The Associations Of Cognition With Anxiety,homocysteine,and Albumin In Middle-aged Patients With Coronary Heart Disease

Objective: Patients with coronary heart disease（CHD）have a large population base and exhibit significant cognitive decline.The chronic disease such as CHD can severely diminish the quality of life of patients,and place a serious burden on their families and society.Cognitive decline is evident from midlife,and it is essential to identify and search for risk factors of cognitive decline in a timely manner.Methods: A total of 160 participants who met the criteria,including 79 patients with CHD and 81 healthy controls（HC）,were ultimately included in this study.Demographic information such as age and gender were collected,as well as relevant hematological information such as albumin and homocysteine.Hamilton Anxiety Scale（HAMA）was applied to assess participants’ anxiety levels and Montreal Cognitive Assessment（Mo CA）was used to assess cognitive function level.Between-group and within-group comparisons were performed for the variables.Correlation analysis was performed on the variables,then binary logistic regression was used to analyze risk factors for cognitive decline.Results: The mean age of the participants was 54.6 ± 5.5 years old.Albumin was significantly lower in the CHD group than in the HC group（t=-9.79,p< 0.01）,and there was no significant difference between males and females within the CHD group（p > 0.05）.There was no difference in Hcy levels between the CHD group and the HC group,however,Hcy levels were significantly higher in males than in females within the CHD group（t=0.47,p< 01）.Additionally,anxiety levels were significantly higher in the CHD group than in the HC group,while there was no significant difference between males and females within the CHD group（p > 0.05）.The Mo CA scores in the CHD group were significantly lower than HC group（Z=-5.63,p< 0.01）.Moreover,the Mo CA scores were significantly higher in males than females within the CHD group（t=2.45,p= 0.02）.The results showed that Mo CA scores of the total participants were positively correlated with education（r=0.53,p < 0.01）,negatively correlated with age（r=-0.26,p < 0.01）,and positively correlated with albumin levels（r= 0.30,p < 0.01）.However,no correlation was found between Mo CA scores and Hcy levels in total participants.While,after grouping,Mo CA scores showed a negative correlation with Hcy levels in male CHD group（r=-0.39,p<0.01）.Additionally,total participants’ Mo CA scores were significantly negatively correlated with HAMA scores（r=-0.58,p<0.01）.Finally,binary logistic regression analysis indicated that having CHD（OR= 5.29,p = 0.04）,fewer years of education（OR= 0.87,p = 0.03）and high levels of mental anxiety（OR= 1.40,p < 0.01）were risk factors for cognitive decline.Conclusion: In middle-aged patients with CHD,higher levels of anxiety,lower levels of albumin,and higher levels of Hcy are associated with cognitive decline.CHD and anxiety are important risk factors for cognitive decline in the middle-aged population.Cognitive decline severely impairs the quality of life in the middle-aged and elderly population,and separating normal aging from disease-induced cognitive impairment may slow down the cognition decline to some extent.This study suggests that preventing CHD,reducing anxiety levels in patients with chronic disease,increasing albumin levels,and lowering Hcy levels may be effective approaches.