云南省农村老年人五种常见慢性病及共病的流行现状及与社会经济地位的关系

  目的  分析云南省农村老年人高血压、糖尿病、脑卒中、冠心病、慢性阻塞性肺疾病(chronic obstructive pneumonia diseases，COPD)及共病的流行现状及与社会经济地位的关系。  方法  采用多阶段分层随机抽样的方法抽取云南省4 833名60岁及以上农村老年人进行问卷调查和体格检查，采用主成分分析法构建社会经济地位。  结果  云南农村老年人高血压、糖尿病、脑卒中、冠心病、COPD和共病的患病率分别为50.6%、10.2%、6.4%、5.5%、5.4%和16.1%。女性高血压和糖尿病的患病率均高于男性(均有P < 0.05)，而男性COPD的患病率高于女性(χ2=5.499，P=0.019)；高血压、冠心病、脑卒中、COPD和共病的患病率均随年龄的增长而增加(均有P < 0.05)；少数民族高血压、冠心病、COPD和共病的患病率均高于汉族(均有P < 0.05)。多因素Logistic回归分析结果显示，社会经济地位越低的老年人，其患高血压、冠心病、脑卒中、COPD和共病的风险越高(均有P < 0.05)。  结论  云南省农村老年人五种慢性病及共病的患病存在明显的社会经济差异，低社会经济地位的老年人是慢性病防控的重点人群。     

江苏省18～69岁男性自报慢性病与戒烟行为关系

  目的  探讨江苏省成年男性自报慢性病患病与戒烟行为的关系。  方法  分别于2007、2010、2013年采用多阶段分层整群抽样的方法,在江苏省14个成人慢性病及其危险因素监测点中抽取居民进行调查,以18~69岁男性为研究对象,分析慢性病患病与吸烟、戒烟行为的关系。  结果  18~69岁男性共8 313名,自报心脑血管疾病、恶性肿瘤、哮喘和慢性阻塞性肺部疾病（chronic obstructive pulmonary disease,COPD）患病率分别为1.5%、1.1%、1.5%和2.8%。戒烟者4种慢性病自报患病率均高于现在吸烟和不吸烟者（均有P < 0.05）。多因素分析显示,患心脑血管疾病、恶性肿瘤、哮喘和COPD者戒烟率分别是未患者的3.356倍（95% CI:1.966~5.728）、3.864倍（95% CI:2.277~6.555）、2.103倍（95% CI:1.321~3.345）和2.586倍（95% CI:1.872~3.573）。  结论  患有慢性病者戒烟率高于未患病者,提示患病后会促进吸烟者的戒烟行为。     

高血压与中心性肥胖对心脑血管疾病的联合作用

目的 探讨高血压合并中心性肥胖患者心脑血管疾病的发病危险性。方法 采用横断面调查的方法,于2016年3~4月期间,共调查苏州市高新区常住居民9 984人,收集其人口统计学、疾病史以及生活方式资料,并进行体格检查以及生化指标检查。采用Logistic回归模型分析高血压合并中心性肥胖与心脑血管疾病的关系。结果 在9 984名研究对象中,患心脑血管疾病者共396人（患病率3.97%）,其中冠心病243人（患病率为2.43%）,脑卒中178人（患病率为1.78%）。经多因素调整后,与腰围及血压均正常者相比,高血压合并中心性肥胖者患脑卒中、冠心病以及心脑血管疾病的OR及95%CI值分别为3.10（1.78~5.40）,2.56（1.61~4.07）和3.06（2.10~4.45）（均有P<0.05）。结论 高血压合并中心性肥胖可能会增加心脑血管疾病的患病风险。     

