Characteristics and risk factors analysis of cognitive decline in elderly patients with cerebral infarction / 中国脑血管病杂志

ABSTRACT

Objective To investigate the characteristics and risk factors for cognitive decline in elderly patients with cerebral infarction.Methods A cross-sectional study was performed to investigate the population of Jiang'an Town,Rugao,Jiangsu Province from November 13,2014 to December 21,2014.The samples from the Rugao longitudinal study of aging included 1 788 individuals from 31 villages aged from 70 to 84 years.They were all Han nationality,including 830 males and 958 females.History of cerebral infarction was identified according to the neurological diagnosis confirmed by the secondary hospital and above or brain CT.The modified Kyohko Hasegawa dementia scale was used to evaluate the cognitive function.Five dimensions (orientation,memory,near memory,computing power,and common sense) of this population were assessed.The total score >21.5 was non-cognitive impairment and ≤21.5 was cognitive impairment.Multivariate logistic regression was used to analyze the risk factors for cognitive decline in elderly patients with cerebral infarction.Results (1) In the 1 788 subjects,133 had cerebral infarction (7.4%),and 1 655 did not have cerebral infarction.The proportion of hypertension in patients with cerebral infarction was higher than that without cerebral infarction (63.9% [n=85] vs.41.7% [n=690]).The high-density lipoprotein cholesterol level was lower than that of the non-cerebral infarction group (1.40±0.29 mmol/L vs.1.47±0.33 mmol/L).There was statistically significant difference (all P<0.05).(2) The patients with cerebral infarction were partially impaired in orientation and computational power,and the overall cognitive function score was 20±7,which was significantly lower than patients with non-cerebral infarction (21±6).The difference between the two groups was statistically significant (P<0.05).(3) In 133 patients with cerebral infarction,76 had cognitive impairment,the incidence was 57.1%,and 59 of them were women.The average value of serum creatinine in patients with cognitive impairment was 59±15 μmol/L,which was significantly lower than those with non-cognitive impairment (66±14 μmol/L).There was significant difference (P<0.05).(4) Multivariate logistic regression analysis showed that the education level below primary school (OR,2.86,95%CI 2.19-3.72) and female (OR,1.85,95%CI 1.50-2.28) were the independent risk factors for cognitive decline in elderly patients with cerebral infarction.High serum creatinine concentration (OR,0.96,95%CI 0.95-0.97) was a protective factor for it.Conclusion The cognitive function of the elderly was decreased after cerebral infarction,especially in the aspect of orientation and calculation.The education level below primary school and women were the independent risk factors for cognitive impairment,and high serum creatinine concentration had a certain protective effect.