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抗高血压药物的使用与老年人认知能力下降的关系:一项回顾性观察研究。

Association between use of antihypertensives and cognitive decline in the elderly-A retrospective observational study.

机构信息

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

出版信息

PLoS One. 2023 Dec 20;18(12):e0295658. doi: 10.1371/journal.pone.0295658. eCollection 2023.

Abstract

AIM

Mild cognitive impairment (MCI) is the prodromal phase of dementia. The objective of this study was to determine whether specific antihypertensives were associated with conversion from MCI to dementia.

METHODS

In this retrospective study, a chart review was conducted on 335 older adults seen at the University of Alberta Hospital, Kaye Edmonton Seniors Clinic who were diagnosed with MCI. At the point of diagnosis, data was collected on demographic and lifestyle characteristics, measures of cognitive function, blood pressure measurements, use of antihypertensives, and other known or suspected risk factors for cognitive decline. Patients were followed for 5.5 years for dementia diagnoses. A logistic regression analysis was then conducted to determine the factors associated with conversion from MCI to dementia.

RESULTS

Mean age (± standard deviation) of the study participants was 76.5 ± 7.3 years. Patients who converted from MCI to dementia were significantly older and were more likely to have a family history of dementia. After controlling for potential confounders including age, sex, Mini Mental Status Exam scores and family history of dementia, patients who were on beta-blockers (BBs) had a 57% reduction in the odds of converting to dementia (OR: 0.43, 95% CI: 0.23, 0.81).

CONCLUSIONS

In this study, BB use was protective against conversion from MCI to dementia. Further studies are required to confirm the findings of our study and to elucidate the effect of BBs on cognitive decline.

摘要

目的

轻度认知障碍(MCI)是痴呆的前驱阶段。本研究旨在确定特定的降压药是否与从 MCI 向痴呆的转化有关。

方法

在这项回顾性研究中,对在阿尔伯塔大学医院和 Kaye 埃德蒙顿老年人诊所就诊的 335 名被诊断为 MCI 的老年人进行了病历回顾。在诊断时,收集了人口统计学和生活方式特征、认知功能测量、血压测量、降压药使用情况以及其他已知或疑似认知能力下降的危险因素的数据。对患者进行了 5.5 年的痴呆诊断随访。然后进行逻辑回归分析,以确定与从 MCI 向痴呆转化相关的因素。

结果

研究参与者的平均年龄(±标准差)为 76.5 ± 7.3 岁。从 MCI 转为痴呆的患者年龄明显较大,且更有可能有痴呆家族史。在控制了年龄、性别、简易精神状态检查评分和痴呆家族史等潜在混杂因素后,使用β受体阻滞剂(BBs)的患者向痴呆转化的几率降低了 57%(OR:0.43,95%CI:0.23,0.81)。

结论

在这项研究中,BB 的使用可预防从 MCI 向痴呆的转化。需要进一步的研究来证实我们研究的结果,并阐明 BBs 对认知能力下降的影响。

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本文引用的文献

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Hypertension and the Risk of Dementia.高血压与痴呆症风险
Front Cardiovasc Med. 2020 Jan 31;7:5. doi: 10.3389/fcvm.2020.00005. eCollection 2020.

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