铝暴露对作业工人延迟回忆的影响

  目的  探讨铝暴露对作业工人延迟回忆的影响。  方法  采用蒙特利尔认知评估量表(Montreal Cognitive Assessment，MoCA)北京版和听觉词语学习测验(Auditory Verbal Learning Test, AVLT)对山西省某铝厂435名作业工人进行延迟回忆评估。根据血铝浓度的P_33.3，P_66.7将研究对象分为低、中、高暴露组(分别以T1、T2、T3组表示)。采用多元logistic回归分析模型分析铝暴露工人轻度认知功能障碍(mild cognitive impairment, MCI)影响因素。  结果  三组工人均为男性。在年龄、婚姻状况、家庭人均月收入、吸烟、饮酒等方面差异无统计学意义(均有P＞0.05)。在工龄、文化程度上比较，差异均有统计学意义(均有P＜0.05)。三组在MoCA和AVLT中，延迟回忆指标均有统计学意义(均有P＜0.05)。多元logistic回归分析模型显示听觉词语学习测验延迟回忆(Auditory Verbal Learning Test-long Recall, AVLT-LR)评分≥6(OR=0.860, 95% CI: 0.769~0.960)时，发生MCI的风险降低；当文化程度越低(OR= 3.556, 95% CI: 1.589~7.957)，插入词语个数(OR=1.415, 95% CI: 1.070~1.871)和重复词语个数(OR=1.419, 95% CI: 1.043~1.931)越多、没有采用记忆策略(OR=2.124, 95% CI: 1.119~4.032)发生MCI的风险增加。  结论  铝暴露可以影响作业工人延迟回忆功能。MoCA和AVLT量表的评估可以判断延迟记忆受影响情况，两个量表相结合更好找出可能有MCI倾向的工人。     

云南省宁洱县农村老年人睡眠质量现状及与心血管疾病的关系研究

  目的  分析云南省农村老年人睡眠质量现状及与心血管疾病的关系。  方法  采用多阶段分层随机抽样方法,抽取1 629例宁洱县≥ 60岁农村老年人进行问卷调查和体检,采用多因素Logistic回归法分析睡眠质量与心血管疾病患病的关系。  结果  云南省宁洱县老年人匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)总分平均为(7.48±3.89)分,男性(6.67±3.69)分,女性(8.07±3.92)分;睡眠障碍、高血压、冠心病和脑卒中的患病率分别为56.78%、52.85%、8.16%和8.66%;女性睡眠障碍率高于男性(62.81%和48.55%,P < 0.001);家庭人均年收入越低和医疗服务可及性越差的老年人其睡眠障碍率越高(P < 0.001);有睡眠障碍的老年人其患高血压、冠心病和脑卒中的可能性越高(均有P < 0.05)。  结论  云南省农村老年人的睡眠障碍率较高,改善老年人的睡眠质量可能会在一定程度上预防和控制心血管疾病的发生。     

高原地区家长喂养认知行为对儿童贫血的影响

  目的  探讨高原少数民族地区儿童喂养人的喂养认知及行为对0~6岁儿童贫血发生的影响,为制定降低儿童贫血患病率干预措施提供依据。  方法  采用分层随机整群抽样方法,抽取甘南藏族自治州4个县共1 726名0~6岁儿童进行血红蛋白测定和喂养认知行为等相关调查。  结果  0~6岁儿童贫血患病率为50.3%。低月龄、藏族、农村、父母学历及家庭收入低者贫血患病率较高(χ2值分别为156.95,899.51,148.17,8.18,16.36,11.03,P值均 < 0.05)。家长喂养知识知晓率为10.0%~53.7%。喂饭时分散孩子注意力、强迫进食的报告率分别为51.4%及36.1%。二分类Logistic回归结果显示,家长错误的喂养认知及强迫进食行为与儿童贫血发生正相关(P值均 < 0.05)。  结论  家长健康素养和喂养行为的改善是降低0~6岁儿童贫血发生的重要干预措施。     

