糖尿病和多发性硬化症共病对老年人的认知功能有负面影响。
Comorbid diabetes and multiple sclerosis negatively affect cognitive functioning in older adults.
作者信息
Gromisch Elizabeth S, Foley Frederick W, Holtzer Roee
机构信息
Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT 06112, USA; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Neurology, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, USA; Holy Name Medical Center Multiple Sclerosis Center, 718 Teaneck Road, Teaneck, NJ 07666, USA.
出版信息
Mult Scler Relat Disord. 2025 Aug 27;103:106707. doi: 10.1016/j.msard.2025.106707.
BACKGROUND
Multiple sclerosis (MS) and diabetes can cause deficits in processing speed, executive functioning, and learning and memory, although there is limited research on their combined impact. This study aimed to evaluate whether having both conditions had a negative effect on cognitive functioning in older adults.
METHODS
Persons with MS (n = 108) and healthy controls (HC; n = 114) completed letter fluency, semantic fluency, Trail Making Test (TMT), Symbol Digit Modalities Test (SDMT), and Hopkins Verbal Learning Test-Revised (HVLT-R). Distribution-based z-scores were calculated for each measure, which were used to compute an overall cognition z-score. Using the composite z-score as the outcome and adjusting for demographics, mood, and vascular-related factors, linear regression models were conducted, first with 1) diabetes and 2) MS as the independent variables, and then with 1) diabetes only, 2) MS only, and 3) both diabetes and MS. The latter approach was used to examine the individual measures.
RESULTS
Sixteen persons with MS (14.8 %) and 13 HC (11.4 %) had diabetes. Both diabetes (b = -0.30, p = .022) and MS (b = -0.30, p = .002) were independently associated with overall cognition. Having both conditions had a significant negative effect on overall cognition (b = -0.67, p < .001). The combination of diabetes and MS was associated with reductions in semantic fluency and HVLT-R Total Learning and Delayed Recall.
CONCLUSIONS
In older adults, having both diabetes and MS negatively affects cognitive functioning. Clinicians should consider how comorbidities may contribute to greater difficulties in certain cognitive domains in older persons with MS.
背景
多发性硬化症（MS）和糖尿病可导致处理速度、执行功能以及学习和记忆方面的缺陷，尽管关于它们联合影响的研究有限。本研究旨在评估同时患有这两种疾病是否会对老年人的认知功能产生负面影响。
方法
MS患者（n = 108）和健康对照者（HC；n = 114）完成了字母流畅性、语义流畅性、连线测验（TMT）、符号数字模式测验（SDMT）以及修订版霍普金斯言语学习测验（HVLT-R）。为每项测量计算基于分布的z分数，用于计算总体认知z分数。以综合z分数作为结果，并对人口统计学、情绪和血管相关因素进行调整，进行线性回归模型分析，首先将1）糖尿病和2）MS作为自变量，然后将1）仅糖尿病、2）仅MS以及3）糖尿病和MS两者作为自变量。后一种方法用于检查各项测量指标。
结果
16名MS患者（14.8%）和13名HC（11.4%）患有糖尿病。糖尿病（b = -0.30，p = 0.022）和MS（b = -0.30，p = 0.002）均与总体认知独立相关。同时患有这两种疾病对总体认知有显著负面影响（b = -0.67，p < 0.001）。糖尿病和MS的组合与语义流畅性以及HVLT-R的总学习和延迟回忆减少有关。
结论
在老年人中，同时患有糖尿病和MS会对认知功能产生负面影响。临床医生应考虑合并症如何可能导致患有MS的老年人在某些认知领域出现更大困难。
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