高血压合并糖尿病与老年人认知功能的关系

Correlation of cognitive function with hypertension and diabetes mellitus in the elderly

目的探讨高血压合并糖尿病(DM)对老年人认知功能的影响。方法选取2015年6月至2016年6月期间在武警后勤学院附属医院心血管内科诊治的60~80岁患者129例。根据合并高血压和糖尿病情况分为3组:单纯高血压组(n=59)、单纯DM组(n=30)和高血压+DM组(n=40)。收集患者的一般资料,并进行简易精神状况检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评估。结果与单纯高血压组和单纯DM组相比,高血压+DM组患者的MMSE和MoCA评分显著降低,且轻度认知障碍(MCI)发生率显著增高,差异均具有统计学意义(P<0.05)。logistic回归分析结果显示,年龄、糖化血红蛋白、高血压病程、独居、痴呆家族史是认知功能减退的危险因素(P<0.05),受教育年限是认知功能减退的保护因素(P<0.05)。结论与单纯高血压和单纯DM患者相比,高血压合并DM会加重认知功能的减退。

Objective To determine the effect of hypertension complicated with diabetes mellitus （DM） on cognitive function in the elderly. Methods A total of 129 elderly patients （aged 60 to 80 years） admitted in our department from June 2015 to June 2016 were recruited in this study. They were divided into hypertension group （n=59）, DM group （n=30）, and hypertension complicated with DM group （hypertension＋DM, n=40）. Their general information and clinical data were collected. Their cognitive function was evaluated by mini-mental state examination （MMSE） and Montreal cognitive assessment （MoCA）. Results Compared with hypertension group and DM group, the hypertension＋DM group had lower scores of MMSE and MoCA, and higher incidence of mild cognitive impairment （MCI, all P〈0.05）. Logistic regression analysis indicated that age, glycosylated hemoglobin （HbA1c）, duration of hypertension, solitary and familial history of dementia were risk factors for cognitive impairment （P〈0.05）, while high educational level was a protective factor （P〈0.05）. Conclusion Compared with essential hypertension and simple DM, hypertension complicated with DM aggravates cognitive impairment in the elderly.