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中国全科医学 ›› 2025, Vol. 28 ›› Issue (11): 1329-1335.DOI: 10.12114/j.issn.1007-9572.2024.0225

所属专题： 生活方式干预相关研究最新文章合集

• 论著 • 上一篇    下一篇

生活方式在心血管代谢性疾病患病时长与轻度认知功能障碍关联中的作用研究

李弈晴1,2,3, 程桂荣1,2,3, 许浪1,2,3, 胡晨璐1,2,3, 李春利1,2,3, 李露寒4,*()   

  1. 1．430065　湖北省武汉市，武汉科技大学
    2．430065　湖北省武汉市，湖北省阿尔茨海默病临床医学研究中心
    3．430065　湖北省武汉市，武汉科技大学脑科学先进技术研究院
    4．430000　湖北省武汉市，中国人民解放军中部战区总医院护理部
  • 收稿日期:2024-05-17 修回日期:2024-08-31 出版日期:2025-04-15 发布日期:2025-02-06
  • 通讯作者: 李露寒


  • 作者贡献：

    李弈晴和程桂荣提出主要研究目标，负责研究的构思与设计，研究的实施，撰写论文；李弈晴、许浪、胡晨璐和李春利进行数据的收集与整理，统计学处理，图、表的绘制与展示；程桂荣和许浪进行论文的修订；李露寒负责文章的质量控制与审查，对文章整体负责，监督管理。

  • 基金资助:
    国家自然科学基金资助项目(72174159)

The Impact of Lifestyle on the Relationship between the Duration of Cardiovascular Metabolic Diseases and Mild Cognitive Impairment

LI Yiqing1,2,3, CHENG Guirong1,2,3, XU Lang1,2,3, HU Chenlu1,2,3, LI Chunli1,2,3, LI Luhan4,*()   

  1. 1. Wuhan Univeristy of Science and Technology, Wuhan 430065, China
    2. Hubei Provincial Clinical Research Center for Alzheimer's Disease, Wuhan 430065, China
    3. Brain Science Research Institute, Wuhan University of Science and Technology, Wuhan 430065, China
    4. Nursing department, General Hospital of Central Theater Command of PLA, Wuhan 430000, China
  • Received:2024-05-17 Revised:2024-08-31 Published:2025-04-15 Online:2025-02-06
  • Contact: LI Luhan

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摘要： 背景 随着人口老龄化的加剧，认知功能障碍患病率逐年上升，心血管代谢性疾病作为重要影响因素，与认知功能障碍密切相关。目前对心血管代谢性疾病患病时长与轻度认知功能障碍（MCI）关联的研究甚少，并缺乏生活方式因素的综合考虑及中国社区老年人群的大规模调查，研究的全面性和可靠性尚需进一步验证。 目的 探究老年人心血管代谢性疾病患病时长与MCI之间的关联，并评估生活方式因素在其中的潜在作用，为MCI预防和干预提供科学依据。 方法 基于湖北老年记忆队列（HMACS），采用整群抽样方法抽取2018—2023年湖北省武汉市3个社区和大悟县48个村≥65岁老年人群，利用标准化量表进行认知功能评估，采用吸烟、饮酒、饮食习惯、体育锻炼、智力活动和BMI共6个因素进行生活方式评估，分析MCI患病率及影响因素，采用多因素Logistic回归分析探究心血管代谢性疾病患病时长与MCI的相关性以及生活方式对患病时长与MCI相关性的影响。 结果 共纳入8 635名研究对象，MCI患病率为26.9%（2 322/8 635）。多因素Logistic回归分析结果显示，高血压（OR=1.263，95%CI=1.093~1.458，P=0.002）、糖尿病（OR=1.907，95%CI=1.476~2.463，P<0.001）、冠心病（OR=1.550，95%CI=1.173~2.047，P=0.002）、脑血管疾病（OR=2.129，95%CI=1.627~2.786，P<0.001）患病时长是老年人患MCI的影响因素。在高血压时长>10年（一般：OR=1.367，95%CI=1.086~1.720，P=0.008；不健康：OR=2.377，95%CI=1.560~3.623，P<0.001）、糖尿病时长>10年（一般：OR=1.688，95%CI=1.134~2.514，P=0.010；不健康：OR=2.083，95%CI=1.035~4.194，P=0.040）、冠心病时长≤10年（一般：OR=1.495，95%CI=1.030~2.169，P=0.034；不健康：OR=2.062，95%CI=1.155~3.682，P=0.014）患者中，生活方式是患MCI的影响因素；在糖尿病时长≤10年患者中，一般生活方式（OR=1.611，95%CI=1.065~2.437，P=0.024）是患MCI的影响因素；在冠心病时长>10年（OR=2.859，95%CI=1.118~7.307，P=0.028）、脑血管疾病时长≤10年（OR=1.778，95%CI=1.079~2.930，P=0.024）、脑血管疾病时长>10年（OR=2.589，95%CI=1.056~6.345，P=0.038）患者中，不健康生活方式是患MCI的影响因素。 结论 老年人心血管疾病患病时间越长，患MCI风险越高，不健康的生活方式加剧了这种风险。建议及早通过改善生活方式和有效管理心血管代谢性疾病来降低MCI的发生。

