心血管合并症和认知障碍

V. Dhikav, Pankaj Kumar, P. Anand
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引用次数: 1

摘要

不同程度的认知障碍通常发生在55岁以上的老年人中,其中心血管风险因素如糖尿病和/或高血压、冠状动脉疾病或脑血管事故也很常见。认知障碍的表现形式多种多样,从轻度或健忘症(如忘记今天的日期)到更严重和渐进的形式(如坦率性痴呆)。全世界有500多万人患有痴呆症,其中大多数人生活在低收入和中等收入国家。人们从一开始就设想痴呆症或认知障碍具有神经退行性起源。然而,最近的研究表明,痴呆可能有一个混合的起源,或者可能之前有血管损伤,然后是神经退行性病理。从病理生理学的角度来看,认知障碍和合并症领域的一个令人困惑的问题是尚不清楚心血管合并症和认知障碍孰先孰后。认知障碍会对活动能力和健康产生负面影响,这可能会导致高血压或/和糖尿病的发展。目前的回顾检查这一令人困惑的情况,并试图回答是否共病条件是无辜的旁观者认知障碍或他们发挥更大的致病作用。这篇综述的基本原理是有可能解决这些心血管危险因素来预防痴呆症,因此它总结了与心血管危险因素和认知障碍相关的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular Comorbidities and Cognitive Impairment
Various grades of cognitive impairment generally occur in older adults over the age of 55, where cardiovascular risk factors such as diabetes and/or hypertension, coronary artery disease, or cerebrovascular accidents are also common. Cognitive impairment occurs in various forms, from mild or amnesia such as forgetting today's date to more ominous and progressive forms, such as frank dementia. Over 5 million people worldwide suffer from dementia, most of whom live in low- and middle-income countries. It has been envisaged from the beginning that dementia or cognitive impairment has neurodegenerative origins. However, recent studies have indicated that dementia may have a mixed origin or may be preceded by vascular insult and then neurodegenerative pathology. From a pathophysiological standpoint, one of the puzzling questions in the field of cognitive impairment and comorbidities is that it is not clear whether cardiovascular comorbidity or cognitive impairment comes first. Cognitive impairment negatively affects mobility and fitness and this can potentially contribute to development of hypertension or/and diabetes. The present review examines this perplexing situation and tries to anser whether the comorbid conditions are innocent bystanders to cognitive impairment or they play greater causative roles. The rationale of the review is that it is possible to address these cardiovascular risk factors for dementia prevention and hence it summarizes the evidence related to cardiovascular risk factors and cognitive impairment.
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