农村老年人臂间血压差与轻度认知功能障碍的关系研究
Study on the Relationship between Inter-arm Blood Pressure Difference and Mild Cognitive Impairment in Rural Elderly People
背景??既往研究发现臂间血压差(IAD)和轻度认知功能障碍(MCI)均与心血管危险因素密切相关,但IAD与MCI之间是否存在关联尚不明确。目的 ?探讨农村老年人IAD与MCI的关系,为明晰老年人认知功能下降的机制提供科学依据。方法 ?于2019年7—8月采用多阶段整群抽样方法抽取贵州省2个县(区)5个乡镇的60岁及以上农村老年人进行问卷调查、一般体格检查、认知功能检查及双臂血压测量。采用简易精神状态评价量表(MMSE)评估认知功能,采用日常生活活动量表(ADL)评估日常生活功能状况。采用Spearman秩相关分析及二分类Logistic回归分析探究老年人IAD与MCI的关联性。结果 ?本次调查共发放问卷1795份,排除问卷信息不完整、未进行血压测量、未进行血液检查对象,最终纳入1088名参与者的数据进行研究。1088名农村老年人中,共检出MCI患者138例(12.68%),臂间收缩压差(sIAD)≥10mmHg者99例(9.10%),臂间舒张压差(dIAD)≥10mmHg者80例(7.35%)。与IAD<10mmHg人群相比,IAD≥10mmHg人群的MCI患病率更高,MMSE总分、定向力、语言能力和延时回忆力得分较低(P<0.05)。相关性分析结果显示,sIAD与MMSE总分(rs=-0.094)、定向力评分(rs=-0.082)、语言能力评分(rs=-0.065)和延迟回忆力评分(rs=-0.104)呈负相关(P<0.05);dIAD与MMSE总分(rs=-0.080)、定向力评分(rs=-0.094)和注意计算力评分(rs=-0.063)呈负相关(P<0.05)。多因素Logistic回归分析显示,sIAD每增加1mmHg,MCI发生风险增加8.80%(OR=1.088,95%CI=1.046~1.131;P<0.001);sIAD≥10mmHg(OR=2.169,95%CI=1.262~3.728;P<0.05)和dIAD≥10mmHg(OR=1.926,95%CI=1.047~3.542;P<0.05)是老年人发生MCI的影响因素。结论 ?农村老年人MCI患病率为12.68%,其IAD升高与MCI发生风险增加相关,IAD≥10mmHg人群MCI患病风险高于IAD<10mmHg人群。
Background??Previous studies have found that inter-arm blood pressure differenceIADand mild cognitive impairmentMCIare both associated with cardiovascular risk factorsbut it is unclear whether there is an association between IAD and MCI. Objective??To explore the relationship between IAD and MCI in rural elderly persons and to provide a scientific basis for clarifying the mechanisms of cognitive decline in elderly persons. Methods??From July to August 2019the rural elderly residents aged 60 years and older were selected using the multi-stage cluster sampling method from 5 townships in 2 countiesdistrictsof Guizhou Provinceand questionnaire surveysgeneral physical examinationscognitive function assessmentsand bilateral arm blood pressure measurements were carried out among them. Cognitive function was evaluated using the Mini-Mental State ExaminationMMSE scaleand activities of daily living were assessed using the Activities of Daily LivingADL scale. Spearman rank correlation analysis and binary logistic regression model were used to investigate the association between IAD and MCI in the elderly persons. Results ?A total of 1 795 questionnaires were distributedand data from 1 088 participants were finally included in the study by excluding subjects with incomplete information on the questionnairesthose who did not undergo blood pressure measurementsand those who did not undergo blood tests. Among the 1 088 rural elderly residents138 patients12.68%with MCI99 patients9.10%with systolic inter-arm blood pressure differencesIAD 10 mmHgand 80 patients7.35%with diastolic inter-arm blood pressure differencedIAD 10 mmHg were detected. Individuals with IAD 10 mmHg had a higher prevalence of MCI and lower MMSE scoresorientation scoreslanguage scoresand delayed recall scores compared to those with IAD <10 mmHg P<0.05. The results of correlation analysis showed that the sIAD was significantly negatively associated with the total MMSE score rs=-0.094orientation score rs=-0.082verbal ability score rs=-0.065 and delayed recall score rs=-0.104and the dIAD was significantly negatively associated with the total MMSE score rs=-0.080orientation score rs=-0.094and attentional calculation score rs=-0.063all P<0.05. Multivariate logistic regression analysis showed that the risk of MCI increased by 8.80% for each 1 mmHg increase in sIAD OR=1.08895%CI=1.046-1.131P<0.001sIAD 10 mmHg OR=2.16995%CI=1.262-3.728P<0.05 and dIAD 10 mmHg OR=1.92695%CI=1.047-3.542P<0.05 were the influencing factors for the occurrence of MCI in the elderly. Conclusion??The prevalence of MCI in rural elderly was 12.68%and their elevated IAD was associated with an increased risk of MCI. And the risk of MCI was higher in elderly with IAD 10 mmHg than in those with IAD <10 mmHg.
杨星、吴清悦、周训琼、周全湘、陈晓玲、杨敬源
神经病学、精神病学内科学预防医学
轻度认知功能障碍臂间血压差农村地区老年人横断面研究
杨星,吴清悦,周训琼,周全湘,陈晓玲,杨敬源.农村老年人臂间血压差与轻度认知功能障碍的关系研究[EB/OL].(2024-05-27)[2025-08-18].https://chinaxiv.org/abs/202405.00299.点此复制
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