Статья
Взаимосвязь факторов сердечно-сосудистого риска с когнитивными функциями у пациентов среднего возраста
Целью настоящего исследования было изучение взаимосвязи показателей когнитивных функций с различными факторами риска сердечно-сосудистых заболеваний и разработка статистической модели для описания процесса изменения во времени показателей когнитивных нарушений. Результаты. Проведенное исследование показало, что у пациентов среднего возраста с метаболическим синдромом (МС) отмечается развитие когнитивной недостаточности большей степени выраженности в сравнении с пациентами с отдельными факторами сердечно-сосудистого риска. Множественный регрессионный анализ продемонстрировал, что результат теста MMSE определяется уровнем глюкозы (бета = 0,0114) и систолическим артериальным давлением (САД) (бета = -0,212). При исключении уровня глюкозы в уравнение регрессии для MMSE в качестве значимых предикторов оказались включенными: САД (бета = -0,202), возраст (бета = -0,093), оперативная память (бета = -0,169), общий холестерин (бета = -0,065), терапия антагонистами кальция (бета = 0,082), ожирение (бета = 0,060), при этом R2 = 92 %.
1. Poon I.O. Effects of antihypertensive drug treatment on the risk of dementia and cognitive impairment // Pharmacotherapy. — 2008. — Vol. 28, № 3. — Р. 366-375.
2. Ferri C.P., Prince M., Brayne C. et al.; Alzheimer's Disease International. Global prevalence of dementia: a Delphiconsensus study // Lancet. — 2005. — Vol. 366, № 9503. — P. 2112-2117.
3. Захаров В.В., Яхно Н.Н. Когнитивные расстройства в пожилом и старческом возрасте / Метод. пособ. для врачей. — М., 2005. — 71 с.
4. Farias S.T., Mungas D., Reed B.R., Harvey D., DeCarli C. Neuropsychological assessment in the diagnosis of Alzheimer's disease // Arch. Neurol. — 2009. — Vol. 66, № 9. — P. 1151-1157.
5. Kivipelto M., Helkala E.L., Laakso M.P. et al. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study // Br. Med. J. — 2001. — Vol. 322, № 7300. — P. 1447-1451.
6. Шляхто Е.В., Зуева И.Б. Влияние терапии блокаторами рецепторов к ангиотензину II на развитие когнитивных расстройств у больных артериальной гипертензией: результаты исследования OSCAR // Артериал. гипертензия. — 2010. — Т. 16, № 2. — С. 219-222.
7. Expert panel on detection E, and treatment of high blood cholesterol in adults: executive summary of the third report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III) // J. Am. Med. Assoc. — 2001. — Vol. 285, № 19. — P. 2486-2497.
8. Yaffe K. Metabolic syndrome and cognitive disorders: is the sum greater than its parts? // Alzheimer Dis. Assoc. Disord. — 2007. — Vol. 21, № 2. — P. 167-171.
9. Dik M.G., Jonker C., Comijs H.C. et al. Contribution of metabolic syndrome components to cognition in older individuals // Diabetes Care. — 2007. — Vol. 30, № 10. — P. 2655-2660.
10. Komulainen P., Lakka T.A., Kivipelto M. et al. Metabolic syndrome and cognitive function: a population-based follow-up study in elderly women // Dement. Geriatr. Cogn. Disord. — 2007. — Vol. 23, № 1. — P. 29-34.
11. Laudisio A., Marzetti E., Pagano F. et al. Association of metabolic syndrome with cognitive function: the role of sex and age // Clin. Nutr. — 2008. — Vol. 27, № 5. — P. 747-754.
12. Muller M., Tang M.X., Schupf N., Manly J.J., Mayeux R., Luchsinger J.A. Metabolic syndrome and dementia risk in a multiethnic elderly cohort // Dement. Geriatr. Cogn. Disord. — 2007. — Vol. 24, № 3. — P. 185-192.
13. Raffaitin C., Gin H., Empana J.P. et al. Metabolic syndrome and risk for incident Alzheimer's disease or vascular dementia: the Three-City Study // Diabetes Care. — 2009. — Vol. 32, № 1. — P. 169-174.
14. van den Berg E., Biessels G.J., de Craen A.J., Gussekloo J., Westendorp R.G. The metabolic syndrome is associated with decelerated cognitive decline in the oldest old // Neurology. — 2007. — Vol. 69, № 10. — P. 979-985.
15. Vanhanen M., Koivisto K., Moilanen L. et al. Association of metabolic syndrome with Alzheimer disease: a population-based study // Neurology. — 2006. — Vol. 67, № 5. — P. 843-847.
16. Yaffe K., Haan M., Blackwell T., Cherkasova E., Whitmer R.A., West N. Metabolic syndrome and cognitive decline in elderly Latinos: findings from the Sacramento Area Latino Study of Aging study // J. Am. Geriatr. Soc. — 2007. — Vol. 55, № 5. — P. 758-762.