2012-2018年重庆市缺血性脑卒中发病死亡趋势

  目的  了解重庆市缺血性脑卒中发病死亡趋势变化,为开展脑卒中防治提供建议。  方法  2012—2018年缺血性脑卒中个案资料来源于重庆市心脑血管疾病监测,采用SPSS 25.0软件分析计算发病率、标化发病率、死亡率、标化死亡率、构成比。不同地区、不同性别发病率与死亡率的比较采用χ2检验。率的趋势变化采用年度变化百分比(annual percent change, APC)表示。  结果  2012年重庆市缺血性脑卒中发病率、标化发病率分别为172.78/10万、140.80/10万,2018年发病率、标化发病率分别为186.63/10万、139.17/10万,APC分别为1.71%、0.80%,变化趋势差异无统计学意义(均有P>0.05)。缺血性脑卒中发病率男性高于女性,城市高于农村(均有P < 0.05)。农村地区缺血性脑卒中发病率以年均6.29%的速度上升(t=2.83, P=0.037)。缺血性脑卒中死亡率与标化死亡率分别由2012年17.89/10万、16.11/10万上升至2018年的39.03/10万、26.12/10万,分别以年均15.37%(t=6.68, P=0.001)与7.79%(t=5.43, P < 0.001)的速度上升。缺血性脑卒中死亡率男性高于女性(均有P < 0.05)。农村地区缺血性脑卒中死亡率与标化死亡率分别以年均14.91%(t=8.72, P < 0.001)与12.86%(t=7.63,P=0.001)上升。  结论  重庆市缺血性脑卒中发病率与死亡率较高,发病率相对稳定,死亡率上升,男性与农村是缺血性脑卒中防治重点。     

50岁及以上人群无牙症与认知功能的关联研究

目的 分析≥50岁人群无牙症和认知功能的关系。方法 数据来源于WHO全球老龄化与成人健康研究中国项目第一轮基线调查。认知能力测试包括词语回忆、语言流畅度、顺序数字跨度、倒序数字跨度。采用两水平（个体层面和社区层面）线性模型分析无牙症和认知功能的关系。结果 共纳入12 843名调查对象,年龄（63.0±9.3）岁。无牙症比例为11.0%。无牙症者词语回忆、语言流畅度、顺序数字跨度、倒序数字跨度、认知能力总分均值分别为4.55、10.88、6.25、2.96和49.15,均低于非无牙症者,差异有统计学意义（P<0.001）。调整年龄、性别、地区、文化程度、婚姻状况、家庭经济水平、慢性病共患情况、BMI和吸烟、饮酒等因素后,无牙症与词语回忆（β=-0.216,95% CI：-0.370～-0.062）、顺序数字跨度（β=-0.186,95% CI：-0.293～-0.078）和认知能力总分（β=-1.703,95% CI：-3.025～-0.381）均呈负相关。结论 无牙症与≥50岁人群认知功能较低有关。     

发展性阅读障碍共患注意缺陷多动障碍儿童视动整合能力特点及相关因素

  目的  了解发展性阅读障碍共患注意缺陷多动障碍儿童视动整合能力特点, 为该群体儿童诊治提供参考。  方法  2020年7-11月, 采用随机整群抽样法从新疆某地区7所小学三至五年级学生中筛选出符合条件的阅读障碍组(DD)、注意缺陷多动障碍组(ADHD)、共病组及正常对照组儿童各56名, 比较视动整合能力及其相关因素差异, 通过多重线性回归分析探究相关因素对视动整合能力的预测作用。  结果  共病组视动整合能力及视知觉得分(95.05±14.01, 12.71±7.40)低于DD组(104.77±17.19, 23.04±11.48)、ADHD组(104.01±14.11, 25.70±10.74)和对照组(129.80±12.91, 44.05±16.56)(F/Z值分别为58.24, 110.49, P值均 < 0.05);共病组视觉工作记忆得分(73.64±5.36)低于对照组(78.96±4.68)(P < 0.05), 与DD组(74.48±7.06)、ADHD组(75.98±7.36)差异无统计学意义(P值均>0.05)。多重线性回归分析结果表明, 视知觉、年龄、智商、视觉工作记忆均可预测DD共患ADHD儿童的视动整合能力(R2值分别为0.32, 0.17, 0.11, 0.04, P值均 < 0.05)。  结论  DD共患ADHD儿童较单纯DD和ADHD儿童视动整合能力和视知觉能力受损更加严重, 视知觉、年龄、智商、视觉工作记忆能对DD共患ADHD儿童的视动整合能力发展结果进行预测。     

