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中老年和高龄老年人心血管健康与认知衰退速度的关系:一项基于人群的研究。

The Relationship Between Cardiovascular Health and Rate of Cognitive Decline in Young-Old and Old-Old Adults: A Population-Based Study.

机构信息

Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden.

Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.

出版信息

J Alzheimers Dis. 2021;84(4):1523-1537. doi: 10.3233/JAD-210280.


DOI:10.3233/JAD-210280
PMID:34690136
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8764601/
Abstract

BACKGROUND: Modifiable vascular risk factors have been associated with late-life cognitive impairment. The Life Simple 7 (LS7) score comprises seven cardiovascular health metrics: smoking, diet, physical activity, body mass index, plasma glucose, total serum cholesterol, and blood pressure. OBJECTIVE: To investigate the association between individual and composite LS7 metrics and rate of cognitive decline, and potential differences in these associations between young-old and old-old individuals. METHODS: This cohort study included 1,950 participants aged≥60 years (M = 70.7 years) from the Swedish National Study on Aging and Care-Kungsholmen (SNAC-K), who underwent repeated neuropsychological testing (episodic and semantic memory, verbal fluency, processing speed, global cognition) across 12 years. The LS7 score was assessed at baseline and categorized as poor, intermediate, or optimal. Level and change in cognitive performance as a function of LS7 categories were estimated using linear mixed-effects models. RESULTS: Having an optimal LS7 total score was associated with better performance (expressed in standard deviation units) at baseline for perceptual speed (β= 0.21, 95%CI 0.12-0.29), verbal fluency (β= 0.08, 0.00-0.16), and global cognition (β= 0.06, 0.00-0.12) compared to the poor group. Age-stratified analyses revealed associations for cognitive level and change only in the young-old (< 78 years) group. For the specific metrics, diverging patterns were observed for young-old and old-old individuals. CONCLUSION: Meeting the LS7 criteria for ideal cardiovascular health in younger old age is associated with slower rate of cognitive decline. However, the LS7 criteria may have a different meaning for cognitive function in very old adults.

摘要

背景:可改变的血管危险因素与晚年认知障碍有关。Life Simple 7(LS7)评分由 7 项心血管健康指标组成:吸烟、饮食、身体活动、体重指数、血糖、总血清胆固醇和血压。

目的:研究个体和综合 LS7 指标与认知下降率之间的关系,以及这些指标在年轻老年人和老年人之间的潜在差异。

方法:本队列研究纳入了来自瑞典国家老龄化和护理- Kungsholmen(SNAC-K)的 1950 名年龄≥60 岁的参与者(平均年龄为 70.7 岁),他们在 12 年内接受了多次神经心理学测试(情景记忆和语义记忆、言语流畅性、加工速度、总体认知)。LS7 评分在基线时进行评估,并分为差、中、优。使用线性混合效应模型估计 LS7 类别与认知表现的水平和变化。

结果:LS7 总分较好与基线时的知觉速度(β=0.21,95%CI 0.12-0.29)、言语流畅性(β=0.08,0.00-0.16)和总体认知(β=0.06,0.00-0.12)表现较好相关。年龄分层分析显示,仅在年轻老年人(<78 岁)组中存在认知水平和变化的相关性。对于特定的指标,年轻老年人和老年人的模式不同。

结论:在年轻老年人中,符合 LS7 理想心血管健康标准与认知下降速度较慢相关。然而,LS7 标准对于非常老年人的认知功能可能具有不同的意义。

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[5]
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[6]
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[7]
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[8]
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本文引用的文献

[1]
Cardiovascular health metrics from mid- to late-life and risk of dementia: A population-based cohort study in Finland.

PLoS Med. 2020-12

[2]
Association of diabetes with stroke and post-stroke dementia: A population-based cohort study.

Alzheimers Dement. 2020-7

[3]
Combined genetic influences on episodic memory decline in older adults without dementia.

Neuropsychology. 2020-9

[4]
Low Cholesterol Level Linked to Reduced Semantic Fluency Performance and Reduced Gray Matter Volume in the Medial Temporal Lobe.

Front Aging Neurosci. 2020-3-31

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Cholinesterase inhibitors in patients with diabetes mellitus and dementia: an open-cohort study of ~23 000 patients from the Swedish Dementia Registry.

BMJ Open Diabetes Res Care. 2020-1

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Lagged Coupled Changes Between White Matter Microstructure and Processing Speed in Healthy Aging: A Longitudinal Investigation.

Front Aging Neurosci. 2019-11-21

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Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study.

BMJ. 2019-8-7

[8]
Life's simple 7 and cardiovascular disease risk knowledge in Hong Kong.

BMC Cardiovasc Disord. 2019-8-2

[9]
High Low-Density Lipoprotein Cholesterol Inversely Relates to Dementia in Community-Dwelling Older Adults: The Shanghai Aging Study.

Front Neurol. 2018-11-12

[10]
Association of Cardiovascular Health Level in Older Age With Cognitive Decline and Incident Dementia.

JAMA. 2018-8-21

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