The metabolic syndrome and development of cognitive impairment among older women.
The metabolic syndrome and development of cognitive impairment among older women.
复制标题
DOI：
10.1001/archneurol.2008.566
复制
发表时间：
2009-03
影响因子：
--
通讯作者：
Krueger, Kathryn A.
中科院分区：
文献类型：
--
作者：
Yaffe, Kristine;Weston, Andrea L.;Blackwell, Terri;Krueger, Kathryn A.
一些研究支持心血管危险因素在认知老化中的作用。代谢综合征是一系列心血管危险因素，在老年人中很常见。越来越多但相互矛盾的文献表明，代谢综合征可能与认知障碍有关。研究代谢综合征及其组分与老年妇女偶发性认知损害之间的关系。我们前瞻性地确定代谢综合征及其组分是否与4年内发生认知功能障碍（痴呆、轻度认知功能障碍或整体认知测试评分低）的风险相关。该研究在25个国家的180个临床中心进行。共有4895名老年骨质疏松症女性（平均年龄66.2岁）参与了一项辅助研究，以确定临床相关的认知功能障碍。这些妇女没有基线认知障碍，并有代谢综合征组成措施。具有临床意义的认知功能障碍定义为包括患有临床判定的痴呆或MCI的女性以及Short Blessed测试评分大于6（与功能障碍一致）但其病例未进行临床判定的女性。使用逻辑回归分析来检查代谢综合征的存在与临床显着认知障碍的发展之间的关联。共有497名女性（10.2%）患有代谢综合征，其中36名（7.2%）发展为认知障碍，而181名女性（4398名，4.1%）没有综合征（年龄调整的比值比，1.66; 95%置信区间，1.14-2.41）。所有女性代谢综合征组分的平均（SD）数为1.0（1.1）; 518名妇女（10.6%）肥胖，895 18.3%有高胆固醇血症，1200高密度脂蛋白胆固醇水平较低者占24.5%，高血压患者占1944例（39.7%），空腹血糖水平较高者占381例（7.8%）。每增加一个单位的成分数，发生认知功能障碍的风险就增加23.0%（比值比，1.23，95%置信区间，1.09-1.39）。进一步的多变量调整在一定程度上降低了影响。我们发现代谢综合征与老年妇女中的成分数量和发展认知障碍的风险之间存在关联。需要进一步的研究来确定这些高危老年妇女的筛查和密切管理是否会减少认知障碍的发生率。
Several studies support a role for cardiovascular risk factors in cognitive aging. The metabolic syndrome, a constellation of cardiovascular risk factors, is common in elderly people. A growing but conflicting body of literature suggests that the metabolic syndrome may be associated with cognitive impairment. To investigate the association between the metabolic syndrome, and its components, and incident cognitive impairment in older women. We prospectively determined if the metabolic syndrome and its components were associated with a 4-year risk of developing cognitive impairment (dementia, mild cognitive impairment or low global cognitive test score). The study was conducted at 180 clinical centers in 25 countries. A total of 4895 older women (mean age, 66.2 years) with osteoporosis who were part of an ancillary study to determine clinically relevant cognitive impairment were included in this study. These women were free of baseline cognitive impairment and had metabolic syndrome component measures. Clinically significant cognitive impairment was defined to include women with clinically adjudicated dementia or MCI and women who had a Short Blessed test score greater than 6 (consistent with impairment), but whose cases were not clinically adjudicated. Logistic regression analysis was used to examine the association between presence of the metabolic syndrome and development of clinically significant cognitive impairment. A total of 497 women (10.2%) had the metabolic syndrome, and of these, 36 (7.2%) developed cognitive impairment compared with 181 women (of 4398, 4.1%) without the syndrome (age-adjusted odds ratio, 1.66; 95% confidence interval, 1.14–2.41). The mean (SD) number of metabolic syndrome components for all women was 1.0 (1.1); 518 women (10.6%) were obese, 895 (18.3%) had hypertriglyceridemia, 1200 (24.5%) had low high-density lipoprotein cholesterol levels, 1944 (39.7%) had high blood pressure, and 381 (7.8%) had high fasting blood glucose levels. There was a 23.0% age-adjusted increase in the risk of developing cognitive impairment (odds ratio, 1.23, 95% confidence interval, 1.09–1.39), per unit increase in the number of components. Further multivariable adjustment somewhat reduced the effect. We found an association between the metabolic syndrome and the number of components and risk of developing cognitive impairment in older women. Additional studies are needed to determine if screening and close management of these at-risk elderly women would diminish the incidence of cognitive impairment.
登录
查看更多内容
影响因子：
3.5
作者：
Asomaning, Kofi;Bertone-Johnson, Elizabeth R.;Pekow, Penelope S.
通讯作者：
Pekow, Penelope S.
影响因子：
--
作者：
Kivipelto, M;Ngandu, T;Nissinen, A
通讯作者：
Nissinen, A
影响因子：
--
作者：
Razay, George;Vreugdenhil, Anthea;Wilcock, Gordon
通讯作者：
Wilcock, Gordon
影响因子：
9.9
作者：
Vanhanen, M.;Koivisto, K.;Kuusisto, J.
通讯作者：
Kuusisto, J.
影响因子：
16.2
作者：
Dik, Miranda G.;Jonker, Cees;Penninx, Brenda W.
通讯作者：
Penninx, Brenda W.