老年糖尿病人群认知功能障碍的临床特征

目的探讨糖尿病老年人群认知功能损伤特点,明确糖尿病对老年认知功能障碍的影响。方法研究对象为2009年1月至2012年12月神经内科住院及门诊就诊老人人群,根据是否患有糖尿病分为糖尿病组和对照组。入选病例进行病史采集,神经系统查体,并进行简易智能精神状态检查量表(MMSE)、听觉词语学习测验(AVLT)、日常生活活动能力量表(ADL)、相似性、领悟力测验,对比分析两组结果。结果共纳入273病例,糖尿病组65例,对照组208例,各组之间年龄、性别及受教育水平无显著统计学差异。糖尿病组MMSE总分为21.35±5.039分,对照组MMSE总分为23.32±5.020,两组比较差异有显著统计学意义(P=0.006)。MMSE子项分析表明,糖尿病组时间定向力评分显著低于对照组(P=0.002)。AVLT检测分析结果表明,糖尿病组在即刻回忆、延迟回忆评分均显著低于对照组(P0.05)。糖尿病组ADL评分亦显著低于对照组(P=0.018)。结论糖尿病人群存在选择性的认知功能下降,积极防治糖尿病对于延缓糖尿病人群认知功能下降具有重要意义。

Clinical features of cognitive dysfunction in the aged population with diabetes

Objective To explore the characters of cognitive dysfunction in the aged population with diabetes. Methods Aged patients were approached through inpatient and outpatient neurology practices between January 2009 and December 2012,which were divided into diabetes group and control group. Medical history acquisition,neurological examination and neuropsychological scales assessment were conducted. The neuropsychological examinations included MMSE,AVLT,ADL,comparability and perception test. Results The results were analyzed by SPSS software. A total of 273 aged patients were enrolled in this study,among which 65 had diabetes. There were no significant difference in age,sex and education level between two groups. The total score of MMSE was 21. 35 ± 5. 039 in diabetes group and 23. 32 ± 5. 020 in control group,which was significant difference between two group. The sub-item analysis showed the orientation to time test in diabetes group,which was significantly lower than that of control group（ P =0. 002）. Persons with diabetes had lower AVLT immediate recall and delayed recall scores than persons without diabetes（ P ﹤0. 05）. ADL score in diabetes group was significantly less than that of in control group（ P =0. 018）. Conclusion The aged population with diabetes had a selective cognitive dysfunction. Preventing and treating diabetes is very important.