社区中老年人认知功能与糖尿病及代谢相关指标的关联性

Relevance between cognitive function of middle-- aged and elderly people in the community and related inde- xes of diabetes and metabolism

目的探讨社区中老年人整体认知功能以及不同认知域功能与糖尿病患病的关联性，为早期预防和延缓糖尿病相关的认知功能减退提供理论依据。方法采用病例对照研究，采用两个总体认知功能评估量表联合8个单项认知功能域评估测验对100例社区中老年糖尿病患者和200名健康中老年人的认知功能进行评估，检测其空腹血糖和糖化血红蛋白水平，分析不同认知域的功能与空腹血糖和糖化血红蛋白水平的相关性。结果（1）糖尿病组总体认知功能、长延迟回忆、图片记忆、视空间和处理速度低于对照组（P〈0．05）；（2）糖尿病组MMSE和MoCA得分均低于对照组[（26．59±2．12）分比（27．53±2．22）分，P〈0．01；（22．45±3．75）分比（23．91±3．46）分，P〈0．01]；糖尿病患病与MMSE和MoCA得分呈负相关（r=-0．237，P〈0．01；r=-0．189，P〈0．01）。（3）糖尿病患者的糖化血红蛋白水平与瞬时记忆、视空间和处理速度呈负相关（P〈0．05）；空腹血糖水平与认知功能无相关性（P〉0．05）。结论糖尿病患者存在总体认知功能减退，主要表现在记忆、视空间和处理速度3个认知领域的下降，其糖化血红蛋白水平与认知功能呈负相关。早期预防控制糖尿病的发生和发展可能对减缓糖尿病相关的认知功能减退具有重要作用。

Objective To explore the overall cognitive function of the middle--aged and elderly people in the community and the relevance between different cognitive domains and the prevalence of dia- betes providing a theoretical basis for the early prevention and delay of diabetes related cognitive dysfunc- tion. Methods Using case--control study, two overall cognitive function assessment scales with eight single--item cognitive domains assessment tests were used to assess the cognitive function of 100 patients with diabetes and 200 controls. Fasting plasma glucose （FPG）and glycated hemoglobin （HbAlc） were detected and the association between the {unctions of the different cognitive domains, FPG and HbAlc was analysed. Results （1）Scores of diabetes group in global cognitive function, long delayed recall, picture memory, visual space and processing speed were significantly lower than control group （P 〈 0.05） （2） MMSE and MoCA scores of diabetes group were lower than control group [（26. 59± 2. 12）vs （27.53±2.22）, P〈0.01; （22.45±3.75）vs（23.91±3.46）, P 〈 0.01] the scores of MMSE were negatively correlated with scores of MoCA in diabetes group （r =-- 0. 237, P〈 0.01 ; r =-- 0. 189, P〈 0.01）; （3）HbAlc level was significantly negatively correlated with immediate recall, visual space and processing speed （P ~ 0.05） ~ the correlation between FPG level and cognitive function was not signifi- cant （P 〉 0.05）. Conclusions Diabetes patients were worse in overall cognitive function, particularly memory, vision space and processing speed, the HbAlc level was significantly negatively correlated with cognitive function. Early prevention and control of the occurrence and development of diabetes may have an important role in slowing down the cognitive decline associated with diabetes.