关键词: 轻度认知功能障碍, 高血压, 痴呆, 影响因素分析, 社区

Abstract: Background　Hypertension is one of the risk factors for Alzheimer's disease，whose neuropathological changes associated with memory and cognitive function predate clinical symptoms for many years.Therefore，it is of great significance to effectively identify high-risk groups of dementia in patients with hypertension for its prevention clinically.Objective　To investigate the changes of cognitive function of elderly people in community and analyze the effects of hypertension-related treatment，other combined physical diseases and blood pressure control on the transformation from mind cognitive impairment（MCI） to dementia，so as to provide a basis for preventing and delaying the occurrence of dementia.Methods　From July to December 2017，439 elderly patients with MCI who had been sampled by probability proportional to size（PPS） in 2011 were examined for their simple mental state with the remeasurement by the Montreal Cognitive Assessment Scale，Hamilton Depression Scale，Clinical Dementia Assessment Scale and the criteria for the diagnosis of cognitive impairment.The outcomes of follow-up were divided into the stable type（MCIs），the progressive type（MCIp） for dementia and the reversed type（MCIr） for normal cognitive status.The follow-up outcomes of MCI was compared between different history of hypertension and its related treatment.And Logistic regression was used to analyze the related influencing factors of MCI without deterioration.Results　There were significant differences in the number of children，BMI and hyperlipidemia among the elderly with hypertension history in 2011（P<0.05）.There were no differences in age，gender，single status，monthly income，education level，occupation type，personality tendency，family structure，alcoholism history，smoking history，memory decline and type 2 diabetes history between the two groups（P>0.05）.The age of new-onset and untreated hypertension group was higher than that of non-hypertension group，and the systolic and diastolic blood pressure levels of non-hypertension group were lower than those of new-onset and untreated hypertension group，and the diastolic blood pressure level of persistent hypertension group was lower than that of untreated hypertension group（P<0.05）.The average age of MCIp group was higher than that of MCIs group，and the difference was significant（P<0.05）.Logistic regression analysis showed that old age was a risk factor for MCIp（OR=0.856，P=0.011），while high month income was a protective factor（OR=2.288，P=0.045）.Conclusion　Community untreated and new-onset hypertension may promote the progression of MCI to dementia and old age is a risk factor.Decreasing or increasing blood pressure is the result of compensatory or disease progression accompanied by neurodegenerative changes.

Key words: Mild cognitive impairment, Hypertension, Dementia, Root cause analysis, Community