老年人脑白质损害与认知功能的关系

目的探讨老年人脑白质损害(WML)与认知功能的关系。方法选择457例男性老年人行头颅CT及数字广度、言语流畅、积木测验、词语延迟回忆、连线测验A、符号数字检查,按头颅CT表现将研究对象分为无WML(132例)、轻度WML(147例)、中度WML(105例)及重度WML(73例)4组。多因素协方差分析比较不同组别各项神经心理测验结果;用logistic回归分析不同WML状态下认知功能损害的相对危险性。结果重度WML组各项认知检测分数较无WML组有显著性差异(P<0.01),重度WML是各项认知功能损害的危险因素(P<0.01)。中度WML组在部分认知项目上与无WML组有显著性差异(P<0.01),轻度WML组与无WML组的认知功能无显著性差异(P>0.05)。结论轻度WML对认知的影响不明显,WML严重到一定程度时将使老年人认知功能产生广泛损害。

Cerebral white matter lesions and cognitive function in an elderly cohort

Objective To examine the association between cerebral white matter lesions(WML)identified on CT and the cognitive function in a male,non-demented cohort.Methods Participants included 457 male individuals from the Cognition Disorders of High Rank Retired Military Officer Study in Nanjing,PR China.All participants underwent CT scan and cognitive function assessment using Delayed Word Recall Test,Symbol Digit Substitution Test,Animals Category Fluency Test,Block Design,Trail Making Test(Part A) and Digit Span Test.A comparison of results of cognitive tests was made between the subgroups by WML status using multivariate analysis of covariance adjusting for age.Logistic regression was used to assess odds ratios(ORs) and 95% confidence intervals(CIs) for impaired performances associated with WML status.Results Cognitive performances in individuals with severe WML differed significantly from those without WML on all tests.Severe WML was strongly associated with increased risk of impaired performances on each of neuropsychological tests as compared with those without WML.Moderate WML group differed significantly from without WML group only on some neuropsychological tests.Conclusion Severe WML is associated with greatly diminished cognitive function.A threshold of WML may be necessary to influence cognitive function in the elderly.