Prof. Liang-Kung Chen, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, Taiwan, TEL: +886-2-28757830, FAX: +886-2-28757711, Email:
J Nutr Health Aging. 2023;27(8):641-648. doi: 10.1007/s12603-023-1954-5.
To evaluate the associations between cardiovascular disease (CVD) risk burden (estimated by the World Health Organization (WHO) algorithm) and cognitive impairments (e.g., incident dementia, global and domain-specific impairments) among CVD-, dementia- and disability-free, community-dwelling middle-aged and older adults during an 8-year follow-up.
A community-based longitudinal cohort study.
Yuanshan township in Yi-Lan County, Taiwan.
A total of 889 community-dwelling residents aged 50 years or older.
Age, sex, educational level, employment status, alcohol status, body mass index, physical activity, gait speed, depressive symptoms, WHO region-specific CVD risk scores (10-year CV risk, low: <10% vs. moderate-to-high: ≥ 10%), Chinese version of the Mini-Mental State Examination (MMSE), verbal memory by the delay-free recall in the Chinese Version Verbal Learning Test (CVVLT), language function by the Boston Naming Test and the category (animal) Verbal Fluency Test, visuospatial function by the Taylor Complex Figure Test, executive function by the digit backward and the Clock Drawing Test.
Compared to those with low CVD risk, middle-aged and older adults with moderate-to-high CVD risk were at greater risk for cognitive impairments with respect to the MMSE (adjusted odds ratio (aOR) 1.60 [95% confidence interval (CI) 1.19-2.15], P=0.002), verbal memory (aOR 1.97 [1.43-2.70], P< 0.001) and language (aOR 1.99 [1.46-2.70], P< 0.001), as well as incident dementia (aOR 2.40 [1.33-4.33], P=0.004). After adjusting for all covariates, CVD risk was not associated with other domains of cognitive impairment.
Among healthy, community-dwelling, middle-aged and older adults, those with moderate-to-high cardiovascular risk burden were significantly associated with incident dementia and global and domain-specific cognitive impairments (verbal memory and language), which suggests the existence of a relationship between early cognitive deficits and CVD risk burden. Further studies are needed to elucidate the pathophysiological mechanism of the link between CVD risk burden and cognitive impairment.
评估心血管疾病（CVD）风险负担（由世界卫生组织（WHO）算法估计）与心血管疾病、痴呆症和无残疾、社区居住的中年和老年人认知障碍（如新发痴呆症、整体和特定领域障碍）之间的关联，随访时间为 8 年。
一项基于社区的纵向队列研究。
中国台湾宜兰县员山乡。
共纳入 889 名年龄在 50 岁及以上的社区居住居民。
年龄、性别、教育水平、就业状况、饮酒状况、体重指数、身体活动、步态速度、抑郁症状、特定 WHO 区域 CVD 风险评分（10 年 CVD 风险，低：<10%与中-高：≥10%）、中文版简易精神状态检查（MMSE）、中文词语学习测试（CVVLT）的延迟无回忆的词语记忆、波士顿命名测试和类别（动物）词语流畅性测试的语言功能、泰勒复杂图形测试的视空间功能、数字倒背和画钟测试的执行功能。
与低 CVD 风险相比，中-高 CVD 风险的中年和老年人在 MMSE（调整后的优势比（aOR）1.60 [95%置信区间（CI）1.19-2.15]，P=0.002）、词语记忆（aOR 1.97 [1.43-2.70]，P<0.001）和语言（aOR 1.99 [1.46-2.70]，P<0.001）以及新发痴呆症（aOR 2.40 [1.33-4.33]，P=0.004）方面的认知障碍风险更高。在调整所有协变量后，CVD 风险与认知障碍的其他领域无关。
在健康的、社区居住的中年和老年人中，具有中-高心血管风险负担的人群与新发痴呆症以及整体和特定领域的认知障碍（词语记忆和语言）显著相关，这表明早期认知缺陷与 CVD 风险负担之间存在关联。需要进一步的研究来阐明 CVD 风险负担与认知障碍之间联系的病理生理学机制。
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