基于心力衰竭的老年人功能状态的认知过渡:一个基于人口的研究
Kensuke Morris1, Misa Takegami1,2, Kanako Teramoto3
1Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Japan.
ESC heart failure
|September 14, 2023
概括
在日常生活活动中依赖心力衰竭患者 (ADL) 面临更高的认知衰退风险. 功能状态下降显著影响认知转变,强调ADL依赖性是心力衰竭认知障碍的关键风险因素.
科学领域:
- 老年学是一门学科.
- 心脏病学 心脏病学
- 神经学 神经学
背景情况:
- 认知障碍和功能状态是心力衰竭 (HF) 结果的关键决定因素.
- 功能状态对整个HF疾病过程中的认知变化的影响仍未得到充分研究.
- 日常生活活动 (ADL) 的依赖是功能状态的关键指标.
研究的目的:
- 描述心力衰竭患者的认知转变.
- 评估认知转变与功能状态之间的关系,特别是ADL依赖.
- 为了确定认知能力下降的风险因素,在老年人与高频率.
主要方法:
- 来自日本长期护理数据库的1764名心力衰竭患者 (≥65岁) 的回顾性队列研究.
- 在基线和24个月评估认知状态;根据基线ADL状态分层的参与者 (独立与依赖).
- 概括估计方程和多状态建模用于分析ADL依赖和认知变化之间的关联.
主要成果:
- 与独立ADL患者 (86%) 相比,依赖ADL患者在24个月内维持正常/轻度认知状态的概率 (47%) 显著降低.
- 在正常/轻度认知状态的患者中,基线ADL依赖与过渡到中度/严重认知障碍的风险增加5.24倍有关.
- 在整个研究期间,在功能状态下降的患者中,认知障碍的患病率始终更高.
结论:
- 在老年心力衰竭患者中,ADL依赖是认知能力下降的重要危险因素.
- 即使在最初的正常/轻度认知状态下,ADL依赖预测24个月内认知恶化风险更高.
- 功能状态,通过ADL依赖性来评估,在心力衰竭患者的认知轨迹中起着至关重要的作用.
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