Association between cardiovascular and cerebrovascular diseases and cognition among Chinese aged 50 years and older
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摘要:
目的 探讨我国≥50岁人群心脑血管疾病与认知功能的关联。 方法 利用WHO全球老龄化与成人健康研究中国项目基线数据。认知功能测试包括即时、延时词语回忆、数字广度、语言流畅度。心脑血管疾病包括高血压、心绞痛和脑卒中。采用一般线性回归模型分析心脑血管疾病与认知功能的关联。 结果 共纳入12 645名调查对象。一般线性回归分析显示，与不患心脑血管疾病者相比，只患心绞痛者即时、延时词语回忆和整体认知得分均更低(均有P < 0.05)，共患高血压和心绞痛者每项认知得分均更低(均有P < 0.05)，共患高血压和脑卒中者即时、延时词语回忆、数字广度测试和整体认知得分更低(均有P < 0.05)，共患心绞痛和脑卒中者数字广度测试和整体认知得分均更低(均有P < 0.05)，共患高血压、心绞痛和脑卒中者数字广度测试得分更低(P=0.019)。心脑血管疾病患病数量与每项认知得分均呈负相关(均有P < 0.05)。 结论 与不患心脑血管疾病者相比，共患心脑血管疾病与更差的认知功能相关。 Abstract:Objective To investigate the association between cardiovascular and cerebrovascular diseases and cognition among Chinese aged 50 and over. Methods Data was collected from the World Health Organization study on global ageing and adult health wave in China. A comprehensive battery of cognitive tests was conducted to assess subjects' cognitive functions, including immediate and delayed verbal recall, digit span and verbal fluency. Cardiovascular and cerebrovascular diseases included hypertension, angina and stroke. General linear model was used to examine the association of cardiovascular and cerebrovascular diseases with cognition. Results A total of 12 645 adults aged 50 and over who did cognitive tests and without obvious cognitive impairment were selected as participants. Compared with people without cardiovascular and cerebrovascular diseases, people who only had angina had lower scores in immediate and delayed verbal recall and composite cognition (all P < 0.05). Participants who had both hypertension and angina had lower scores in immediate and delayed verbal recall, digit span, verbal fluency and composite cognition (all P < 0.05). Participants who had both hypertension and stroke had lower scores in immediate and delayed verbal recall, digit span and composite cognition (all P < 0.05). Participants who had both angina and stroke had lower scores in digit span and composite cognition (all P < 0.05). Participants who had all of hypertension, angina and stroke had lower score in digit span (P=0.019). The number of cardiovascular and cerebrovascular diseases was negatively associated with immediate and delayed verbal recall, digit span, verbal fluency and composite cognition (all P < 0.05). Conclusions Comorbid cardiovascular and cerebrovascular diseases were associated with worse cognitive function. -
Key words:
- Elderly /
- Cognition /
- Cardiovascular and cerebrovascular diseases
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表 1 研究对象的基本特征[n(%)]
Table 1. Characteristics of the study participants [n(%)]
变量 例数[n(%)] 年龄(岁) 50~ 5 525(43.69) 60~ 3 796(30.02) 70~ 2 641(20.89) ≥80 683(5.40) 性别 男 5 899(46.65) 女 6 746(53.35) 文化程度 小学及以下 8 011(63.35) 初中 2 543(20.11) 高中 1 559(12.33) 大学及以上 532(4.21) 家庭经济水平 第1分位(最低) 2 557(20.32) 第2分位 2 538(20.17) 第3分位 2 557(20.32) 第4分位 2 575(20.46) 第5分位(最高) 2 357(18.73) BMI 低体重 566(4.60) 正常 6 214(50.53) 超重 4 101(33.35) 肥胖 1 417(11.52) 吸烟 从未吸烟 8 387(66.65) 目前不吸烟 781(6.21) 目前偶尔吸烟 317(2.52) 目前每日吸烟 3 098(24.62) 饮酒 从未饮酒 8 705(77.07) 非重度饮酒 1 899(16.81) 重度饮酒 691(6.12) 体力活动 低活动量 4 045(32.00) 中活动量 3 501(27.69) 高活动量 5 096(40.31) 蔬果摄入 不足 5 577(44.10) 充足 7 068(55.90) 心脑血管疾病 未患 3 475(35.43) 高血压 4 818(49.12) 心绞痛 307(3.13) 脑卒中 46(0.47) 高血压+心绞痛 888(9.05) 高血压+脑卒中 175(1.78) 心绞痛+脑卒中 13(0.13) 高血压+心绞痛+脑卒中 87(0.89) 心脑血管疾病共患(种) 0 3 475(35.43) 1 5 171(52.72) 2 1 076(10.97) 3 87(0.89) 
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表 2 心脑血管疾病与认知功能的关联分析
Table 2. The association between cardiovascular and cerebrovascular diseases and cognition
心脑血管疾病患病情况 即时词语回忆 延时词语回忆 数字广度 语言流畅度 整体认知功能 回归系数 P值 回归系数 P值 回归系数 P值 回归系数 P值 回归系数 P值 高血压 -0.05 0.176 -0.04 0.450 -0.09 0.074 -0.17 0.119 -0.14 0.052 心绞痛 -0.19 0.048 -0.42 0.002 -0.26 0.052 -0.56 0.055 -0.59 0.002 脑卒中 0.19 0.397 -0.00 0.999 -0.12 0.713 -0.16 0.820 0.09 0.851 高血压+心绞痛 -0.39 < 0.001 -0.59 < 0.001 -0.44 < 0.001 -0.58 0.004 -0.89 < 0.001 高血压+脑卒中 -0.64 < 0.001 -0.63 0.001 -0.61 0.001 -0.71 0.087 -1.21 < 0.001 心绞痛+脑卒中 -0.61 0.162 -0.06 0.923 -1.43 0.021 -2.40 0.080 -1.85 0.037 高血压+心绞痛+脑卒中 -0.36 0.057 -0.32 0.233 -0.63 0.019 -0.04 0.948 -0.74 0.057 心脑血管疾病共患(种) 患1种 -0.06 0.072 -0.08 0.125 -0.12 0.021 -0.22 0.043 -0.19 0.008 患2种 -0.38 < 0.001 -0.57 < 0.001 -0.44 < 0.001 -0.55 0.002 -0.88 < 0.001 患3种 -0.31 0.102 -0.33 0.208 -0.60 0.026 0.02 0.971 -0.69 0.074 趋势检验 Z值 13.49 14.19 -12.65 -8.92 -15.57 P值 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 注：控制了年龄、性别、文化程度、家庭经济水平、BMI、吸烟、饮酒、体力活动、蔬果摄入。
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