不宁腿综合征与认知障碍的前瞻性研究:基于社区的5年纵向队列研究

Restless legs syndrome and cognitive decline: a community-based 5-year longitudinal cohort study

目的探讨不宁腿综合征(RLS/WED)与认知功能减退间的关系。方法这是一项基于上海黄浦区五里桥社区≥50岁人群的前瞻性研究。首先于2009年,使用中国版简易精神状态检查量表(MMSE-C)对该社区中222例RLS/WED患者(基于2003版诊断标准制定的量表筛查)和1669例无RLS/WED患者进行认知功能评定,通过问卷调查和病案回顾的方法收集混杂因素信息,建立基线标准,5年后(2014年)随访该人群的认知功能(MMSE-C)。通过Logistic regression方法分析RLS/WED人群与认知功能减退的相关性。结果仅调整年龄和性别后,RLS/WED对认知能力减退有保护作用(OR=0.68, 95%CI:0.46~0.99,P=0.04)。然而,继续调整其他混杂因素(包括性别、年龄、职业、教育状况、糖尿病、高血压、鼾症、失眠、吸烟和饮酒、体重指数、载脂蛋白Eε4、抑郁、头部创伤史、全身麻醉史、冠状动脉疾病史、脑梗死、脑出血史)后,RLS/WED和认知能力减退无显著相关性(OR=0.64, 95%CI:0.40~1.04,P=0.07)。结论基于社区随访5年的前瞻性研究未发现RLS与认知功能减退有相关性。

Objective The aim of the study was to investigate the relationship between restless legs syndrome(RLS/WED) and cognitive decline. Methods This is a prospective study based on people aged ≥ 50 in Wuli Bridge urban community of Huangpu district of Shanghai. Firstly, in 2009, 222 patients with RLS/WED(scale screening based on the 2003 version of diagnostic criteria) and 1669 patients without RLS/WED were evaluated by mini-mental State Examination-Chinese(MMSE-C), Confounders were collected by questionnaire and medical record review, baseline criteria were established, and cognitive function(MMSE-C) was followed up 5 years later(2014).Logistic regression was used to analyze the correlation between RLS/WED and cognitive decline. Results Only after adjusting for age and gender, RLS/WED had a protective effect on cognitive decline(OR=0.68, 95%CI: 0.46-0.99, P=0.04). however, continue to adjust other confounding factors(including gender, age, occupation, education status, diabetes, hypertension, snoring, insomnia, smoking and alcohol consumption, Body Mass Index( BMI), apolipoproteinEε4(ApoEε4), depression, head trauma history, history of general anesthesia, history of coronary artery disease, cerebral infarction and cerebral hemorrhage), there was no significant correlation between RLS/WED and cognitive impairment(OR=0.64, 95%CI: 0.40-1.04, P=0.07).Conclusion We did not found any association between RLS/WEDand cognitive decline in this 5 years longitudinal prospective community-based study.