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中等收入国家认知功能脆弱的老年人中的心血管危险因素

Cardiovascular risk factors among older persons with cognitive frailty in middle income country.

作者信息

Ibrahim Azianah Mohamad, Singh Devinder Kaur Ajit, Ludin Arimi Fitri Mat, Sakian Noor Ibrahim Mohamed, Rivan Nurul Fatin Malek, Shahar Suzana

机构信息

Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur 50300, Malaysia.

Basic Medical Sciences, University of Cyberjaya, Selangor Darul Ehsan, Malaysia 63000, Malaysia.

出版信息

World J Clin Cases. 2024 Jun 16;12(17):3076-3085. doi: 10.12998/wjcc.v12.i17.3076.

Abstract

BACKGROUND

Cognitive frailty, characterized by the coexistence of cognitive impairment and physical frailty, represents a multifaceted challenge in the aging population. The role of cardiovascular risk factors in this complex interplay is not yet fully understood.

AIM

To investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty by pooling data from two cohorts of studies in Malaysia.

METHODS

A comprehensive approach was employed, with a total of 512 community-dwelling older persons aged 60 years and above, involving two cohorts of older persons from previous studies. Datasets related to cardiovascular risks, namely sociodemographic factors, and cardiovascular risk factors, including hypertension, diabetes, hypercholesterolemia, anthropometric characteristics and biochemical profiles, were pooled for analysis. Cognitive frailty was defined based on the Clinical Dementia Rating scale and Fried frailty score. Cardiovascular risk was determined using Framingham risk score. Statistical analyses were conducted using SPSS version 21.

RESULTS

Of the study participants, 46.3% exhibited cognitive frailty. Cardiovascular risk factors including hypertension (OR:1.60; 95%CI: 1.12-2.30), low fat-free mass (OR:0.96; 95%CI: 0.94-0.98), high percentage body fat (OR:1.04; 95%CI: 1.02-1.06), high waist circumference (OR:1.02; 95%CI: 1.01-1.04), high fasting blood glucose (OR:1.64; 95%CI: 1.11-2.43), high Framingham risk score (OR:1.65; 95%CI: 1.17-2.31), together with sociodemographic factors, , being single (OR 3.38; 95%CI: 2.26-5.05) and low household income (OR 2.18; 95%CI: 1.44-3.30) were found to be associated with cognitive frailty.

CONCLUSION

Cardiovascular-risk specific risk factors and sociodemographic factors were associated with risk of cognitive frailty, a prodromal stage of dementia. Early identification and management of cardiovascular risk factors, particularly among specific group of the population might mitigate the risk of cognitive frailty, hence preventing dementia.

摘要

背景

认知衰弱以认知障碍和身体衰弱并存为特征,是老年人群面临的多方面挑战。心血管危险因素在这种复杂相互作用中的作用尚未完全明确。

目的

通过汇总马来西亚两项队列研究的数据,调查心血管危险因素与患有认知衰弱的老年人之间的关系。

方法

采用综合方法,共有512名60岁及以上的社区居住老年人,涉及之前研究中的两组老年人群。汇总与心血管风险相关的数据集,即社会人口学因素,以及心血管危险因素,包括高血压、糖尿病、高胆固醇血症、人体测量特征和生化指标,进行分析。认知衰弱根据临床痴呆评定量表和弗里德衰弱评分来定义。使用弗雷明汉风险评分确定心血管风险。使用SPSS 21版进行统计分析。

结果

在研究参与者中,46.3%表现出认知衰弱。心血管危险因素包括高血压(比值比:1.60;95%置信区间:1.12 - 2.30)、低去脂体重(比值比:0.96;95%置信区间:0.94 - 0.98)、高体脂百分比(比值比:1.04;95%置信区间:1.02 - 1.06)、高腰围(比值比:1.02;95%置信区间:1.01 - 1.04)、高空腹血糖(比值比:1.64;95%置信区间:1.11 - 2.43)、高弗雷明汉风险评分(比值比:1.65;95%置信区间:1.17 - 2.31),以及社会人口学因素,单身(比值比3.38;95%置信区间:2.26 - 5.05)和低家庭收入(比值比2.18;95%置信区间:1.44 - 3.30)均与认知衰弱相关。

结论

心血管风险特定危险因素和社会人口学因素与认知衰弱(痴呆的前驱阶段)风险相关。早期识别和管理心血管危险因素,特别是在特定人群组中,可能会降低认知衰弱风险,从而预防痴呆。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf9d/11185391/c4d658de4de7/WJCC-12-3076-g001.jpg

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