The Association between Aggregate Cardiovascular Risk and Cognitions in Community-dwelling Older Adults

集合心血管危險因子與老人認知功能之相關性研究

莊宜芳(Yi-Fang Chuang)；Michelle C. Carlson；曾美智(Meg Mei-Chih Tseng)

心血管因子 ； 老年人 ； 認知功能 ； 集合心血管危險因子 ； cardiovascular risk ； aggregate cardiovascular risk ； the elderly ； cognition

台灣精神醫學

30卷3期（2016 / 09 / 01）

185 - 195+iii

英文

背景：過去研究顯示個別心血管危險因子，如高血壓、糖尿病、高血脂症等，與老人認知功能障礙及失智症風險相關。然而，這些心血管因子在老人族群多為共病存在，彼此之間可能有加成或協同作用而影響健康狀況。此研究的目的即在探討集合性的心血管因子與老人認知功能之間的關係。方法：Baltimore Experience Corps^® Trial 是一個研究老人志工服務與認知、身體及社交功能改善的社區試驗。所有參與試驗的老人都接受一系列的認知功能測試，包含訊息處理速度，記憶，及執行功能的評估。此研究包含503 位參與試驗的老人，使用Framingham general cardiovascular profile 來計算其集合性之血管危險因子，並與認知功能探討橫斷性之相關研究。結果：校正可能的干擾因子包括年齡，性別，教育程度，社經地位，憂鬱症狀及活動量後，較高的集合性心血管風險與顯著的較差的訊息處理速度相關 (β= -0.35,95% confidence interval = -0.68, -0.02, p ＜ 0.05) 及顯著較差的執行性功能的神經情況有關 (β =-0.16, 95% CI = -0.32 - -0.00, p ＜ 0.05)。結論：在一群認知功能正常，沒有重大心血管疾病的社區老人，較高的心血管風險與較差的訊息處理速度／執行性功能的神經情況相關。

Objective: Cardiovascular (CV) risk factors such as hypertension, diabetes, and hyperlipidemia, are associated with cognitive impairment and risk of dementia in the elderly. But CV risk factors rarely exist alone in older adults and probably exert additive or synergistic effect on health outcomes. In this study, we intended to investigate the associations between aggregate CV risk and cognitions in a group of community-dwelling older adults. Methods: Five hundred and three participants (mean age: 65.7 years) from the Baltimore Experience Corps^® Trial, received cognitive tests for information processing speed, memory, and executive function. We examined whether aggregate CV risk at baseline as measured by the Framingham general cardiovascular risk profile was associated with cognitions. Results: Higher aggregate CV risk was significantly associated with baseline poorer information-processing speed (β = -0.35, 95% confidence interval = -0.68 - -0.02, p ＜ 0.05) and baseline neutral condition of the executive function (β = -0.16, 95% confidence interval = -0.32 - -0.00, p ＜ 0.05) after adjusting factors for age, sex, education, socioeconomic status, depression and physical activity. Conclusion: Higher CV risk was associated with slower processing speed and lower neutral condition of the executive function in a group of cognitively normal adults without prevalent major CV events.

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