17. Yaffe K., Kanaya A., Lindquist K. et al. The metabolic syndrome, inflammation, and risk of cognitive decline // J. Am. Med. Assoc. — 2004. — Vol. 292, № 18. — P. 2237-2242.
18. Благосклонная Я.В., Шляхто Е.В., Бабенко А.Ю. Эндокринология: Уч. для мед. вузов. — СПб.: СпецЛит, 2004. — 398 с.
19. Ballard C., Patel A., Oyebode F., Wilcock G. Cognitive decline in patients with Alzheimer's Disease, vascular dementia and senile dementia of Lewy body type // Age Ageing. — 1996. — Vol. 25, № 3. — Р. 209-213.
20. Ashby D., West C.R., Ames D. The ordered logistic regression model in psychiatry: rising prevalence of dementia in old people's homes // Statistics in Medicine. — 1989. — Vol. 8, № 11. — Р. 1317-1326.
21. Radanovic M., Carthery-Goulard M.T., Charchat-Fichman Y. et al. Analysis of brief language tests in the detection of cognitive decline and dementia // Dement. Neuropsychol. — 2007. — Vol. 1, № 1. — P. 37-45.
22. Zawacki T.M., Grace J., Paul R., Moser D.J., Ott B.R., Gordon N. Behavioral problems as predictors of functional abilities of vascular dementia patients // J. Neuropsych. Clin. Neurosci. — 2002. — Vol. 14, № 3. — Р. 296-302.
23. Shankle W.R., Mani S., Pazzani M.J., Smyth P. Detecting very early stages of dementia from normal aging with machine learning methods / In: E.T. Keravnou, C. Garbay, R.H. Band, J.C. Wyatt (Eds.) // Artificial Intelligence Medicine, Proc. 6th Conference on Artificial Intelligence in Medicine in Europe, Grenoble, France. Lecture Notes in Computer Science. — Springer, 1997. — Р. 73-85.
24. Fabrigoule C., Rouch I., Taberly A. et al. Cognitive process in preclinical phase of dementia // Brain. — 1998. — Vol. 121, Pt. 1. — P. 135-141.
25. Ford E., Giles W., Dietz W. Prevalence of the metabolic syndrome among US Adults // J. Am. Med. Assoc. — 2002. — Vol. 287, № 3. — P. 356-359.
26. Kuo H.K., Sorond F., Iloputaife I., Gagnon M., Milberg W., Lipsitz L.A. Effect of blood pressure on cognitive functions in elderly persons // J. Gerontol. Biol. Sci. Med. Sci. — 2004. — Vol. 59, № 11. — Р. 1191-1194.
27. Singh-Manoux A., Marmot M. High blood pressure was associated with cognitive function in middle-age in the Whitehall II study // J. Clin. Epidemiol. — 2005. — Vol. 58, № 12. — Р. 1308-1315.
28. Knecht S., Wersching H., Lohmann H. et al. High-normal blood pressure is associated with poor cognitive performance // Hypertension. — 2008. — Vol. 51, № 3. — Р. 663-668.
29. Yaffe K., Fiocco A.J., Lindquist K. et al.; Health ABC Study. Predictors of maintaining cognitive function in older adults: the Health ABC study // Neurology. — 2009. — Vol. 72, № 23. — Р. 2029-2035.
30. Elias M.F., Elias P.K., Sullivan L.M., Wolf P.A., D'Agostino R.B. Obesity, diabetes and cognitive deficit: The Framingham Heart Study // Neurobiol. Aging. — 2005. — Vol. 26, Suppl. 1. — P. 11-16.
31. Bagger Y.Z., Tanko L.B., Alexandersen P., Qin G., Christiansen C. The implications of body fat mass and fat distribution for cognitive function in elderly women // Obes. Res. — 2004. — Vol. 12, № 9. — Р. 1519-1526.
32. Meigs J.B., Hu F.B., Rifai N., Manson J.E. Biomarkers of endothelial dysfunction and risk of type 2 diabetes mellitus // J. Am. Med. Assoc. — 2004. — Vol. 291, № 16. — P. 1978-1986.
33. Tezapsidis N., Johnston J.M., Smith M.A. et al. Leptin: a novel therapeutic strategy for Alzheimer's disease // J. Alzheimers Dis. — 2009. — Vol. 16. — P. 731-740.
34. Harvey J. Leptin regulation of neuronal excitability and cognitive function // Curr. Opin. Pharmacol. — 2007. — Vol. 7, № 6. — Р. 643-647.
35. Willey J.Z., Xu Q., Boden-Albala B. et al. Lipid profile components and risk of ischemic stroke: the Northern Manhattan Study (NOMAS) // Arch. Neurol. — 2009. — Vol. 66, № 11. — P. 1400-1406.
