社区老年人糖尿病和高血压患病情况与轻度认知障碍的关联性研究

目的 探讨糖尿病共患高血压与社区老年人轻度认知障碍(Mild cognitive impairment, MCI)的关系，为社区认知障碍防控提供科学依据。方法 数据来源于湖北老年记忆队列（注册号:ChiCTR1800019164）第一轮基线调查。对参与者进行问卷调查、身体测量和神经心理评估，根据糖尿病和高血压患病情况将参与者分成四组:不患病组、糖尿病组、高血压组和糖尿病共患高血压组。采用多因素logistic回归分析不同患病组与MCI的关系。结果 共纳入3011人，年龄范围为65~92岁 (平均年龄70.93±5.24岁)，MCI患病率为17.9% (16.5%~19.2%)。组间两两比较结果显示:糖尿病组、高血压组和糖尿病共患高血压组MCI的患病率均高于不患病组（21.9%、19.1%、23.8% vs 14.7%），差异具有统计学意义（P<0.05）。调整性别、年龄、文化程度、婚姻状况、吸烟、饮酒、体育锻炼、智力活动、BMI、收缩压、舒张压后，糖尿病组、高血压组和糖尿病共患高血压组MCI的患病风险分别是不患病组的1.53(1.09~2.14)、1.32(1.02~1.54)和1.79(1.23~2.32)倍。结论 MCI患病率在糖尿病、高血压和糖尿病共患高血压人群中均增高，且在糖尿病共患高血压人群中具有更高的患病风险，科学管理糖尿病和高血压，阻止共病的发生，有利于MCI的预防。

The association analysis of concurrent diabetes and hypertension with mild cognitive impairment in community-dwelling older adults

To analyze the association of concurrent diabetes and hypertension with mild cognitive impairment(MCI) in community-dwelling older adults, and to provide scientific evidence for the prevention and control of MCI in the community. Methods Cross-sectional data was collected from the first round of baseline survey of Hubei Aging And Memory Cohort Study(HAMCS),(Registration Number: ChiCTR180019164). Eligible participants received questionnaire survey, physical measurement and neuropsychological testing. All subjects were divided into 4 groups based on the diagnose of comorbidity: Non-disease group, Diabetes group, Hypertension group and Concurrent Diabetes and Hypertension group. Multivariate logistic regression analysis was used to analyze the association between different groups and MCI. Results A total of 3 011 participants aged 65 and older were included, with an age range of 65-92 years(average age was 70.93±5.24 years). The overall prevalence of MCI was 17.9%(16.5%-19.2%). Pairwise comparisons between groups showed that the prevalence of MCI in diabetes group, hypertension group and concurrent diabetes and hypertension group were higher than that in non-disease group(21.9%,19.1%,23.8% vs 14.7%, P<0.05). After adjusting for gender, age, education level, marital status, smoking, drinking, physical exercise, intellectual activity, BMI, systolic blood pressure and diastolic blood pressure, compared with non-disease group, diabetes, hypertension and concurrent diabetes and hypertension group were significantly associated with a higher risk of MCI, with OR values of 1.53(1.09-2.14), 1.32(1.02-1.54) and 1.79(1.23-2.32), respectively. Conclusion Diabetes, hypertension and concurrent diabetes and hypertension are associated with higher prevalence of MCI in community-dwelling older adults, and there is a notable higher risk of MCI among people with concurrent diabetes and hypertension. Successful management of diabetes and hypertension and prevention of comorbidity are in favor of prevention of the occurrenceof MCI.