Zhu L, Viitanen M, Guo Z, Winblad B, Fratiglioni L
Stockholm Gerontology Research Center and Department of Geriatric Medicine, Karolinska Institute, Sweden.
J Clin Epidemiol. 1998 May;51(5):385-91. doi: 10.1016/s0895-4356(98)00003-1.
We observed the decline in cognitive functioning in a community cohort of 924 persons aged > or =75 years with initially good cognition. Cognitive performance was indexed with the Mini-Mental State Examination (MMSE) on two occasions, 3 years apart. The average decline in MMSE score was 0.4 points per year. However, 23.4% of the participants lost more than 10% of their baseline MMSE scores. Women declined more rapidly than men. Baseline advanced age, lower education, and stroke predicted the greater decline in women. It appears that the relation of lower education and stroke with cognitive decline was more pronounced in men, but age did not predict cognitive decline in men. In addition, there was a correlation between systolic pressure reduction and cognitive decline in women, which was not accounted for by other factors. In summary, although the cognitive ability is generally spared longitudinally, in terms of the entire population, a considerable proportion of individuals show substantial decline that is related to several factors such as advanced age, female gender, lower education, stroke, and systolic pressure reduction.
我们观察了924名年龄≥75岁、初始认知功能良好的社区队列人群的认知功能衰退情况。相隔3年对认知表现进行了两次简易精神状态检查表（MMSE）评估。MMSE评分的平均年下降幅度为0.4分。然而，23.4%的参与者的MMSE基线评分下降超过了10%。女性的衰退速度比男性更快。基线高龄、低教育水平和中风预示着女性衰退更严重。似乎低教育水平和中风与认知衰退之间的关系在男性中更为明显，但年龄并不能预测男性的认知衰退。此外，女性收缩压降低与认知衰退之间存在相关性，且其他因素无法解释这一相关性。总之，尽管认知能力在纵向总体上得以保留，但就整个人口而言，相当一部分个体出现了显著衰退，这与高龄、女性性别、低教育水平、中风和收缩压降低等多种因素有关。
