Elmstáhl S, Rosén I
Department of Community Medicine, University of Lund, Malmö, Sweden.
Dement Geriatr Cogn Disord. 1997 May-Jun;8(3):180-7. doi: 10.1159/000106629.
Quantified electroencephalographic activity (EEG) has been used to study normal ageing and dementia. Few studies have described longitudinal changes in the very old. A cognitive decline has been described in subjects with white-matter lesions and hypertension but the association with hypotension is unclear. Our aim was to study the predictive value of quantified EEG for the development of cognitive decline and associations with postural hypotension. Participants. Thirty-three healthy women aged 75-95 years, with no signs of cerebrovascular disease, dementia or acute illness at baseline examination took part in a longitudinal 5-year follow-up study. The women were recruited from a random selection using the Municipal Registry. Quantified EEG was assessed twice and recorded on a Siemens-Elema connected to a Biological Banker. The medical and neuropsychological examination was conducted twice. Dementia was classified according to DSM criteria. The assessment included Mini-Mental Scale Examination (MMSE), spatial and vocabulary tests. Blood pressure was measured in supine position and an orthostatic test was performed with continuous ECG recording. Seven women (cases) developed cognitive decline at the 5-year follow-up, defined as newly developed MMSE < 27 and dementia symptoms. Low beta activity at baseline predicted development of cognitive decline. The women who remained healthy at follow-up showed an increase of alpha and theta activity. The cases had a higher orthostatic blood pressure fall during tilting at baseline (16 mm Hg) than the controls (1 mm Hg, p < 0.01). The orthostatic reaction was correlated with increased levels of theta and alpha activity at follow-up (r = -0.47 to -0.52; p < 0.01). Low beta activity predicts for cognitive decline in the elderly and an orthostatic blood pressure reaction is a risk factor for cognitive decline.
定量脑电图活动（EEG）已被用于研究正常衰老和痴呆症。很少有研究描述过极老年人的纵向变化。已有研究描述了白质病变和高血压患者的认知衰退情况，但与低血压的关联尚不清楚。我们的目的是研究定量脑电图对认知衰退发展的预测价值以及与体位性低血压的关联。参与者。33名年龄在75至95岁之间的健康女性，在基线检查时无脑血管疾病、痴呆症或急性疾病迹象，参与了一项为期5年的纵向随访研究。这些女性是从市政登记处随机挑选招募的。定量脑电图进行了两次评估，并记录在连接到生物银行的西门子 - 埃莱玛设备上。医学和神经心理学检查也进行了两次。痴呆症根据《精神疾病诊断与统计手册》标准进行分类。评估包括简易精神状态检查表（MMSE）、空间和词汇测试。测量了仰卧位血压，并进行了体位试验，同时持续记录心电图。7名女性（病例组）在5年随访中出现了认知衰退，定义为新出现的MMSE < 27以及痴呆症状。基线时低β波活动可预测认知衰退的发展。随访中保持健康的女性α波和θ波活动增加。病例组在基线时倾斜过程中的体位性血压下降幅度（16毫米汞柱）高于对照组（1毫米汞柱，p < 0.01）。体位反应与随访时θ波和α波活动水平的增加相关（r = -0.47至 -0.52；p < 0.01）。低β波活动可预测老年人的认知衰退，体位性血压反应是认知衰退的一个危险因素。
