Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan.
Department of Rehabilitation, Tokyo Metropolitan Police Hospital, Tokyo, Japan.
PLoS One. 2024 Aug 22;19(8):e0309306. doi: 10.1371/journal.pone.0309306. eCollection 2024.
Cognitive function decline is influenced by cardiovascular diseases and associated risk factors. However, changes in the cognitive function of patients with cardiovascular diseases during hospitalization and the factors influencing these changes remain unclear. This study elucidated the proportion and characteristics of changes in cognitive function during hospitalization in patients with cardiovascular diseases.
We conducted cognitive function assessments at admission and discharge for patients with cardiovascular diseases. Using the Mini-Mental State Examination (MMSE) and the Japanese version of the Montreal Cognitive Assessment (MoCA-J), we categorized the patients into cognitive impairment, mild cognitive impairment (MCI), and non-cognitive impairment. Changes in MMSE or MoCA-J scores of ≥2 points at discharge were classified as improvement or decline, and all others as maintenance.
The cognitive impairment, MCI, and non-cognitive impairment categories comprised 215 (41.3%), 224 (40.2%), and 103 (18.5%) patients, respectively. The results of the cognitive function assessment at the time of discharge classified 90 patients (35.9%) into the maintenance group, 117 (46.6%) into the improvement group, and 44 (17.5%) into the decline group based on changes during hospitalization. There was a statistically significant difference among the three groups only in cognitive function at admission (P = 0.026). In multivariate analysis, those with MCI or cognitive impairment at admission and younger patients were associated with improved cognitive function during hospitalization. No factors were extracted that showed statistically significant associations with cognitive decline.
Approximately half of the patients with cardiovascular disease experienced improvements in cognitive function during hospitalization, while approximately 20% showed a decline in cognitive function during the same period. These findings demonstrate the importance of assessing cognitive changes in hospitalized patients with cardiovascular disease. Future studies are needed to identify factors associated with changes in cognitive function.
认知功能下降受心血管疾病和相关危险因素的影响。然而，心血管疾病患者住院期间认知功能的变化及其影响因素尚不清楚。本研究阐明了心血管疾病患者住院期间认知功能变化的比例和特征。
我们对心血管疾病患者进行了入院和出院时的认知功能评估。使用简易精神状态检查（MMSE）和日本蒙特利尔认知评估（MoCA-J），我们将患者分为认知障碍、轻度认知障碍（MCI）和非认知障碍。出院时 MMSE 或 MoCA-J 评分提高≥2 分者为改善，其他均为维持。
认知障碍、MCI 和非认知障碍患者分别为 215 例（41.3%）、224 例（40.2%）和 103 例（18.5%）。出院时认知功能评估结果将 90 例（35.9%）患者分为维持组，117 例（46.6%）患者分为改善组，44 例（17.5%）患者分为下降组。三组间仅入院时认知功能差异有统计学意义（P = 0.026）。多变量分析显示，入院时存在 MCI 或认知障碍以及年龄较小的患者与住院期间认知功能改善有关。未提取出与认知下降有统计学显著关联的因素。
约一半的心血管疾病患者在住院期间认知功能有所改善，而约 20%的患者在同一时期认知功能下降。这些发现表明评估住院心血管疾病患者认知变化的重要性。需要进一步的研究来确定与认知功能变化相关的因素。
