Anemia and 9-Year Domain-Specific Cognitive Decline in Community-Dwelling Older Women: The Women's Health and Aging Study II
Anemia and 9-Year Domain-Specific Cognitive Decline in Community-Dwelling Older Women: The Women's Health and Aging Study II
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DOI：
10.1111/j.1532-5415.2009.02400.x
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发表时间：
2009-09-01
影响因子：
6.3
通讯作者：
Chaves, Paulo H. M.
中科院分区：
文献类型：
--
作者：
Deal, Jennifer A.;Carlson, Michelle C.;Chaves, Paulo H. M.
目的：测试基线时 70 至 80 岁社区居住女性样本中贫血（血红蛋白 < 12 g/dL）与 9 年内认知衰退速度加快相关的假设。设计：一项基于人群的前瞻性队列研究。地点：马里兰州东巴尔的摩。参与者：抽样的 436 名女性代表了三分之二的残疾程度最低的老年女性基线时（1994-1996 年）为 70 至 80。 测量：使用线性随机效应模型在立即言语回忆、延迟言语回忆、精神运动速度和执行功能领域分析认知能力下降的九年轨迹。 结果：在基线和调整人口和疾病协变量后，贫血女性完成执行功能测试的速度较慢；贫血女性完成执行功能测试的速度较慢。在跟踪测试 B 部分中，患有贫血的女性和没有贫血的女性之间的基线功能差异为 -0.43 个标准差 (SD)（95% 置信区间 (CI) = -0.74 至 -0.13）。在随访期间，贫血与记忆力下降速度加快有关。在基线和第 3 年之间，患有贫血的女性和没有贫血的女性之间的下降率差异，在霍普金斯言语学习测试 (HVLT) 中每年 -0.18 个标准差 (95% CI = -0.29 至 -0.06)，在 HVLT 延迟测试中每年 -0.15 个标准差 (95% CI = -0.26 至 -0.04)。 结论：贫血与较差的基线表现相关。执行功能测试，并且在即时和延迟言语回忆测试中下降速度更快。如果这种关系是因果关系，那么贫血治疗可能可以预防或推迟认知能力下降。 J Am Geriatr Soc 57：1604-1611，2009。
OBJECTIVES: To test the hypothesis that anemia (hemoglobin < 12 g/dL) is associated with a faster rate of cognitive decline over 9 years in a community-dwelling sample of women aged 70 to 80 at baseline.DESIGN: A population-based, prospective cohort study.SETTING: East Baltimore, Maryland.PARTICIPANTS: Four hundred thirty-six women sampled to be representative of the two-thirds least-disabled women aged 70 to 80 at baseline (1994-1996).MEASUREMENTS: Nine-year trajectories of cognitive decline, analyzed using linear random effects models, in the domains of immediate verbal recall, delayed verbal recall, psychomotor speed, and executive function.RESULTS: At baseline and after adjustment for demographic and disease covariates, women with anemia were slower to complete a test of executive function; the difference in baseline function between women with anemia and those without was -0.43 standard deviations (SDs) (95% confidence interval (CI) = -0.74 to -0.13) on the Trail Making Test Part B. During follow-up, anemia was associated with a faster rate of decline in memory. Between baseline and Year 3, the difference in the rates of decline between women with anemia and those without was -0.18 SDs per year (95% CI = -0.29 to -0.06) on the Hopkins Verbal Learning Test (HVLT) and -0.15 SDs per year (95% Cl = -0.26 to -0.04) on the HVLT-Delayed.CONCLUSION: Anemia was associated with poorer baseline performance on a test of executive function and with faster rates of decline on tests of immediate and delayed verbal recall. If this relationship is causal, it is possible that treatment of anemia could prevent or postpone cognitive decline. J Am Geriatr Soc 57:1604-1611, 2009.