台灣社區老人代謝症候群與認知障礙之相關性探討

Association between Metabolic Syndrome and Cognitive Impairment among Community-dwelling Elderly in Taiwan

陳信豪(Hsin-Hao Chen) ； 黃秀梨(Hsiu-Li Huang) ； 林啟民(Chi-Min Lin) ； 王惠玲(Hui-Ling Wang)

《台灣老年醫學暨老年學雜誌》 11卷4期 (2016/11) Pp. 262-277

https://doi.org/10.29461/TGG.201611_11(4).0005

摘要

隨著台灣人口快速老化，罹患認知障礙疾病的長者也急速增加，而代謝症候群被視為可能為認知障礙相關的危險因子，因此本研究目的為探討社區長者其兩者間之相關性。研究者以2015年新竹市某區域教學醫院共596位65歲以上長者之健康檢查結果作研究分析，並以中文版「AD8」量表≧2分為認知障礙的切點，結果顯示代謝症候群及其各別危險因子與認知障礙並沒有顯著相關，但年較大(＞75歲)、教育程度較低、罹患心臟病或腦中風、較少運動(每週＜2.5小時)及較低的舒張壓均為認知障礙的獨立危險因子，其中又以腦中風之風險性最高(OR: 5.93, 95% CI: 1.52～23.20)。雖然代謝症候群在本研究並無顯著升高認知障礙的風險，但其控制不良所產生的併發症如心臟病、腦中風卻對認知功能有顯著影響，因此在罹患代謝症候群相關危險因子後仍應積極介入治療，但影響大腦灌流的舒張壓在長者似乎不需控制太嚴格，另外足夠量的身體活動(每週≧2.5小時)及增加大腦認知儲備，對於減少或延緩認知障礙的發生也有助益，期待未來能有長期追蹤及擴大收案族群的研究，進一步探討認知障礙可能的危險因子，特別是代謝症候群隨著時間年紀的變化與認知功能改變的相關性。

關鍵字

認知障礙 ； 失智症 ； 代謝症候群 ； 老人 ； AD8量表

並列摘要

The number of elderly people with cognitive impairment has grown rapidly as the population of Taiwan ages. Metabolic syndrome (MetS) is considered a potential risk factor. The objective of the study is to explore the association between cognitive impairment and MetS among the elderly community dwellers in Taiwan. The study analyzed the data from 596 elderly subjects examined in a regional teaching hospital in Hsinchu City in 2015, using the Chinese AD8 questionnaire to determine cognitive impairment with the cut-off score set at 2. The result identified no significant correlation between cognitive impairment and MetS. However, older age (＞ 75 years old), lower education level, heart disease, stroke, less exercise (＜ 2.5 hours/week) and lower diastolic pressure were all independent risk factors of cognitive impairment. Stroke in particular appeared to be the most significant risk factor (OR: 5.93, 95% CI: 1.52～23.20). Although MetS did not significantly increase the risk of cognitive impairment, related complications like heart disease and stroke played significant roles. The components of MetS should therefore be treated aggressively. On the other hand, diastolic pressure, which affects brain perfusion, does not seem to require strict control in the elderly. More exercise (≧2.5 hours/week) and activities for increasing cognitive reserve also help to decrease the occurrence of cognitive impairment. Further studies with a longer duration of follow-up and a larger study population are needed to explore the relationship between cognitive impairment and its risk factors, especially the association of Mets with age-related changes in cognitive function.

並列關鍵字

cognitive impairment ； dementia ； metabolic syndrome ； elderly ； AD8