认知行为团体辅导对高强迫特质大学生认知控制的影响

  目的  探讨认知行为团体辅导(GCBT)对高强迫特质大学生认知控制的影响,为开展高校学生心理辅导干预提供基础资料。  方法  2019年3—4月,方便选取合肥市2所高校的687名学生为研究对象,按照纳入与排除标准选取其中58例高强迫特质大学生,随机数字表法分为实验组(29名)和对照组(29名)。实验组接受8次的认知行为团体辅导(共4周,每周2次,每次90 min),对照组不做任何处理。在基线与4周后对2组进行强迫症状量表(OCI-R)及Stroop色词测验(SWCT)、数字广度测验(DST)和威斯康辛卡片测试(WSCT)测评。  结果  干预后,GCBT组OCI-R评分(10.28±7.22)低于对照组(15.90±10.20)分(t=2.42,P < 0.05)。在Stroop C和干扰效应(SIE)耗时上,对照组干预前后分别为(21.89±6.63,8.62±4.43;20.52±7.37,8.04±4.84)s,GCBT组分别为(22.14±4.92,8.36±3.87;16.81±3.43,4.82±1.86)s,时间×组别的交互作用均有统计学意义(F值分别为14.60,10.54,P值均 < 0.05);在DST-倒背得分上,对照组干预前后为(6.21±1.35,6.55±1.45)个,GCBT组为(6.31±1.44,7.24±1.38)个,时间×组别的交互作用有统计学意义(F=3.96,P < 0.05)。  结论  认知行为团体辅导可以改善高强迫特质大学生的抑制控制和工作记忆,但未改变认知灵活性。     

High-dose antioxidant supplements and cognitive function in community-dwelling elderly women

BACKGROUND: Experimental data suggest that oxygen free radicals are probably involved in the deterioration of cognitive processes. OBJECTIVE: Our objective was to investigate the relation of high-dose antioxidant supplements to cognition. DESIGN: Information on the use of specific supplements containing vitamins E and C was collected biennially via mailed questionnaires beginning in 1980 from 14 968 community-dwelling women who participated in the Nurses' Health Study. From 1995 to 2000, telephone tests of cognitive function [Telephone Interview of Cognitive Status (TICS), delayed recall of the TICS 10-word list, immediate and delayed recall of a short paragraph, a test of verbal fluency, and a digit span backwards test] were administered to the women, who were 70-79 y of age at that time. We used linear and logistic regression models to calculate multivariate-adjusted mean differences in test scores and relative risks of a low score for specific supplement users compared with nonusers. RESULTS: Long-term, current users of vitamin E with vitamin C had significantly better mean performance, as judged by a global score that combined individual test scores, than did women who had never used vitamin E or C (P = 0.03); there was a trend for increasingly higher mean scores with increasing durations of use (P = 0.04). These associations were strongest among women with low dietary intakes of alpha-tocopherol. Benefits were less consistent for women taking vitamin E alone, with no evidence of higher scores with longer durations of use. Use of specific vitamin C supplements alone had little relation to performance on our cognitive tests. CONCLUSION: The use of specific vitamin E supplements, but not specific vitamin C supplements, may be related to modest cognitive benefits in older women.     

Long-term intake of nuts in relation to cognitive function in older women

Objective

Nuts contain nutrients that may benefit brain health; thus, we examined long-term intake of nuts in relation to cognition in older women.

Design

Population-based prospective cohort study.

Setting

Academic research using data from the Nurses’ Health Study.

Participants

Nut intake was assessed in a food-frequency questionnaire beginning inl980, and approximately every four years thereafter. Between 1995–2001, 16,010 women age 70 or older (mean age = 74 years) without a history of stroke were administered 4 repeated telephone-based cognitive interviews over 6 years. Our final sample included 15,467 women who completed an initial cognitive interview and had complete information on nut intake.

Main Outcome Measures

The Telephone Interview for Cognitive Status (TICS), a global score averaging the results of all tests (TICS, immediate and delayed verbal recall, category fluency, and attention), and a verbal memory score averaging the results of tests of verbal recall.

Results

In multivariable-adjusted linear regression models, higher long-term total nut intake was associated with better average cognitive status for all cognitive outcomes. For the global composite score combining all tests, women consuming at least 5 servings of nuts/week had higher scores than non-consumers (mean difference=0.08 standard units, 95% confidence interval 0.00–0.15; p-trend=0.003). This mean difference of 0.08 is equivalent to the mean difference we find between women 2 years apart in age. Long-term intake of nuts was not associated with rates of cognitive decline.

