老年认知障碍合并代谢综合征患者认知功能特点

目的：研究老年认知障碍合并代谢综合征患者认知功能改变特点，探讨各代谢指标与认知功能障碍的关系。方法将认知障碍患者分为代谢综合征组（n=41）和非代谢综合征组（n=122），采用蒙特利尔认知量表（MoCA）进行认知功能测评，并测量其体重指数、血压、血糖、血脂等代谢指标水平。结果代谢综合征组的MoCA总分、视空间与执行功能、抽象概括、记忆、语言评分明显低于非代谢综合征组，定向力、注意及命名评分差异无统计学意义。代谢综合征组分数与MoCA的得分有一定的相关性（r=-0.13，P=0.02）。Spearman相关分析显示，体重指数、舒张压与MoCA评分无相关性，高密度脂蛋白胆固醇水平与MoCA评分呈正相关，其余指标与MoCA评分呈显著负相关。多元逐步回归分析显示，年龄、空腹血糖、收缩压是影响MoCA评分的独立危险因素，受教育年限及高密度脂蛋白胆固醇则是认知功能受损的保护性因素。结论老年认知障碍合并代谢综合征患者其认知障碍具有一定的选择特异性，认知功能障碍患者常伴有代谢指标的异常，而且代谢异常指标的数量与认知功能损害的程度呈正相关。

Cognitive Function Characteristic in the Cognitive Impairment Patients with Metabolic Syndrome for Elderly Population

Objective To investigate the cognitive function characteristic in the cognitive impairment patients with metabolic syndrome and study the relation between cognitive function and metabolic indicators. Methods The cognitive impairment patients were divided into group of patients with metabolic syndrome （MS, 41 cases） and group of patients without metabolic syndrome （NMS, 122 cases）. Cognitive function assessed using MoCA scale, body mass index （BMI）, blood pressure （BP）, serum lipid profiles and plasma glucose （PG） were tested. Results Compared with the score of the sub-items, MoCA score, visuospatial-executive function, abstraction, memory, language were significantly decreased in MS group, while attention, orientation and naming score had no significant difference in each group. MoCA score were correlated with the number of metabolic syndrome components （r=-0.13, P=0.02）. Spearman correlation analysis showed that MoCA score no correlation with BMI and DBP, and high-density lipoprotein cholesterol （HDL-C） was positively related to MoCA score, while the remaining indicators were negatively related to MoCA score. Stepwise regression analysis showed that age, FPG and SBP were dependent risk factors of MoCA score. Years of education and HDL-C were protective factors in impaired cognitive function. Conclusion For elderly population, the cognitive impairment has selected specificity. Patients with cognitive impairment often have accompanying metabolic dysregulation, and there is positive correlation between the number of abnormal metabolism-related indices and the degree of cognitive impairment.