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约旦颈动脉狭窄患者的认知障碍与生活质量:一项横断面研究

Cognitive impairment and quality of life among patients with carotid artery stenosis in Jordan: a cross-sectional study.

作者信息

Alnaeem Mohammad Minwer, Obeid Aya, Suleiman Khalid, Alzoubi Majdi, Al-Mugheed Khalid, Saeed Alabdullah Amany Anwar, Farghaly Abdelaliem Sally Mohammed

机构信息

School of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan.

Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan.

出版信息

Sci Rep. 2025 Jun 4;15(1):19639. doi: 10.1038/s41598-025-04004-5.

Abstract

Carotid artery stenosis (CAS) is a significant health problem associated with poor cerebral perfusion, which might negatively affect patients' psychological, physical, and cognitive health status. This study aimed to examined the relationship between CAS, cognitive status, and quality of life (QoL) among patients with CAS. A cross-sectional study was recruited a convenience sample of 140 adults (≥ 18 years) diagnosed via Doppler ultrasound with CAS of ≥ 10% severity from two tertiary hospitals in Jordan. Exclusion criteria included patients who had undergone CAS revascularization procedures and those with confirmed psychiatric disorders. Data was collected using three sections; demographic data, the World Health Organization Quality of Life BREF, and the mini-mental state examination tools. About 56.6% of the patients had moderate-severe CAS, and 87.1% had moderate-severe cognitive impairment. A significant association was observed between CAS severity and cognitive impairment (χ = 33.91, p < 0.001). Notably, 66% of patients with mild CAS exhibited moderate-to-severe cognitive impairment, rising to 71.3% in those with moderate-to-severe CAS. The overall patents' QoL was poor while the highest mean was for psychological domain (58.86 ± SD = 16.15), and the lowest mean was for physical domain (45.46 ± SD = 19.62). There was a significant impact of the level of cognitive impairment on physical health [F (138) = 5.31, p < 0.01, η = 0.072], psychological health [F (138) = 7.05, p < 0.01, η = 0.093], and total QoL score [F (138) = 4.59, p < 0.05, η = 0.063]. The hierarchical regression revealed that cognitive status does significantly affect QoL, with severe cognitive impairment being associated with worse QoL. After controlling for sociodemographic variables, severe CAS (β = - 0.273, p = 0.015) and severe cognitive impairment (β = - 0.291, p = 0.007) were associated with poor QoL. Patients with CAS exhibited moderate cognitive impairment and reduced QoL, particularly in psychological and social domains. Integrating routine cognitive assessments into clinical evaluations is critical to guide holistic care addressing both vascular and cognitive health. Further interventions are required to reduce the potential for cognitive decline while also enhancing patients' QoL, particularly by improving emotional well-being, daily functioning, and social engagement.

摘要

颈动脉狭窄(CAS)是一个与脑灌注不良相关的重大健康问题,这可能会对患者的心理、身体和认知健康状况产生负面影响。本研究旨在探讨CAS患者中CAS、认知状态和生活质量(QoL)之间的关系。一项横断面研究从约旦两家三级医院招募了140名成年人(≥18岁)的便利样本,这些患者经多普勒超声诊断为严重程度≥10%的CAS。排除标准包括接受过CAS血运重建手术的患者和确诊患有精神疾病的患者。数据收集使用三个部分:人口统计学数据、世界卫生组织生活质量简表和简易精神状态检查工具。约56.6%的患者患有中度至重度CAS,87.1%的患者患有中度至重度认知障碍。观察到CAS严重程度与认知障碍之间存在显著关联(χ=33.91,p<0.001)。值得注意的是,66%的轻度CAS患者表现出中度至重度认知障碍,中度至重度CAS患者中这一比例上升至71.3%。总体患者的生活质量较差,其中心理领域的平均得分最高(58.86±标准差=16.15),身体领域的平均得分最低(45.46±标准差=19.62)。认知障碍程度对身体健康[F(1,38)=5.31,p<0.01,η=0.072]、心理健康[F(1,38)=7.05,p<0.01,η=0.093]和总体生活质量得分[F(1,38)=4.59,p<0.05,η=0.063]有显著影响。层次回归显示,认知状态确实会显著影响生活质量,严重认知障碍与较差的生活质量相关。在控制了社会人口学变量后,严重CAS(β=-0.273,p=0.015)和严重认知障碍(β=-0.291,p=0.007)与较差的生活质量相关。CAS患者表现出中度认知障碍和生活质量下降,尤其是在心理和社会领域。将常规认知评估纳入临床评估对于指导兼顾血管和认知健康的整体护理至关重要。需要进一步的干预措施来降低认知衰退的可能性,同时提高患者的生活质量,特别是通过改善情绪健康、日常功能和社会参与度。

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