合评分的类别绘制首次心血管事件概率的 Kaplan-Meier 生存曲线显示，与认知功能正常的参与者相比，认知功能降低的患者发生事件的概率更高（p<0.05）。