Conclusions

Higher nut intake may be related to better overall cognition at older ages, and could be an easily-modifiable public health intervention.     

A healthy dietary pattern at midlife is associated with subsequent cognitive performance

Few studies have investigated the long-term impact of overall dietary patterns (DP) on cognition. We evaluated the association between empirically derived DP in midlife and cognitive performance 13 y later. Dietary data were based on 24-h dietary records obtained from a subsample of the Supplémentation en Vitamines et Minéraux Antioxydant Study. Cognitive performance was assessed via a battery of neuropsychological tests that included verbal fluency, the RI-48 cued recall test, the trail-making test, and forward and backward digit span. Three composite variables, for global cognitive function, verbal memory, and executive functioning, were built. The multivariate analyses were adjusted for baseline characteristics (age, gender, intervention group, education, alcohol and energy intake, number of dietary records, physical activity, BMI, tobacco use, self-reported memory troubles, diabetes, hypertension, and, for women, menopausal status and hormone therapy use), follow-up time, history of cardiovascular disease, and depressive symptoms. Adjusted means ± SEM of composite variables across quartiles (Q4 vs. Q1) of DP were estimated using ANCOVA. A healthy and a traditional DP were identified. In the multivariate model, the healthy pattern was associated with better global cognitive function (50.1 ± 0.7 vs. 48.9 ± 0.7; P-trend = 0.001) and verbal memory (49.7 ± 0.4 vs. 48.7 ± 0.4; P-trend = 0.01). These relationships were stronger in participants scoring below the gender-specific median values for energy intake (<2490 kcal for men and <1810 for women) than in those scoring at or above those values. Adherence to a healthy DP in middle life may help preserve global cognitive function, especially verbal memory, when total energy intake is regulated.     

Effects of a diet integration with an oily emulsion of DHA-phospholipids containing melatonin and tryptophan in elderly patients suffering from mild cognitive impairment

Abstract

Age-related changes in nutritional status can play an important role in brain functioning. Specific nutrient deficiencies in the elderly may exacerbate pathological processes in the brain. Consequently, the potential of nutritional intervention to prevent or delay cognitive impairment and the development of dementia is an important topic. A randomized, double-blind, placebo-controlled trial has been performed in 25 elderly subjects (86 ± 6 years, 20 females, 5 males) with mild cognitive impairment (MCI). These subjects were randomly assigned to supplement their diet with either an oily emulsion of docosahexaenoic acid (DHA)-phospholipids containing melatonin and tryptophan (11 subjects) or a placebo (14-matched subjects) for 12 weeks. The main aim of this study was to evaluate the efficacy of the dietary supplement on cognition, by the assessment at the start and after 12 weeks of: (1) Orientation and other cognitive functions: Mini-Mental State Examination (MMSE); (2) Short-term memory: digit, verbal, and spatial span (digit span; verbal span; Corsi's test); (3) Long-term memory: Rey's auditory-verbal learning test; ‘short story’ test; Rey-Osterrieth complex figure (recall); (4) Attentional abilities: attentive matrices; (5) Executive functions: Weigl's sorting test; phonological fluency ‘FAS’; (6) Visuo-constructional and visuo-spatial abilities: copy of simple drawings; Rey-Osterrieth complex figure (copy); (7) Language: semantic fluency; (8) Mood: Geriatric Depression Scale (GDS). Moreover, Sniffin' Sticks olfaction test and Mini Nutritional Assessment (MNA) have been performed. After 12 weeks, a significant treatment effect for the MMSE (P < 0.001) and a positive trend for the semantic verbal fluency was found in the supplement group (P < 0.06). A significant treatment effect was found out for the olfactory sensitivity assessment (P < 0.009). As regards the nutrition evaluation, after 12 weeks of treatment the supplemented group showed an improvement in the MNA score with a significant difference relative to placebo (P < 0.005). Older adults with MCI had significant improvements in several measures of cognitive function when supplemented with an oily emulsion of DHA-phospholipids containing melatonin and tryptophan for 12 weeks, compared with the placebo.     

Chronic neurobehavioural effects of elemental mercury in dentists.

