老年高血压糖尿病高脂血症及其共病对认知功能的影响研究  

The impact of hypertension,diabetes,hyperlipidemia and the comorbidities on cognitive function in the elderly

作　　者：张微 严亚琼[1] 刘新会[1] 周小琦[1] 郭燕[1] ZHANG Wei;YAN Ya-qiong;LIU Xin-hui;ZHOU Xiao-qi;GUO Yan(Wuhan Center for Disease Control and Prevention,Wuhan,hiubei 430000,China)

机构地区：[1]武汉市疾病预防控制中心慢病所,湖北武汉430000

出　　处：《中国预防医学杂志》2021年第6期411-417,共7页Chinese Preventive Medicine

基　　金：湖北省卫生健康委员会科研项目(WJ2019F011);武汉市医学科研项目(WG19Y06)。

摘　　要：目的探讨高血压、糖尿病、高脂血症及其共病对老年人认知功能的影响。方法2019年3—8月从武汉市28个社区卫生服务中心/乡镇卫生院分层随机抽取年龄≥65岁老年人1997人,其中单纯高血压639人,单纯糖尿病67人,单纯高脂血症208人,高血压共病糖尿病115人,高血压共病高脂血症250人,糖尿病共病高脂血症40人,三病共患63人,正常组615人。测量所有调查对象身高、体质量、腰臀围、血压及生化指标等。认知功能采用简易精神状态量表评估。结果高血压共病高脂血症组(χ^(2)=5.73,P=0.01)、糖尿病共病高脂血症组(χ^(2)=5.00,P=0.03)、三病共患组(χ^(2)=11.36,P<0.01)认知功能障碍发生率均高于正常组。三病共患组认知功能障碍发生率均高于患单种疾病组(P<0.05)。多因素非条件logistic回归分析显示,同患高血压、糖尿病、高脂血症是认知功能障碍的危险因素(OR=2.01,P=0.03)。认知功能各维度与各分组的多元线性回归分析显示,注意力与计算力与三病共患呈负相关(t=-2.29,P=0.02),语言能力与高血压共病高脂血症(t=-2.03,P=0.04)、三病共患(t=-2.34,P=0.02)呈负相关。结论高血压共病高脂血症,糖尿病共病高脂血症,同患高血压、糖尿病、高脂血症患者易出现认知功能障碍,共病对认知功能的影响主要体现在影响其语言能力、注意力与计算力。Objective To elucidate the effect of hypertension,diabetes mellitus,hyperlipidemia and the comorbidities on the cognitive function of the elderly.Methods From March 2019 to August 2019,a total of 1997 seniors of age 65 years and older were randomly selected from 28 community healthcare centers or township hospitals in Wuhan using stratified sampling method,among them,639 with hypertension,67 with diabetes,208 with hyperlipidemia,115 with hypertension and diabetes,250 with hypertension and hyperlipidemia,40 with diabetes and hyperlipidemia,63 with hypertension,diabetes and hyperlipidemia,615 normal controls.All subjects received physical examination.Cognitive function was assessed by Mini-Mental State Examination.Results Compare to the control group,the rates of cognitive impairment were significantly higher in subjects with hypertension and hyperlipidemia(χ^(2)=5.73,P=0.01),diabetes and hyperlipidemia(χ^(2)=5.00,P=0.03)and those with comorbidity of three diseases(χ^(2)=11.36,P<0.01).The cognitive dysfunction rate was higher in patients with comorbidity of three diseases than those with single disease(P<0.05).Multivariate unconditional logistic regression analysis showed that comorbidity with hypertension,diabetes and hyperlipidemia was risk factor for cognitive impairment(OR=2.01,P=0.03).Multiple linear regression analysis for each dimension and each group of cognitive function showed that attention and calculation were negatively correlated with the comorbidity of three diseases(t=-2.29,P=0.02),Language ability was also negatively correlated with comorbidity of hypertension and hyperlipidemia(t=-2.03,P=0.04),as well as comorbidity of hypertension,diabetes and Hyperlipidemia(t=-2.34,P=0.02).Conclusions Individuals with concurrent hypertension and hyperlipidemia,diabetes and hyperlipidemia are more likely to suffer from cognitive dysfunction,comorbidity with three diseases has the most significant effect on cognitive function,mainly on language ability,attention and calculating ability.

关 键 词：高血压 糖尿病 高脂血症 共病 认知功能 

分 类 号：R18[医药卫生—流行病学]