Inverse relationship between the evans index and cognitive performance in non-disabled, stroke-free, community-dwelling older adults. A population-based study
Inverse relationship between the evans index and cognitive performance in non-disabled, stroke-free, community-dwelling older adults. A population-based study
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DOI：
10.1016/j.clineuro.2018.03.021
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发表时间：
2018-06-01
影响因子：
1.9
通讯作者：
Sedler, Mark J.
中科院分区：
文献类型：
--
作者：
Del Brutto, Oscar H.;Mera, Robertino M.;Sedler, Mark J.
目的：应用Evans指数（EI）对正常压力脑积水患者进行识别。然而，最近的研究表明，EI不是这种情况的可靠标志物。相反，EI可能与认知表现呈负相关，但缺乏关于这种相关性的信息。我们的目的是评估社区居住的老年人的EI和认知性能之间的关系。患者和方法：该研究包括314非残疾，无中风，年龄>= 60岁的人参加了阿塔瓦尔帕项目进行脑MRI和莫卡测试。使用广义线性模型，调整人口统计学，心血管危险因素缺牙症，抑郁症，全球皮质萎缩和血管起源的白色高信号，我们评估了EI和认知能力之间的关系。在调整了单变量模型中达到显著性的变量后，还评估了莫卡评分的预测范围，平均EI为0.248 +/- 0.022，平均莫卡评分为19.7 +/- 4.8分。完全校正的广义线性模型显示EI和莫卡评分之间存在显著的反比关系。预测模型显示莫卡评分随着EI水平的增加而降低（β：-3.28，95%CI：-6.09 to-0.47，p = 0.022）。结论：EI对莫卡评分的独立影响为EI评估认知能力的实用性提供了证据。
Objective: The Evans Index (EI) is used for recognition of individuals with normal pressure hydrocephalus. However, recent studies suggest that the EI is not a reliable marker of this condition. Rather, the EI may be inversely correlated with cognitive performance, but information on this correlation is lacking. We aimed to assess the relationship between the EI and cognitive performance in community-dwelling older adults.Patients and Methods: The study included 314 non-disabled, stroke-free, individuals aged >= 60 years enrolled in the Atahualpa Project undergoing brain MRI and MoCA testing. Using generalized linear models, adjusted for demographics, cardiovascular risk factors edentulism, depression, global cortical atrophy and white matter hyperintensities of vascular origin, we assessed the relationship between the EI and cognitive performance. Predictive margins of the MoCA score according to percentiles of the El were also evaluated, after adjusting for variables reaching significance in univariate models.Results: The mean EI was 0.248 +/- 0.022 and the mean MoCA score was 19.7 +/- 4.8 points. A fully-adjusted generalized linear model showed a significant inverse relationship between the EI and the MoCA score. Predictive models showed a decrease in the MoCA score according to increased levels of the EI (beta: -3.28; 95% CI: - 6.09 to - 0.47; p = 0.022).Conclusion: The independent effect of the EI on the MoCA score provides evidence of the utility of the EI to evaluate cognitive performance.