Neurobehavioural tests were performed by 98 dentists (mean age 32, range 24-49) exposed to elemental mercury vapour and 54 controls (mean age 34, range 23-50) with no history of occupational exposure to mercury. The dentists were exposed to an average personal air concentration time weighted average (TWA) of 0.014 (range 0.0007-0.042) mg/m3 for a mean period of 5.5 (range 0.7-24) years and had a mean blood mercury concentration of 9.8 (range 0.6-57) micrograms/l. In neurobehavioural tests measuring motor speed (finger tapping), visual scanning (trail making), visuomotor coordination and concentration (digit symbol), verbal memory (digit span, logical memory delayed recall), visual memory (visual reproduction, immediate and delayed recall), and visuomotor coordination speed (bender-gestalt time), the performance of the dentists was significantly worse than that of the controls. The dentists scored 3.9 to 38.9% (mean 13.9%) worse in these tests. In trail making, digit span, logical memory delayed recall, visual reproduction delayed recall, and bender-gestalt time test scores were more than 10% poorer. In each of the tests in which significant differences were found and in the block design time, the performance decreased as the exposed dose (product of the TWA of air mercury concentrations and the years of exposure) increased. These results raise the question as to whether the current threshold limit value of 0.050 mg/m3 (TWA) provides adequate protection against adverse effects of mercury.     

Chronic neurobehavioural effects of elemental mercury in dentists.

Neurobehavioural tests were performed by 98 dentists (mean age 32, range 24-49) exposed to elemental mercury vapour and 54 controls (mean age 34, range 23-50) with no history of occupational exposure to mercury. The dentists were exposed to an average personal air concentration time weighted average (TWA) of 0.014 (range 0.0007-0.042) mg/m3 for a mean period of 5.5 (range 0.7-24) years and had a mean blood mercury concentration of 9.8 (range 0.6-57) micrograms/l. In neurobehavioural tests measuring motor speed (finger tapping), visual scanning (trail making), visuomotor coordination and concentration (digit symbol), verbal memory (digit span, logical memory delayed recall), visual memory (visual reproduction, immediate and delayed recall), and visuomotor coordination speed (bender-gestalt time), the performance of the dentists was significantly worse than that of the controls. The dentists scored 3.9 to 38.9% (mean 13.9%) worse in these tests. In trail making, digit span, logical memory delayed recall, visual reproduction delayed recall, and bender-gestalt time test scores were more than 10% poorer. In each of the tests in which significant differences were found and in the block design time, the performance decreased as the exposed dose (product of the TWA of air mercury concentrations and the years of exposure) increased. These results raise the question as to whether the current threshold limit value of 0.050 mg/m3 (TWA) provides adequate protection against adverse effects of mercury.     

Effects of a diet integration with an oily emulsion of DHA-phospholipids containing melatonin and tryptophan in elderly patients suffering from mild cognitive impairment

Age-related changes in nutritional status can play an important role in brain functioning. Specific nutrient deficiencies in the elderly may exacerbate pathological processes in the brain. Consequently, the potential of nutritional intervention to prevent or delay cognitive impairment and the development of dementia is an important topic. A randomized, double-blind, placebo-controlled trial has been performed in 25 elderly subjects (86 ± 6 years, 20 females, 5 males) with mild cognitive impairment (MCI). These subjects were randomly assigned to supplement their diet with either an oily emulsion of docosahexaenoic acid (DHA)-phospholipids containing melatonin and tryptophan (11 subjects) or a placebo (14-matched subjects) for 12 weeks. The main aim of this study was to evaluate the efficacy of the dietary supplement on cognition, by the assessment at the start and after 12 weeks of: (1) Orientation and other cognitive functions: Mini-Mental State Examination (MMSE); (2) Short-term memory: digit, verbal, and spatial span (digit span; verbal span; Corsi's test); (3) Long-term memory: Rey's auditory-verbal learning test; 'short story' test; Rey-Osterrieth complex figure (recall); (4) Attentional abilities: attentive matrices; (5) Executive functions: Weigl's sorting test; phonological fluency 'FAS'; (6) Visuo-constructional and visuo-spatial abilities: copy of simple drawings; Rey-Osterrieth complex figure (copy); (7) Language: semantic fluency; (8) Mood: Geriatric Depression Scale (GDS). Moreover, Sniffin' Sticks olfaction test and Mini Nutritional Assessment (MNA) have been performed. After 12 weeks, a significant treatment effect for the MMSE (P < 0.001) and a positive trend for the semantic verbal fluency was found in the supplement group (P < 0.06). A significant treatment effect was found out for the olfactory sensitivity assessment (P < 0.009). As regards the nutrition evaluation, after 12 weeks of treatment the supplemented group showed an improvement in the MNA score with a significant difference relative to placebo (P < 0.005). Older adults with MCI had significant improvements in several measures of cognitive function when supplemented with an oily emulsion of DHA-phospholipids containing melatonin and tryptophan for 12 weeks, compared with the placebo.     