关键词: 认知功能障碍, 心血管疾病, 生活方式, 患病时长, 影响因素分析

Abstract:

Background

With the aggravation of population aging, the prevalence of cognitive disfunction is increasing year by year. Cardiovascular metabolic diseases, as an important influencing factor, are closely related to cognitive function. At present, there are few studies on the association between duration of cardiovascular metabolic diseases and mild cognitive impairment (MCI), which lack comprehensive consideration of lifestyle factors and large-scale surveys of elderly people in Chinese communities. The comprehensiveness and reliability of the research need to be further verified.

Objective

To explore the association between the duration of cardiovascular metabolic diseases and MCI in the elderly, and to evaluate the potential role of lifestyle factors in MCI, so as to provide scientific basis for the prevention and intervention of MCI.

Methods

The data from Hubei Memory and Aging Cohort Study (HMACS), a cluster sampling method was used to select the elderly aged 65 and over in 3 communities and 48 villages in Dawu County, Wuhan City, Hubei Province from 2018 to 2023. The standardized scale was used to evaluate the cognitive function. Six factors including smoking, drinking, eating habits, physical exercise, intellectual activity and body mass index (BMI) were used for lifestyle assessment to analyze the prevalence of MCI and its influencing factors. Multivariate Logistic regression analysis was used to analyze the correlation between the duration of cardiovascular metabolic diseases and MCI, the effect of lifestyle on the correlation between the duration of disease and MCI .

Results

A total of 8 635 subjects were included, and the prevalence of MCI was 26.9%. Multivariate Logistic regression analysis showed that among hypertension (OR=1.263, 95%CI=1.093-1.458, P=0.002), diabetes (OR=1.907, 95%CI=1.476-2.463, P<0.001), coronary heart disease (OR=1.550, 95%CI=1.173-2.047, P=0.002), cerebrovascular disease (OR=2.129, 95%CI=1.627-2.786, P<0.001) the duration of illness was influencing factors for MCI in the elderly. Duration of hypertension >10 years (General: OR=1.367, 95%CI=1.086-1.720, P=0.008; Unhealthy: OR=2.377, 95%CI=1.560-3.623, P<0.001), diabetes duration >10 years (General: OR=1.688, 95%CI=1.134-2.514, P=0.010; Unhealthy: OR=2.083, 95%CI=1.035-4.194, P=0.040) duration of coronary heart disease≤10 years (General: OR=1.495, 95%CI=1.030-2.169, P=0.034; Unhealthy: OR=2.062, 95%CI=1.155-3.682, P=0.014), life style was the influencing factor of MCI. In patients with diabetes duration ≤10 years, general lifestyle (OR=1.611, 95%CI=1.065-2.437, P=0.024) was the influencing factor for MCI. Duration of coronary heart disease >10 years (OR=2.859, 95%CI=1.118-7.307, P=0.028), duration of cerebrovascular disease ≤10 years (OR=1.778, 95%CI=1.079-2.930, P=0.024), duration of cerebrovascular disease >10 years (OR=2.589, 95%CI=1.056-6.345, P=0.038), unhealthy lifestyle was the influencing factor for MCI.

Conclusion

The longer the duration of cardiovascular disease in the elderly, the higher the risk of MCI and the unhealthy lifestyle exacerbates this risk. It is recommended to reduce the incidence of MCI early by improving lifestyle and effectively managing chronic cardiovascular disease.

Key words: Cognitive impairment, Cardiovascular disease, The way of life, Duration of illness, Root cause analysis

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