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老年人认知障碍与常见心血管疾病之间的相互作用及发病机制。

The interaction and pathogenesis between cognitive impairment and common cardiovascular diseases in the elderly.

作者信息

Zuo Wenhang, Wu Jinhui

机构信息

National Clinical Research Center for Geriatrics, Department of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, People's Republic of China.

National Clinical Research Center for Geriatrics, Department of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China.

出版信息

Ther Adv Chronic Dis. 2022 Feb 2;13:20406223211063020. doi: 10.1177/20406223211063020. eCollection 2022.

Abstract

Both cognitive impairment and cardiovascular diseases have a high incidence in the elderly population, increasing the burden of care and reducing the quality of life. Studies have suggested that cognitive impairment interacts with cardiovascular diseases such as coronary heart disease, abnormal blood pressure, heart failure, and arrhythmia. On one hand, cognitive impairment in the elderly influences the progression and self-management of cardiovascular diseases and increases the risk of cardiovascular-related adverse events. On the other hand, coronary heart disease, heart failure, higher blood pressure variability, orthostatic hypotension, and atrial fibrillation may aggravate cognitive impairment. The role of blood pressure levels on cognition remains controversial. Several shared biological pathways have been proposed as the underlying mechanism for the association. Cardiovascular diseases may lead to cognitive decline even dementia through cerebral perfusion damage, brain structural changes, inflammation, β-amyloid deposition, and neuroendocrine disorders. It is of great significance to study the interaction and put forward effective interventions in an overall perspective to reduce care burden and improve the quality of life of the elderly patients.

摘要

认知障碍和心血管疾病在老年人群中发病率都很高,这增加了护理负担并降低了生活质量。研究表明,认知障碍与冠心病、血压异常、心力衰竭和心律失常等心血管疾病相互作用。一方面,老年人的认知障碍会影响心血管疾病的进展和自我管理,并增加心血管相关不良事件的风险。另一方面,冠心病、心力衰竭、较高的血压变异性、体位性低血压和心房颤动可能会加重认知障碍。血压水平对认知的作用仍存在争议。已经提出了几种共同的生物学途径作为这种关联的潜在机制。心血管疾病可能通过脑灌注损伤、脑结构变化、炎症、β-淀粉样蛋白沉积和神经内分泌紊乱导致认知下降甚至痴呆。从整体角度研究这种相互作用并提出有效的干预措施,对于减轻护理负担和提高老年患者的生活质量具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ebd/8814974/bc981bb98fc4/10.1177_20406223211063020-fig1.jpg

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