Neuropsychological Characteristics Of Vascular Cognitive Impairment And Analysis Of Its Related Factors

BackgroundWith the aging of the population,the prevalence of cerebrovascular diseases and vascular cognitive impairment(VCI)is also increasing annually.VCI is not only the second leading cause of dementia,but also a preventable type.At present,a large number of studies at home and abroad have shown that VCI patients have different degrees of cognitive impairment or different cognitive impairment field.The multiple risk factors able to intervene have discovered in addition to factors unable to intervene,such as age,gender,etc.,which provides an important basis for preventing VCI.In this study,We evaluated the patients who have cerebrovascular disease or the presence of vascular risk factors using neuropsychological scales and compared their general data,clinical and imaging data,to identify the relevant influencing factors and provide evidence for identifying,preventing and delaying the occurrence and development of VCI in the future.ObjectiveTo explore the characteristics of cognitive impairment of VCI patients in neuropsychology,and analyze the related influencing factors of VCI.MethodsThe inpatients met the inclusion criteria from the department of Neurology in our hospital from November 2018 to January 2022 were selected and assessed with MMSE and MoCA.According to the scores of MoCA,the patients were divided into vascular cognitive impairment group(VCI group)and normal cognitive function group(NC group).The general data such as age,gender,education,the laboratory related date and the brain imaging data of the two groups of patients were collected respectively.Compared the results of the total scores and the scores of each sub item of MMSE and MOCA were compared between the two groups,and the differences of the general data,clinical data,and imaging data between the two groups were analyzed.ResultsA total of 149 patients finally were included in our study,which divided into 93 in the VCI group and 56 in the NC group.The total scores of MMSE and MoCA in VCI group were significantly lower than those in NC group,the difference was statistically significant(P<0.05).In MMSE sub items,the scores of time orientation,place orientation,attention and calculation,delayed recall,language understanding,language expression and graphic description in VCI group were lower than those in NC group,the difference was statistically significant(P<0.05).In MoCA sub items,the scores in VCI group were lower than those in NC group,the difference was statistically significant(P<0.05).Univariate analysis showed that the differences between the two groups were statistically significant in the education,history of cerebral infarction,hyperlipidemia,ALT,AST,SCr,the grade of white matter lesions,and number of infarcts(all P<0.05).Multivariate logistic regression analysis showed that the influencing factors of VCI were AST,SCr,the grade of white matter lesions,history of cerebral infarction,and number of infarcts.SCr and no white matter lesions were the protective factors of VCI,and AST,history of cerebral infarction,and multiple infarcts were the risk factors of VCI.ConclusionsPatients with VCI may have cognitive impairment in different fields,especially delayed memory,visual space and executive function.MMSE and MoCA assessment are conducive to early detection of VCI.The occurrence of VCI may be related to AST,SCr,the grade of white matter lesions,history of cerebral infarction,and number of infarcts,which suggests that patients with previous history of cerebral infarction,multiple infarcts indicated by imaging and elevated AST should be alert to the occurrence of VCI.