社区老年人糖尿病认知功能障碍及危险因素调查

Survey of Cognitive Impairment and Risk Factors in Aged Diabetics Patients in Community

目的探讨老年人糖尿病与认知功能障碍之间的关系及影响因素。方法在北京市宣武区社区居民健康体检管理档案中,随机抽取60岁及以上符合2型糖尿病诊断标准的糖尿病患者308例,其中单纯糖尿病144例,糖尿病合并高血压164例,作为研究对象,并随机抽取225例原发性高血压病和186例相同年龄段及性别的健康老年人作为对照组,进行简易智能状态量表(MMSE)测查,同时进行统一问卷调查、体格检查,测定血糖、血脂,糖尿病者加测糖化血红蛋白。结果单纯糖尿病组认知功能障碍发生率高于正常对照组,糖尿病合并高血压组认知功能障碍发生率明显高于对照组;血糖对认知功能障碍存在单独效应,高血压对认知功能障碍有协同作用,而且两者存在交互效应。空腹血糖及糖化血红蛋白达标率与认知功能障碍呈负相关,糖尿病病程与认知功能障碍呈正相关。结论糖尿病是老年人认知功能障碍的危险因素。糖尿病合并高血压等血管危险因素时,可加重认知功能障碍。

Objectives To evaluate the relation between senile diabetics and cognitive impairment(CI), and to find out influencing factors in the elders. Methods 308 type 2 diabetic patients including 225 diabetic patients and 164 diabetic with hypertension patients were randomly enrolled from Xuanwu community. And 225 hypertension and 186 healthy elders were randomly selected as controls. Patients and controls were matched in sex and age. Each case was tested with Mini-Mental State Examination (MMSE). Results The prevalence rate of CI in diabetes was significantly higher than that in healthy controls , and in diabetic with hypertension was much higher than that in healthy controls .Blood glucose had simple effect on CI, whereas hypertension had synergy effect on CI. There were some interactive effects between glucose and hypertension.And MMSE scores in diabetic combined with hypertension group were lower than pure diabetic group . Fasting glucose level and Hemoglobin A1c (HbA1c) pass rate were negative correlated with CI, while the course of the disease was positively correlated with CI. Conclusions Diabetic is a risk factor of CI in senile. Diabetic with hypertension can aggravate CI.