Memory one month after acute carbon monoxide intoxication: a prospective study

Background: Serious delayed neuropsychological sequelae may complicate carbon monoxide intoxication. The existence of minor manifestations, especially memory disturbances, is not well documented.

Aims: To study several memory functions after carbon monoxide intoxication.

Methods: In a prospective study, 32 poisoned patients without risk factors for cognitive disturbances were compared to 32 paired control subjects one month after acute carbon monoxide intoxication (blood carbon monoxide concentration at least 1.0 mmol/l), who had been treated with standard conventional therapy. Psychometric tests included Buschke's verbal memory testing, verbal digit span, Corsi's visuospatial span, reaction times, Stroop's colours decoding test, and verbal fluency test.

Results: (1) Memory functions in poisoned subjects were not worse than in the control group and were even better in some areas: learning, word recall, and quality of learning by Buschke's verbal memory testing. Attention was also better in the patients, in whom visual reaction time was shorter than in controls. (2) Results of several memory functions—quality of learning and immediate visual memory—were positively correlated with the initial carbon monoxide level.

Conclusions: In a highly selected subset of patients devoid of risk factors for memory impairment, memory, objectively evaluated by psychometric testing, was not worse one month after carbon monoxide intoxication in patients undergoing standard treatment than in paired control subjects.

     

激素补充治疗对绝经早期妇女血清生殖激素水平与认知功能的影响

目的 评估使用激素补充治疗(HRT)对绝经早期妇女血清生殖激素水平与认知功能的影响.方法 对215例围绝经期及绝经后女性进行一般情况、围绝经期症状等调查.从中筛选研究对象共30例,按一般情况、KMI及月经情况等调查结果,组间匹配HRT组(10例),非HRT组(20例),分别测定血清雌激素(E2)、卵泡刺激素(FSH)、雄激素(T)、总胆固醇(TC)及甘油三酯(TC)的水平,并进行认知功能测试评分,分析组间差异.结果 HRT组血清E2水平明显高于非HRT组,FSH水平明显低于非HRT组(P＜0.05);两组T、TC及TG水平差异无统计学意义(P＞0.05).HRT组AVLT、VFT得分明显高于非HIT组,CFT耗时明显低于非HRT组(P＜0.05),两组MMSE、DST、CFT得分差异无统计学意义(P＞0.05).结论 HRT可以明显提高绝经早期妇女血清雌激素水平,降低FSH水平;HRT可能提高绝经早期妇女的语言表达能力及短时记忆能力.     

Cognitive Function and Vascular Risk Factors Among Older African American Adults

To evaluate the association between vascular risk factors and cognitive impairment among older African American (AA) adults in a primary care clinic. Participants included 96 AA adults aged 60 years or older who were evaluated for global and domain-specific cognition. Participants were interviewed using the Computerized Assessment of Memory and Cognitive Impairment (CAMCI). The relationship between CAMCI cognitive domain scores and vascular risk factors were examined using hierarchical regression models. Patients who smoked, those with higher SBP/DBP values had lower accuracy rates on CAMCI cognitive domains (attention, executive, memory).Those with higher BMI had better attention scores. Patients with higher HbA1C values had worse verbal memory. Patients with higher blood pressure were significantly faster in responding to tasks in the executive domain. Primary care providers working with older AA adults with these VRFs could implement cognitive screening earlier into their practice to reduce barriers of seeking treatment.