Influencing Factors And Correlation Analysis Of Cognitive Impairment In Elderly Patients With Hypertension

Objective:As our country gradually enters the aging society,how to protect the health and quality of life of the elderly patients with hypertension has become an important issue in the medical and health system.Cognitive impairment has become an important health problem for this group.The purpose of this study is to explore the risk factors or protective factors related to cognitive impairment in elderly patients with hypertension,and to evaluate whether these risk factors or protective factors can independently predict the risk of cognitive impairment in elderly patients with hypertension,so as to provide a basis for clinical screening and management of cognitive impairment in elderly patients with hypertension.Methods:(1)Study objects: This study is a retrospective study.The included research objects are elderly hypertensive patients who were hospitalized in the cadre ward of the First Hospital of Jilin University from October 2020 to February 2021 and aged ≥ 60 years.(2)Study methods: The subjects were divided into two groups: normal cognitive function group(225 cases)and cognitive impairment group(75 cases)according to the MMSE scoring criteria.General data,blood pressure,biochemical indicators,depression status inventory(DSI),activities of daily living(ADL),fall risk assessment(FRA)and clinical dementia Rating(CDR)were collected as observation indexes,and compare the cognitive function in normal group and cognitive impairment in the differences in clinical data,looking for elderly cognitive dysfunction in patients with hypertension related clinical risk factors or protection factors.(3)Statistical method: SPSS 23.0 statistical software was used for data processing and analysis.The measurement data conforming to normal distribution were expressed as mean ±standard deviation((?)±S),and independent sample t test was used for comparison between the two groups.Enumeration data and grade data were expressed as percentage(%).Chi-square test or rank sum test was used for comparison between two groups.The measurement data that did not conform to normal distribution were compared by rank sum test.Multivariate analysis of cognitive impairment was conducted using binary Logistics regression analysis;Spearman correlation analysis was used to analyze the correlation between each factor.ROC curve was drawn to evaluate forecast value.For all statistical methods,P <0.05 was considered statistically significant.Results:A total of 300 patients were included in this study,which were divided into 225 patients with normal cognitive function(75%)and 75 patients with cognitive impairment(25%)according to MMSE score results.(1)The average age of the cognitive impairment group is higher than that of the normal cognitive function group,and the difference between the groups is statistically significant.(2)There were significant differences in age,depression status inventory(DSI),fall risk,activities of daily living,dementia assessment,hemoglobin,RBC count,albumin,total cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein and other aspects between the two groups,and the differences were statistically significant(P <0.05).In gender,height,weight,BMI,smoking,alcohol consumption,educational level,leukocyte count,neutrophil count,aspartate transaminase,alanine aminotransferase,γ-glutamyltranspeptidase,alkaline phosphatase,cholinesterase,total protein,globulin,creatinine,urea,uric acid,systolic pressure,diastolic blood pressure,fasting glucose,there was no statistically significant difference(P > 0.05).(3)Logistic regression analysis was performed with cognitive impairment as the dependent variable,and age,depression status inventory(DSI),risk of falls,ability of daily living,dementia assessment,hemoglobin,RBC count,albumin,total cholesterol,triglyceride,HDL,LDL as the independent variables.The results showed that: Depression status(DSI)(OR=1.567,95%CI[1.209-1.727],P<0.001),age(OR=1.221,95%CI[1.053-1.481],P=0.018),total cholesterol(OR=1.307,95%CI[1.117-2.759],P=0.026)were independent risk factors affecting cognitive function in elderly patients with hypertension,while activities of daily living(OR=0.857,95%CI[0.712-0.995],P=0.031),serum albumin(OR=0.811,95%CI[0.705-0.979],P=0.042)were independent protective factors.(4)Spearman correlation analysis showed that DSI scale score and MMSE scale score(r=0.491,P <0.05)were positively correlated.(5)The ROC curve showed that the area of depression state(DSI)(AUC)was 0.642,P< 0.001;The cut-off value was 32 points,the sensitivity was 0.876,and the specificity was0.807.AUC of age was 0.630,P < 0.001;The cut-off value was 73.5 years,the sensitivity was0.811,and the specificity was 0.779.AUC of total cholesterol was 0.607,P=0.019;The critical value was 4mmol/L,the sensitivity was 0.710,and the specificity was 0.723.AUC of daily living ability was 0.625,P < 0.001;The cut-off value was 25.5 points,the sensitivity was0.775,and the specificity was 0.719.AUC of albumin was 0.618,P = 0.022;The cut-off value was 32.5 g/l,the sensitivity was 0.807,and the specificity was 0.756.Conclusion:(1)The elderly patients with hypertension are more likely to suffer from cognitive impairment with age;(2)The severity of cognitive impairment in elderly patients with hypertension was positively correlated with the degree of depression;(3)Age,depression and total cholesterol level are important and independent risk factors for cognitive impairment in elderly patients with hypertension;Activities of daily living and albumin levels are important and independent protective factors of cognitive impairment in elderly patients with hypertension;(4)DSI score is the most important predictor of cognitive impairment in elderly patients with hypertension.