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心血管疾病患者认知功能障碍的危险因素。

Risk factors for cognitive dysfunction amongst patients with cardiovascular diseases.

机构信息

Department of Internal Medicine V, George Emil Palade University of Medicine Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania.

Department of Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures, Targu Mures, Romania.

出版信息

Front Public Health. 2024 Sep 13;12:1385089. doi: 10.3389/fpubh.2024.1385089. eCollection 2024.


DOI:10.3389/fpubh.2024.1385089
PMID:39346594
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11427290/
Abstract

BACKGROUND: The impact of cardiovascular diseases on cognition raises important research questions. The study aimed to investigate the relationship between demographic data, cardiovascular diseases, kidney disease and depressive symptoms on cognition. METHODS: A cross-sectional study of patients with cardiovascular diseases was performed. The Montreal Cognitive Assessment (MoCA) was applied for cognitive evaluation. Based on MoCA three groups were defined: preserved cognition, mild, and advanced cognitive dysfunction (CD). Data were analyzed using Cronbach alpha (Cα) and McDonald's ω (Mω) for internal consistency. The Chi-square test, Cramer's V test, and correlation analyses were also applied. RESULTS: Of 628 patients, 55.2% had mild CD, and the mean age was 67.95 (SD 9.53) years. Cα and Mω were 0.7, indicating good internal consistency. We found a moderate positive correlation between depression and the severity of CD ( = 0.25,  = 0.0001). A weak association between CD and female gender ( = 0.016), atrial fibrillation ( = 0.03), stroke ( = 0.009), and a moderate association for age group ( < 0.0001), education level ( < 0.0001), smoking ( < 0.0001), and renal dysfunction ( < 0.0001) was found. Age ≥ 70 years, eGFR 30-59 mL/min/1.73m significantly increased the likelihood for mild and advanced CD, while smoking and > 9 classes decreased it. Female gender, history of atrial fibrillation, and stroke significantly increased the likelihood of advanced CD. CONCLUSION: Mild CD was the most common in patients with cardiovascular diseases. Older age, lower education, being a non-smoker, and renal dysfunction were risk factors for both mild and advanced CD. Female gender, previous diagnosis of atrial fibrillation, and stroke are risk factors for advanced CD.

摘要

背景:心血管疾病对认知的影响引发了重要的研究问题。本研究旨在探讨人口统计学数据、心血管疾病、肾脏疾病和抑郁症状与认知之间的关系。

方法:对心血管疾病患者进行了一项横断面研究。采用蒙特利尔认知评估(MoCA)进行认知评估。根据 MoCA 将患者分为三组:认知正常、轻度认知障碍和认知功能障碍(CD)。采用 Cronbach 阿尔法(Cα)和 McDonald's ω(Mω)进行内部一致性分析。还应用了卡方检验、Cramer's V 检验和相关分析。

结果:在 628 名患者中,55.2%有轻度 CD,平均年龄为 67.95(SD 9.53)岁。Cα 和 Mω分别为 0.7,表明内部一致性良好。我们发现抑郁与 CD 严重程度呈中度正相关( = 0.25, = 0.0001)。CD 与女性( = 0.016)、心房颤动( = 0.03)、中风( = 0.009)之间存在弱关联,与年龄组( < 0.0001)、教育程度( < 0.0001)、吸烟( < 0.0001)和肾功能不全( < 0.0001)之间存在中度关联。年龄≥70 岁、eGFR 30-59 mL/min/1.73m 显著增加了轻度和重度 CD 的可能性,而吸烟和≥9 级则降低了这种可能性。女性、心房颤动和中风病史显著增加了发生重度 CD 的可能性。

结论:在心血管疾病患者中,最常见的是轻度 CD。年龄较大、教育程度较低、不吸烟和肾功能不全是轻度和重度 CD 的危险因素。女性、先前诊断的心房颤动和中风是重度 CD 的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff4/11427290/9656e0ebebd8/fpubh-12-1385089-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff4/11427290/f9458f5009da/fpubh-12-1385089-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff4/11427290/9656e0ebebd8/fpubh-12-1385089-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff4/11427290/f9458f5009da/fpubh-12-1385089-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff4/11427290/9656e0ebebd8/fpubh-12-1385089-g002.jpg

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本文引用的文献

[1]
Cognitive Impairment in Heart Failure: A Heart Failure Society of America Scientific Statement.

J Card Fail. 2024-3

[2]
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Front Aging Neurosci. 2023-11-10

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BMC Med. 2023-6-6

[4]
Cognitive Impairment in Patients With Cardiac Disease: Implications for Clinical Practice.

Stroke. 2023-8

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Role of cognitive reserve in ischemic stroke prognosis: A systematic review.

Front Neurol. 2023-2-22

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Neurology. 2023-4-4

[7]
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Front Neurol. 2022-9-27

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Risk Factors Affecting Cognitive Impairment of the Elderly Aged 65 and Over: A Cross-Sectional Study.

Front Aging Neurosci. 2022-6-16

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Tobacco and nicotine use.

Nat Rev Dis Primers. 2022-3-24

[10]
Cognitive Impairment in Heart Failure: Landscape, Challenges, and Future Directions.

Front Cardiovasc Med. 2022-2-7

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