Mitincu-Caramfil Simona-Dana, Plesea-Condratovici Alina, Balta Alexia Anastasia Stefania, Bulza Valentin, Bradeanu Andrei-Vlad, Moroianu Lavinia-Alexandra, Isailă Oana-Maria, Drima Eduard
Department of Pharmaceutical Sciences, Dunărea de Jos University, 800008 Galati, Romania.
Medical Department, Dunărea de Jos University, 800008 Galati, Romania.
J Clin Med. 2025 Jun 28;14(13):4595. doi: 10.3390/jcm14134595.
Cognitive deficiency associated with chronic alcohol consumption in older people remains an under-investigated public health issue in Romania, particularly concerning rural-urban disparities and the impact of reversible hepatic dysfunction on cognitive performance. To evaluate cognitive function at hospital admission and discharge using the Mini-Mental State Examination (MMSE); to identify rural-urban disparities; and to analyze the relationship between hepatic markers and MMSE scores in older people with chronic alcohol consumption. This retrospective, single-center observational study was conducted on 152 patients aged ≥55 years, hospitalized between January 2021 and December 2023 at the "Elisabeta Doamna" Psychiatric Hospital, Galați. Demographic variables, MMSE scores (at admission and discharge), and hepatic parameters (AST, ALT, GGT, total bilirubin, and ammonia) were collected. Statistical analysis included descriptive statistics, chi-square tests for categorical variables, paired -tests or ANOVA for MMSE scores, and Pearson correlations between MMSE and hepatic markers (α = 0.05). At admission, 94% of patients had an MMSE score < 24. The mean MMSE score increased from 23.4 ± 4.1 to 25.0 ± 3.7 at discharge (Δ = +1.6; < 0.001). Patients from rural areas (63.8% of the sample) had significantly lower MMSE scores at admission compared to urban patients (22.6 ± 3.9 vs. 24.8 ± 4.2; = 0.02). However, no statistically significant difference was observed between rural and urban patients regarding cognitive improvement during hospitalization ( = 0.88), indicating that the initial gap persisted at discharge. GGT levels were inversely correlated with MMSE scores (r = -0.41; < 0.001), suggesting a contribution of hepatic dysfunction to cognitive decline. Alcohol-related cognitive impairment is highly prevalent among older patients hospitalized for withdrawal, with partial reversibility observed through inpatient management. The observed rural disparities and the association between hepatic dysfunction and cognitive performance highlight the need of concurrent MMSE and hepatic screening, with prioritized interventions in rural settings. Prospective, multicenter studies are warranted to validate these findings and to identify additional prognostic biomarkers.
在罗马尼亚，老年人慢性酒精消费相关的认知缺陷仍是一个研究不足的公共卫生问题，尤其是在城乡差距以及可逆性肝功能障碍对认知表现的影响方面。使用简易精神状态检查表（MMSE）评估住院时和出院时的认知功能；确定城乡差距；并分析慢性酒精消费老年人的肝脏标志物与MMSE评分之间的关系。这项回顾性单中心观察性研究针对152名年龄≥55岁的患者进行，这些患者于2021年1月至2023年12月期间在加拉茨的“伊丽莎贝塔夫人”精神病医院住院。收集了人口统计学变量、MMSE评分（住院时和出院时）以及肝脏参数（谷草转氨酶、谷丙转氨酶、γ-谷氨酰转肽酶、总胆红素和氨）。统计分析包括描述性统计、分类变量的卡方检验、MMSE评分的配对t检验或方差分析，以及MMSE与肝脏标志物之间的Pearson相关性分析（α = 0.05）。住院时，94%的患者MMSE评分<24。出院时MMSE平均评分从23.4±4.1提高到25.0±3.7（差值=+1.6；P<0.001）。农村地区患者（占样本的63.8%）住院时的MMSE评分显著低于城市患者（22.6±3.9对24.8±4.2；P = 0.02）。然而，农村和城市患者在住院期间认知改善方面未观察到统计学显著差异（P = 0.88），这表明出院时初始差距仍然存在。γ-谷氨酰转肽酶水平与MMSE评分呈负相关（r = -0.41；P<0.001），表明肝功能障碍对认知下降有影响。酒精相关的认知障碍在因戒断住院的老年患者中非常普遍，通过住院治疗观察到部分可逆性。观察到的城乡差距以及肝功能障碍与认知表现之间的关联凸显了同时进行MMSE和肝脏筛查的必要性，并在农村地区优先进行干预。有必要开展前瞻性多中心研究来验证这些发现并确定其他预后生物标志物。
