糖尿病与认知和功能下降相关因素。欧洲老年人慢性肾脏病筛查(SCOPE)研究。
Diabetes and factors associated with cognitive and functional decline. The screening for CKD among older people across Europe (SCOPE) study.
机构信息
Geriatric Unit, Internal Medicine Department, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy.
出版信息
Aging Clin Exp Res. 2023 Nov;35(11):2693-2701. doi: 10.1007/s40520-023-02536-2. Epub 2023 Sep 5.
BACKGROUND
Type 2 diabetes mellitus (DM) in older people is a heterogeneous condition that exhibits differential characteristics in comparison with younger adults. DM increases the risk of disability, is associated with dementia and loss of function, and cognition may often be interrelated and more pronounced in older patients with DM than in those without.
AIMS
Our aim was to evaluate the incidence of functional and/or cognitive impairment in older adults with and without DM, and its associated factors in DM participants.
METHODS
A 2-year prospective analysis was conducted in a European multicenter prospective cohort (SCOPE study). Older community-dwelling adults (aged ≥ 75 years) underwent a comprehensive geriatric assessment. New functional and/or cognitive decline was explored.
RESULTS
Of 1611 participants, 335 (22.0%) had DM at baseline. The percentage of participants scoring at least one ADL impairment and/or cognitive impairment (MMSE < 24) was similar in both groups (9.6%). Factors associated with any new disability in participants with DM in the multivariate analysis were female sex (OR 3.28, 95% CI 1.42-7.56), history of stroke (OR 4.58, 95% CI 1.64-12.7), and greater IADL dependency (OR 1.08 95% CI 1.02-1.15).
DISCUSSION
Association between DM and cognitive or functional decline in outpatients of 75 years and older was not found, but factors such as female gender, history of stroke, and IADL dependency could be related.
CONCLUSION
Decline in functional and cognitive status of community-dwelling older adults with DM was similar to participants without DM in a short period of 2 years of follow-up, though several clinical factors may increase its risk in this population.
背景
老年人 2 型糖尿病(DM)是一种异质性疾病,与年轻成年人相比表现出不同的特征。DM 增加了残疾的风险,与痴呆和功能丧失有关,并且认知功能障碍在 DM 患者中往往比非 DM 患者更为常见且更为严重。
目的
我们旨在评估有和无 DM 的老年患者中功能和/或认知障碍的发生率,以及 DM 患者中其相关因素。
方法
在一项欧洲多中心前瞻性队列研究(SCOPE 研究)中进行了为期 2 年的前瞻性分析。年龄在 75 岁及以上的社区居住的老年人接受了全面的老年评估。探索新的功能和/或认知下降。
结果
在 1611 名参与者中,335 名(22.0%)在基线时患有 DM。在两组参与者中,至少有一项 ADL 受损和/或认知受损(MMSE<24)的比例相似(9.6%)。在多变量分析中,与 DM 患者出现任何新残疾相关的因素为女性(OR 3.28,95%CI 1.42-7.56)、中风史(OR 4.58,95%CI 1.64-12.7)和更高的 IADL 依赖性(OR 1.08,95%CI 1.02-1.15)。
讨论
在 75 岁及以上的门诊患者中,DM 与认知或功能下降之间没有关联,但女性、中风史和 IADL 依赖性等因素可能与之相关。
结论
在 2 年的随访期间,社区居住的 DM 老年患者的功能和认知状态下降与无 DM 患者相似,但在该人群中,某些临床因素可能会增加其风险。