老年人高血压、抑郁与认知功能减退的相关性研究

目的分析老年人高血压、抑郁患者认知功能状况及其相关性。方法共收集207例患者，分为单纯高血压组、单纯抑郁组、高血压合并抑郁组和正常对照组。采用简易精神状况检查表（MMSE）进行认知功能检查，采用汉密顿抑郁量表（HAMD）进行抑郁程度的评定，并收集相关资料。结果抑郁老人中独居比例较大。与正常对照组比较，单纯高血压组的注意力和计算力明显下降（P〈0．01），单纯抑郁组的MMSE总分、定向力、注意力和计算力、语言能力明显下降（P〈0．05）；与单纯高血压组比较，高血压合并抑郁组的MMSE总分、定向力、回忆力、语言能力明显降低（P〈0．05）；与单纯抑郁组比较，高血压合并抑郁组的注意力和计算力明显降低（P〈0．05）。抑郁患者的MMSE得分与HAMD得分呈负相关（r=一0．706，P〈0．01）。Logistic回归结果显示抑郁及高血压合并抑郁均为认知功能减退的影响因素（P〈0．01）。结论老年人高血压和抑郁均会引起认知功能的减退，高血压合并抑郁者认知功能减退更为严重，抑郁的严重程度与认知功能减退有关。有效的控制高龄老人的血压和抑郁状态，可能有助于降低其认知功能减退发生的危险。

Hypertension, depression and cognitive function impairment in elderly

Objective To investigate the relationship between hypertension, depression and cognitive function in elderly. Methods General conditions and health status were surveyed in 207 individuals, which were divided into hypertension group, depression group, hypertension and depression group and controls. Patients cognitive function was assessed by the mini-mental state examination (MMSE), depression severity was detected by Hamilton rating scale for depression (HAMD) , other relative data were collected. Results Elderly patients with depression were more inclined to live alone. Comparing with control, hypertension patients had lower attention and calculation. Depression patients had lower orientation, attention, calculation and linguistic ability ( P < 0.05). Compared with hypertension patients, patients combined with depression had significantly lower MMSE scores, orientation, recall and language ( P <0. 05). Patients with hypertension and depression had lower attention and calculation, compared with hypertension a-lone patients ( P <0. 05 ). MMSE scores of depressed patients were negatively related to HAMD scores ( r = -0. 706, P <0.01). Logistic regression revealed depression or combination of hypertension and depression were related to impairment of cognitive ability ( P < 0.01). Conclusion Both hypertension and depression in the elderly impaired cognitive function. The cognitive function impairment in elderly was closely associated with hypertension and depression. Prevention and control of hypertension and depression might be helpful in slowing down impairment of cognitive function in elderly.