García-Lluch Gemma, Muedra-Moreno Ariadna, García-Zamora Mar, Gómez Beatriz, Sánchez-Roy Rafael, Moreno Lucrecia
Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, 46115 Valencia, Spain.
Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain.
J Clin Med. 2024 Oct 9;13(19):6009. doi: 10.3390/jcm13196009.
: Cognitive impairment, marked by a decline in memory and attention, is frequently underdiagnosed, complicating effective management. Cardiovascular risk factors (CVR) and anticholinergic burden (ACB) are significant contributors to dementia risk, with ACB often stemming from medications prescribed for neuropsychiatric disorders. This study evaluates cognitive profiles through three brief cognitive tests, analyzing the impact of CVR and ACB presence. : This cross-sectional study was performed between 2019 and 2023 in community pharmacies and an outpatient clinic in Valencia, Spain. Eligible participants were patients with subjective memory complaints 50 years or older with clinical records of cardiovascular factors. Patients with conflicting information regarding diabetes diagnosis or not taking concomitant medications were excluded. Three brief cognitive tests (Memory Impairment Screening (MIS), Semantic Verbal Fluency Test, and SPMSQ) were assessed. CVR was calculated using the European SCORE2 table, and ACB was assessed using the CALS scale. : Among 172 patients with memory complaints and CVR factors, 60% failed at least one cognitive test. These patients were on significantly more medications and had higher blood pressure and HbA1c levels. An increase in CVR and ACB was associated with more failed tests. Additionally, elevated SCORE2 scores were associated with a greater failure rate on the MIS test, while patients with elevated ACB more frequently failed the SPMSQ test. : Selecting an adequate brief cognitive test according to patients' characteristics offers an opportunity to screen patients who are probably cognitively impaired. Whereas the MIS test may be helpful for patients with cardiovascular risk, SPMSQ stands out among patients with significant ACB.
认知障碍以记忆力和注意力下降为特征，常常未得到充分诊断，这使得有效管理变得复杂。心血管危险因素（CVR）和抗胆碱能负担（ACB）是痴呆风险的重要促成因素，ACB通常源于为神经精神疾病开具的药物。本研究通过三项简短认知测试评估认知概况，分析CVR和ACB存在的影响。
这项横断面研究于2019年至2023年在西班牙瓦伦西亚的社区药房和一家门诊诊所进行。符合条件的参与者是50岁及以上有主观记忆主诉且有心血管因素临床记录的患者。排除糖尿病诊断信息冲突或未服用伴随药物的患者。评估了三项简短认知测试（记忆障碍筛查（MIS）、语义言语流畅性测试和简易精神状态问卷（SPMSQ））。使用欧洲SCORE2表计算CVR，并使用CALS量表评估ACB。
在172名有记忆主诉和CVR因素的患者中，60%至少一项认知测试未通过。这些患者服用的药物明显更多，血压和糖化血红蛋白（HbA1c）水平更高。CVR和ACB的增加与更多测试未通过相关。此外，SCORE2分数升高与MIS测试的更高失败率相关，而ACB升高的患者更频繁地在SPMSQ测试中失败。
根据患者特征选择适当的简短认知测试为筛查可能存在认知障碍的患者提供了机会。虽然MIS测试可能对有心血管风险的患者有帮助，但SPMSQ在有显著ACB的患者中表现突出。
