慢性阻塞性肺疾病对老年人认知功能下降速度的影响

Effect of chronic obstructive pulmonary disease on cognitive decline in the elderly

目的本文观察慢性阻塞性肺疾病（COPD）对老年认知功能纵向变化速度的影响并探讨其机制。方法采用前瞻性病例对照研究，自2010年1～11月对92例COPD患者及97例对照老年人基线状态的认知功能与全身临床状况进行评估测定。认知功能测定包括简易精神状态量表（MMSE）、词语学习及延迟回忆、动物流畅性及符号数字转换测验。每年随访观察研究对象，测定其认知功能，连续随访2年。采用随机效应模型分析COPD对基线认知功能及认知功能下降速度的影响。结果调整高血压的影响后，COPD患者的MMSE、词语学习及延迟回忆、动物流畅性及符号数字转换测验的下降速度均较对照组明显加快（P〈0．01）。结论COPD与老年人认知功能的快速减退有关。

Objective To determine the change in cognitive function in the elderly patients with chronic obstructive pulmonary disease （COPD） and to explore its mechanism. Methods In this hospital-based, prospective, case-control study, cognitive function and general clinical status of 92 elderly with COPD and 97 control subjects between January and September 2010 were evaluated. Cognitive tests at the dme of the baseline and annual evaluations （2 years） were conducted in all of the subjects, which included the Mini-Mental State Examination （MMSE） , word list recall, delayed recall, animal category fluency, and symbol digit modalities test. Results In mixed-effects models adjusted for hypertension, COPD was associated with a more rapid rate of cognitive decline based on the MMSE, word list recall, delayed recall, animal flu- ency, and symbol digit modalities test （ all P〈 0.01 ） compared to controls. Conclusions COPD is associated with a more rapid rate of cognitive decline in the elderly.