Shang Jing, Dong Jianye, Zhu Sijia, Chen Qingmei, Hua Jianian
Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Front Aging Neurosci. 2024 Feb 22;16:1283997. doi: 10.3389/fnagi.2024.1283997. eCollection 2024.
Incident stroke was associated with cognitive dysfunction after stroke and even before stroke. However, cognitive trends prior to myocardial infarction (MI) and the timeline of cognitive decline in a few years following incident MI remain unclear, especially among the Chinese population. We aimed to evaluate whether MI was associated with cognitive change both before and after MI in China.
This cohort study included 11,287 participants without baseline heart problems or stroke from the China Health and Retirement Longitudinal Study. The exposure was self-reported MI. The outcomes were scores of cognitive functions in five domains, which reflected abilities of episodic memory, visuospatial abilities, orientation, attention and calculation, and global cognition as a summary measure. A Linear mixed model was constructed to explore cognitive function before and after incident MI among the MI participants and the cognitive trends of participants free of MI.
During the 7-year follow-up, 421 individuals [3.7% of 11,287, mean (SD) age, 60.0 (9.0) years; 59.1% female] experienced MI events. The cognitive scores of participants of both the MI group and the control group without MI declined gradually as time went by. The annual decline rate of the MI group before incident MI was similar to that of the control group during the whole follow-up period. Incident MI was not associated with acute cognitive decline in all five cognitive domains. Moreover, MI did not accelerate the cognitive decline rate after MI compared with the pre-MI cognitive trends. The decline rate of cognitive function after MI was similar to the rate before MI.
Different from stroke, participants who had an MI did not show steeper cognitive decline before MI. MI was not associated with acute cognitive decline and accelerated decline in several years after MI. Future studies are needed to learn the mechanisms behind the different patterns of cognitive decline between MI and stroke.
新发卒中与卒中后甚至卒中前的认知功能障碍有关。然而，心肌梗死（MI）之前的认知趋势以及新发MI后几年内认知功能下降的时间线仍不明确，尤其是在中国人群中。我们旨在评估在中国MI是否与MI前后的认知变化有关。
这项队列研究纳入了来自中国健康与养老追踪调查的11287名无基线心脏问题或卒中的参与者。暴露因素为自我报告的MI。结局指标是五个领域的认知功能得分，这些得分反映了情景记忆、视觉空间能力、定向、注意力和计算能力，以及作为综合指标的整体认知能力。构建线性混合模型以探讨MI参与者中MI发生前后的认知功能以及无MI参与者的认知趋势。
在7年的随访期间，421人[11287人的3.7%，平均（标准差）年龄为60.0（9.0）岁；59.1%为女性]发生了MI事件。MI组和无MI的对照组参与者的认知得分均随时间逐渐下降。MI组在MI发生前的年下降率与对照组在整个随访期间的年下降率相似。新发MI与所有五个认知领域的急性认知下降均无关。此外，与MI前的认知趋势相比，MI并未加速MI后的认知下降率。MI后认知功能的下降率与MI前相似。
与卒中不同，发生MI的参与者在MI前并未表现出更陡峭的认知下降。MI与急性认知下降以及MI后几年的加速下降均无关。未来需要开展研究以了解MI和卒中之间不同认知下降模式背后的机制。