36. Chambless L.E., Shahar E., Sharrett A.R. et al. Association of transient ischemic attack/stroke symptoms assessed by standardized questionnaire and algorithm with cerebrovascular risk factors and carotid artery wall thickness. The ARIC Study, 1987-1989 // Am. J. Epidemiol. — 1996. — Vol. 144, № 9. — P. 857-866.
37. Longstreth W.T. Jr., Bernick C., Manolio T.A., Bryan N., Jungreis C.A., Price T.R. Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study // Arch. Neurol. — 1998. — Vol. 55, № 9. — P. 1217-1225.
38. Launer L.J., White L.R., Petrovitch H., Ross G.W., Curb J.D. Cholesterol and neuropathologic markers of AD: a population-based autopsy study // Neurology. — 2001. — Vol. 57, № 8. — P. 1447-1452.
39. Panza F., Frisardi V., Capurso C. et al. Metabolic syndrome and cognitive impairment: current epidemiology and possible underlying mechanisms // J. Alzheimer's disease. — 2010. — Vol. 21, № 3. — Р. 691-724.
40. Muller M., van Raamt F., Visseren F.L. et al. Metabolic syndrome and cognition in patients with manifest atherosclerotic disease: the SMART study // Neuroepidemiology. — 2009. — Vol. 34, № 2. — Р. 83-89.
41. Liu C.Y., Zhou H.D., Xu Z.Q., Zhang W.W., Li X.Y., Zhao J. Metabolic syndrome and cognitive impairment amongst elderly people in Chinese population: a cross-sectional study // Eur. J. Neurol. — 2009. — Vol. 16, № 9. — Р. 1022-1027.
42. Raffaitin C., Feart C., Le Goff M. et al. Metabolic syndrome and cognitive decline in French elders. The Three-City Study // Neurology. — 2011. — Vol. 76, № 6. — P. 518-525.
43. Patel A.B., Kostis J.B., Wilson A.C., Shea M.L., Pressel S.L., Davis B.R. Long-term fatal outcomes in subjects with stroke or transient ischemic attack: fourteen-year follow-up of the systolic hypertension in the elderly program // Stroke. — 2008. — Vol. 39, № 4. — P. 1084-1089.
44. Rothwell P.M., Howard S.C., Dolan E. et al.; ASCOT-BPLA and MRC Trial Investigators. Effects of beta blockers and calcium-channel blockers on within-individual variability in blood pressure and risk of stroke // Lancet Neurol. — 2010. — Vol. 9, № 5. — Р. 469-480.
45. Hanon O., Forette F. Prevention of dementia: lessons from SYSTEUR and PROGRESS // J. Neurol. Sci. — 2004. — Vol. 226, № 1-2. — Р. 71-74.
46. Saxby B.K., Harrington F., Wesnes K.A., McKeith I.G., Ford G.A. Candesartan and cognitive decline in older patients with hypertension: a substudy of the SCOPE trial // Neurology. — 2008. — Vol. 70, № 19, Pt. 2. — P. 1858-1866.
47. Ratnasabapathy Y., Lawes C.M., Anderson C.S. The perindopril protection against recurrent stroke study (PROGRESS): clinical implications for older patients with cerebrovascular disease // Drugs Aging. — 2003. — Vol. 20, № 4. — Р. 241-251.
48. Schrander J., Luders S., Kulschewski A. et al. Morbidity and mortality after stroke, eprosaran compared with netrendipine for secondary prevention (MOSES study) // Stroke. — 2005. — Vol. 36, № 6. — P. 1218-1226.
49. Pathak A., Hanon O., Negre-Pages L., Sevenier F.; OSCAR investigators. Rationale, design and methods of the OSCAR study: observational study on cognitive function and systolic blood pressure reduction in hypertensive patients // Fundam. Clin. Pharmacol. — 2007. — Vol. 21, № 2. — Р. 199-205.
50. Levine D.A., Langa K.M. Vascular cognitive impairment: disease mechanisms and therapeutic implications // Neurotherapeutics. — 2011. — Vol. 8, № 3. — Р. 361-373.
51. Lopez-Arrieta A., Birks J. Nimodipine for primary degenerative, mixed and vascular dementia. Cochrane database of systematic reviews 2002, issue 3. Art. No.: CD000147. DOI: 10.1002/14651858.CD000147.
52. Filosa J., Blanco V. Neurovascular coupling in the mammalian brain // Exp. Physiol. — 2007. — Vol. 92, № 4. — P. 641-646.
53. Girouard H., Iadecola C. Neurovascular coupling in the normal brain and in hypertension. Stroke and Alzheimer disease // J. Appl. Physiol. — 2006. — Vol. 100, № 1. — P. 328-335.
54. Kazda S., Towart R. Nimodipine: a new calcium antagonist with preferential cerebrovascular action // Acta Neurochirurgica. — 1982. — Vol. 63. — P. 8-15.