Ahto M, Isoaho R, Puolijoki H, Laippala P, Sulkava R, Kivelä S L
Unit of General Practice, Oulu University Hospital and Department of Public Health Science and General Practice, University of Oulu,
Gerontology. 1999;45(2):87-95. doi: 10.1159/000022069.
Coronary heart disease (CHD) and decline in cognitive functioning and dementia are common problems in the elderly. Cardiovascular diseases (CVDs) are connected with vascular dementia, but less is known about cognitive functioning among elderly patients with CHD based on population studies.
To describe the associations between CHD and cognitive impairment among the elderly.
Of the total population of the Lieto study (488 community-dwelling men and 708 women, >/=64 years old), the ambulatory patients with CHD (89 men and 73 women) and sex- and age-matched controls without any sign of CHD (178 men and 146 women) were selected to make up the study population. CHD was defined as the presence of angina pectoris or a past myocardial infarction. Cognitive assessment was based on the Mini-Mental State Examination (MMSE).
The total MMSE scores, the MMSE subtest scores and the overall test-based cognitive functioning did not differ between patients and controls. Among men, higher MMSE subscores in orientation and language were related to more severe chest pain. According to logistic regression analyses, the cognitive impairment of men was associated with high age, the use of cardiac glycosides and physical disability. Among women, cognitive impairment was associated with high age and the use of antipsychotics.
In general, CHD has no independent association with cognitive impairment among the non-institutionalized community-living elderly. Among men, however, a complicated CHD may negatively affect cognitive functioning.
冠心病（CHD）以及认知功能衰退和痴呆是老年人常见的问题。心血管疾病（CVDs）与血管性痴呆有关，但基于人群研究，对于老年冠心病患者的认知功能了解较少。
描述老年人中冠心病与认知障碍之间的关联。
在Lieto研究的总人口（488名社区男性居民和708名女性居民，年龄≥64岁）中，选取患有冠心病的门诊患者（89名男性和73名女性）以及年龄和性别匹配且无任何冠心病迹象的对照组（178名男性和146名女性）组成研究人群。冠心病定义为存在心绞痛或既往心肌梗死。认知评估基于简易精神状态检查表（MMSE）。
患者和对照组之间的MMSE总分、MMSE子测试分数以及基于测试的整体认知功能并无差异。在男性中，定向和语言方面较高的MMSE子分数与更严重的胸痛有关。根据逻辑回归分析，男性的认知障碍与高龄、使用强心苷和身体残疾有关。在女性中，认知障碍与高龄和使用抗精神病药物有关。
总体而言，在非机构化的社区居住老年人中，冠心病与认知障碍没有独立关联。然而，在男性中，复杂的冠心病可能会对认知功能产生负面影响。
