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背景动脉硬化性疾病增加痴呆的风险。由于二者有共同的病因和风险因素,冠心病(CHD)可以影响痴呆的病程。目的确定CHD是否加速了阿尔茨海默病的认知功能衰退,并讨论继发性心血管预防的潜在可能性,从而控制这种衰退。设计与场所基于德国6个城市的全科医生诊所开展前瞻性多中心队列研究。方法选取可能患有轻、中度阿尔茨海默病或混合型痴呆的患者〔n=118;年龄80~96岁,平均年龄(85.6±3.4)岁〕。根据家庭医师的诊断,评估CHD的存在。在以6个月为间隔的长达3年的家庭随访期间,采用简易精神状态检查量表(MMSE)和临床痴呆评定量表(CDR-So B)评估患者认知功能。并记录观察期内患者的死亡情况。结果 65例(55%)患者患CHD和/或心肌梗死后的心脏病。CHD的存在使得认知功能衰退加快约66%(由MMSE评分得出,P<0.05),认知功能能力下降约83%(由CDR-So B评分得出,P<0.05),但对存活率没有任何影响。结论研究表明,CHD对老年晚发性痴呆患者的认知功能衰退有显著影响。痴呆过程可能因此会受到心血管预防的积极影响,应该进一步证实该研究结论。
Background Arteriosclerotic diseases increase the risk of dementia. Because of their common etiology and risk factors, coronary heart disease (CHD) can affect the course of dementia. Purpose To determine whether CHD accelerates cognitive decline in Alzheimer’s disease and discusses the potential for secondary cardiovascular prophylaxis to control this decline. Design and site A prospective, multicenter cohort study was conducted based on the GP practice in six cities in Germany. Methods Patients (n = 118; aged 80-96 years, mean age (85.6 ± 3.4) years) with possible mild to moderate Alzheimer’s disease or mixed dementia were selected. Based on the diagnosis of a family physician, assess the presence of CHD. Patients were assessed for cognitive function using the Mini-Mental State Examination Scale (MMSE) and Clinical Dementia Rating Scale (CDR-So B) during up to three years of home follow-up at 6-month intervals. The patient’s death was recorded during the observation period. Results 65 (55%) patients had heart disease after CHD and / or myocardial infarction. The presence of CHD accelerated the decline of cognitive function by about 66% (derived from the MMSE score, P <0.05) and decreased cognitive function by 83% (derived from the CDR-So B score, P <0.05) Rate has no effect. Conclusions Studies have shown that CHD has a significant effect on cognitive decline in elderly patients with late-onset dementia. The dementia process may therefore be positively influenced by cardiovascular prophylaxis and the findings of the study should be further substantiated.