急性感染性疾病对老年人认知功能的影响

Effect of acute infectious diseases on cognitive function in the elderly

摘要:

目的 观察急性感染性疾病对老年人认知功能的影响并探讨其发病机制。方法 按1∶2匹配的回顾性巢式病例对照研究方法，选择2009年1月至2013年12月期间入住南京军区南京总医院并伴有急性感染性疾病的老年患者72例作为病例组以及研究期间内未患急性感染性疾病的老年住院患者144例作为对照组。采用随机效应模型分析并比较两组患者4年内重复测定的各项认知功能测评的结果；认知功能评测包括简易智能量表（MMSE）、词语学习、延迟回忆、动物流畅性和符号数字转换的测定。结果 调整高血压及体质量指数等混杂因素后，4年期间重复测定两组患者的MMSE、词语学习及延迟回忆、动物流畅性和符号数字测评得分并计算平均分数，急性感染性疾病组（病例组）各项测评的平均得分与对照组比较明显偏低，差异均具有统计学意义（P＜0.05）。结论 急性感染性疾病老年患者的认知功能下降幅度较对照组明显增加。

Abstract:

Objective To determine the effect of acute infectious diseases on the cognitive function in the elderly and explore the underlying mechanisms. Methods A 1∶2 matched nested case-control study was carried out retrospectively on 72 hospitalized elderly with coexisting acute infectious diseases and 144 age-matched in-patients without the infection admitted in our hospital from January 2009 to December 2013. All the subjects had annual cognitive tests for 4 consecutive years, which included the Mini-Mental State Examination (MMSE), Word List Recall, Delayed Recall, Animal Category Fluency, and Symbol Digit Modalities tests. The differences in mean cognition scores of the 4 years’ measurement were compared between the 2 groups by multivariable mixed linear models. Results After adjusting for hypertension and body mass index (BMI), the mean MMSE, Word List Recall, Delayed Recall, Animal Category Fluency, and symbol Digit Modalities score of the repeated measurement were significantly lower in the elderly with coexisting acute infectious diseases than those without (all P＜0.05) . Conclusion Cognitive function impairment is more common in the elderly with acute infectious diseases than those without.