Selective impairment of frontal-executive cognitive function in African Americans with cardiovascular risk factors
Selective impairment of frontal-executive cognitive function in African Americans with cardiovascular risk factors
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DOI：
10.1046/j.1532-5415.2003.51463.x
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发表时间：
2003-10-01
影响因子：
6.3
通讯作者：
Lipsitz, LA
中科院分区：
文献类型：
--
作者：
Pugh, KG;Kiely, DK;Lipsitz, LA
目的：为了确定是否汇总心血管风险评分与额叶执行认知功能障碍的风险增加有关。设计：横断面研究。设置：受试者被招募从高级中心，高级住宅区，社区在波士顿大都市区。参与者：43个主要是女性老年人非裔美国人。测量：心血管危险因素进行了评估，在采访和临床检查。对于每例受试者，将心血管（CV）风险因素总数相加，以计算CV风险评分。一组神经心理学测试，检查记忆，视觉空间能力，和额叶执行功能。认知测试分数转换为特定领域（记忆，视觉空间，额叶-执行）复合z分数。每个复合z评分的认知障碍定义为研究组的表现低于中位数。多元Logistic回归分析CV风险评分与三个认知领域的认知功能障碍风险之间的关系。结果：在控制年龄和教育程度后，CV风险评分仅与额叶-执行认知功能障碍相关（OR = 2.44，95%可信区间CI = 1.06-5.65）。CV风险评分与记忆（OR = 1.30，95% CI = 0.64-2.67）或视觉空间损害（OR = 1.49，95% CI = 0.66-3.36）风险无关。更大的CV风险评分与额叶执行认知功能障碍的可能性增加相关。结论：CV风险因素可能对额叶执行认知能力产生特定的有害影响，而不是记忆或视觉空间功能。相关的执行功能障碍可能会损害具有CV风险因素的患者遵守风险降低建议的能力。
OBJECTIVES: To determine whether a summary cardiovascular risk score is associated with an increased risk of frontal-executive cognitive impairment.DESIGN: Cross-sectional study.SETTING: Subjects were recruited from senior centers, senior housing complexes, and communities in the Boston metropolitan area.PARTICIPANTS: Forty-three predominantly female elderly African Americans.MEASUREMENTS: Cardiovascular risk factors were assessed during an interview and clinical examination. For each subject, the total number of cardiovascular (CV) risk factors was summed to compute a CV risk score. A battery of neuropsychological tests was administered that examined memory, visuospatial abilities, and frontal-executive functions. Cognitive test scores were transformed into domain-specific (memory, visuospatial, frontal-executive) composite z scores. Cognitive impairment for each composite z score was defined as performance less than the median for the study group. Multivariate logistic regression was used to examine the relationship between the CV risk score and the risk for cognitive impairment in the three cognitive domains of interest.RESULTS: After controlling for age and education, the CV risk score was associated only with frontal-executive cognitive impairment (odds ratio (OR) = 2.44, 95% confidence interval (CI) = 1.06-5.65). The CV risk score was not associated with the risk of memory (OR = 1.30, 95% CI = 0.64-2.67) or visuospatial impairment (OR = 1.49, 95% CI = 0.66-3.36). Greater CV risk scores were associated with an increased likelihood of having frontal-executive cognitive impairment.CONCLUSION: CV risk factors may exert a specific deleterious effect on frontal-executive cognitive abilities as opposed to memory or visuospatial functions. Associated executive dysfunction may compromise the ability of patients with CV risk factors to comply with recommendations for risk reduction.