社区老年人轻度认知功能损害的血管危险因素分析

Analysis of the vascular risk factors for the elderly with mild cognitive impairment in community

目的 探讨多种血管危险因素对老年人认知功能的影响.方法 随机抽取3个社区,对1 269名老年人(65岁以上)进行横断面研究,通过面对面访谈,用简易精神状态量表(MMSE)评估认知功能,并收集血样进行实验室检查.采用二元Logistic回归分析影响认知功能的血管危险因素.结果 年龄(t=4. 603,P<0. 05)、文化程度(χ2=12. 727,P<0. 05)、高血压( χ2=9. 106,P<0. 05)、LDL-C(χ2=5. 157,P<0. 05)在有无轻度认知功能损害社区老年人中差异有统计学意义 .控制年龄、性别、文化程度后进行 Logistic 回归分析,发现高血压[ β=0. 378,P=0. 006,OR ( 95% CI)= 1. 44 ( 1. 10~1. 91)]、收缩压≥140 mmHg[β=0. 350,P=0. 011,OR(95%CI)=1. 42(1. 08~1. 86),1 mmHg=0. 133 kPa],低密度脂蛋白升高[ β=0. 355,P=0. 014,OR(95% CI)= 1. 43( 1. 08~1. 89)]是社区老年人患MCI的危险因素.单独存在高血压或LDL-C水平升高[β=0. 365,P=0. 029,OR(95%CI)=1. 44(1. 04~2. 00)]是社区老年人发生轻度认知功能损害的危险因素,高血压和LDL-C水平升高共存的老年人发生轻度认知功能损害的风险是健康老年人的2. 00倍[β=0. 696,P<0. 05,OR(95%CI)=2. 00(1. 36~2. 97)].结论 老年人轻度认知功能损害与高血压和LDL-C水平升高密切相关,多种血管危险因素叠加可进一步增加认知障碍的患病风险.

Objective To explore the effects of vascular risk factors on cognitive function among the elderly in community. Methods A cross-sectional study was conducted in 1 269 elderly people ( aged 65 and over) who were randomly selected from three communities. Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE),and blood samples were collected for labo-ratory examination. Logistic regression analysis was used to analyze the vascular risk factors affecting cogni-tive function. Results Age (( 73. 1 ± 6. 6), ( 71. 3 ± 4. 9),t=4. 603,P<0. 05),education level ( χ2=12. 727,P<0. 05),hypertension (χ2=9. 106,P<0. 05) and LDL-C (χ2=5. 157,P<0. 05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age,gender and ed-ucation,the logistic regression analysis showed that hypertension(β=0. 378,P=0. 006,OR(95%CI)=1. 44 (1. 10-1. 91)),systolic blood pressure ≥140 mmHg( β=0. 350,P=0. 011,OR( 95% CI)= 1. 42( 1. 08-1. 86),1 mmHg=0. 133 kPa),and high LDL-C( β=0. 355,P=0. 014,OR(95%CI)=1. 43( 1. 08-1. 89)) were the risk factors of MCI in the elderly in the community. Hypertension alone or high LDL-C (β=0. 365, P=0. 029,OR(95%CI)=1. 44(1. 04-2. 00)) alone was risk factor for mild cognitive impairment in the eld-erly in the community. The risk of mild cognitive impairment in the elderly with hypertension and high LDL- C was 2. 00 times higher than that in the healthy elderly ( β=0. 696,P<0. 05,OR( 95%CI)= 2. 00( 1. 36-2. 97)). Conclusion Mild cognitive impairment in the elderly is closely related to hypertension and elevat-ed LDL-C levels. Multiple vascular risk factors can further increase the risk of cognitive impairment.