心力衰竭与并发性痴呆症:与临床特征和结果的关联
Michael S Jensen1, Irena Cenzer2, Amy S Kelley3
1Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
Journal of the American Geriatrics Society
|June 12, 2023
概括
大约有21%的心力衰竭的老年人也患有痴呆症. 这种并发症显著恶化功能衰退,增加住院风险,并提高老年患者的死亡率.
科学领域:
- 老年学是指老年学的学科.
- 心脏病学 心脏病学
- 神经学 神经学
背景情况:
- 心力衰竭 (HF) 和痴呆症显著影响老年人的功能和生存.
- 对于同时发生的HF和痴呆症的影响的了解有限.
- 这项研究调查了同时出现HF和痴呆症的患病率和后果.
研究的目的:
- 确定心力衰竭患者痴呆症的发生频率.
- 分析心力衰竭和痴呆症对功能状态,住院和死亡率的影响.
主要方法:
- 来自2015年健康和衰老趋势研究 (NHATS) 的65岁以上912名参与者的回顾性分析与医疗保险索赔相关.
- 利用NHATS痴呆算法来识别可能的痴呆症.
- 使用调整后回归模型,比较了包括日常生活活动 (ADL),功能衰退,住院和死亡率在内的结果.
主要成果:
- 在患有HF的参与者中,有21%的人也患有痴呆症.
- 同时出现的HF和痴呆症与显著更高的IDL/ADL援助需求相关,特别是药物管理 (71.8%对16.6%).
- 患有这两种疾病的患者面临功能衰退 (aOR=2.69),住院 (aOR=2.02) 和死亡率 (aHR=1.52) 的风险增加.
结论:
- 五分之一的患有HF的老年人患有并发性痴呆症.
- 高频率和痴呆症的同时出现大大提高了功能障碍,住院率和死亡率.
- 医生应对HF患者的痴呆进行查,并相应地调整管理策略.
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