2型糖尿病伴发认知功能障碍的危险因素研究
|
摘要
目的:探讨与2型糖尿病相关的认知功能障碍。
方法:采用以医院为基础的频数匹配病例对照研究方法。病例来自2005年3月至10月于天津医科大学代谢病医院就诊的2型糖尿病(T2DM)患者共118例。对照组:为同期于天津医科大学总医院接受健康检查的非糖尿病者共100例,对照组与病例组按年龄、性别、文化程度进行频数匹配。认知功能测试分别采用(1)简易智能状态评价(MMSE);(2)韦克斯勒成人智力量表中国修订版(WATS-RC)中的4项测验,即填图测验、数字广度、数字符号及类同测验;(3)临床记忆量表(甲套)全部5项测验。综合医院焦虑和抑郁量表(HAD)评价研究对象的焦虑和抑郁状态。采用t检验比较病例组与对照组认知功能评分差异,x2检验比较各调查因素在两组间分布的差异。
结果:病例组与对照组MMSE得分分别为27.0±3.2和27.8±2.0,差别未达到统计学显著性水平(t=1.668,P=0.098);病例组在填图测验、数字广度测验、数字符号及类同测验项目的年龄量表分均低于年龄、性别、文化程度匹配的对照组,差别均具有统计学意义(P均<0.001),说明病例组在逻辑思维能力、抽象思维能力、分析概括能力,视觉敏锐性、注意力、记忆力、信息处理速度及神经肌肉运动能力等方面的认知功能表现均差于对照组;病例组与对照组的记忆商(MQ)分别为90.0±15.6和100.3±12.8,两组MQ差别具有统计学意义(t=5.354,P<0.001)。病例组的MQ显著低于常模均数100(t=6.926,P<0.001),而对照组MQ与常模均数比较,无统计学差异(t=0.251,P=0.803),说明病例组存在记忆力损害。病例组在指向记忆、联想记忆、图像自由回忆、无意义图形再认、人像特点回忆五项分测验的年龄量表分均显著低于年龄、性别、文化程度匹配的对照组(P均<0.005),说明病例组的言语记忆(学习记忆)和非言语记忆(视空记忆)能力均存在不同程度的损害。本研究发现,不同年龄组(55岁以下组、55岁及以上组),不同性别的T2DM患者的多项认
Objective: To explore the relationship of type 2 diabetes to cognitive impairment. Methods: A hospital-based frequency matched case-control study was conducted. 118 type 2 diabetes mellitus (T2DM) patients were compared with 100 age, gender and level of education matched non-diabetic controls. Cognitive function of the subjects was assessed by the following cognitive tests: (1) Mini-Mental State Examination (MMSE);(2) Four cognitive tests from Wechsler Adult Intelligence Scale-Revised in China (WATS-RC), namely, Picture Completion Test, Digit Span Test, Digit Symbol Substitution Test and the Similarities Test;(3) Clinical Memory Scale (CMS). The anxiety and depression symptoms of the subjects were assessed using Hospital Anxiety and Depression Scale (HAD). The statistical differences of cognitive scores between case and control groups were examined with t-test. Chi-square test was used to examine the differences for variable's proportions.Results: The MMSE scores of case and control groups were 27.0±3.2 and 27.8±2.0 respectively, which had no statistical difference between two groups (t=1.668, P=0.098) . The scores of four WATS-RC tests were all significantly lower in the cases than those in the controls. The results indicate that the cases were likely to be cognitively impaired in several cognitive domains including logical and abstractive reasoning, memory, attention, processing and psychomotor speed. The mean memory quotient (MQ) of the case group was significantly lower than that of the control group(90.0±15.6 vsl00.3±12.8, t=5.354, P<0.001). Similarly, the mean MQ of the case group was also significantly lower than the mean of Norm, while no significant difference of MQ was found between control group and the Norm (t=0.251, P=0.803) . The scores of 5 memory tests from
CMS in the cases were all significantly lower than those in the controls, which suggested that the case group had impaired verbal memory and visuospatial memory. Both age groups ( below 5 5-years old group and 5 5-years or older group) and gender groups of the cases had poorer performance in a number of cognitive tests copmpared with the controls, which indicate that the cases in different age and gender groups have impaired cognitive function. The results of HAD showed that the scores of depression in the case group were higher than those in the control group.Conclusion: Results from the present study suggest that type 2 diabetes are associated with cognitive impairment in a number of cognitive domains including logical and abstractive reasoning, memory, attention, processing and psychomotor speed, verbal memory and visuospatial memory. Further studies on delineating the mechanisms of the observed associations are warranted.
方法:采用以医院为基础的频数匹配病例对照研究方法。病例来自2005年3月至10月于天津医科大学代谢病医院就诊的2型糖尿病(T2DM)患者共118例。对照组:为同期于天津医科大学总医院接受健康检查的非糖尿病者共100例,对照组与病例组按年龄、性别、文化程度进行频数匹配。认知功能测试分别采用(1)简易智能状态评价(MMSE);(2)韦克斯勒成人智力量表中国修订版(WATS-RC)中的4项测验,即填图测验、数字广度、数字符号及类同测验;(3)临床记忆量表(甲套)全部5项测验。综合医院焦虑和抑郁量表(HAD)评价研究对象的焦虑和抑郁状态。采用t检验比较病例组与对照组认知功能评分差异,x2检验比较各调查因素在两组间分布的差异。
结果:病例组与对照组MMSE得分分别为27.0±3.2和27.8±2.0,差别未达到统计学显著性水平(t=1.668,P=0.098);病例组在填图测验、数字广度测验、数字符号及类同测验项目的年龄量表分均低于年龄、性别、文化程度匹配的对照组,差别均具有统计学意义(P均<0.001),说明病例组在逻辑思维能力、抽象思维能力、分析概括能力,视觉敏锐性、注意力、记忆力、信息处理速度及神经肌肉运动能力等方面的认知功能表现均差于对照组;病例组与对照组的记忆商(MQ)分别为90.0±15.6和100.3±12.8,两组MQ差别具有统计学意义(t=5.354,P<0.001)。病例组的MQ显著低于常模均数100(t=6.926,P<0.001),而对照组MQ与常模均数比较,无统计学差异(t=0.251,P=0.803),说明病例组存在记忆力损害。病例组在指向记忆、联想记忆、图像自由回忆、无意义图形再认、人像特点回忆五项分测验的年龄量表分均显著低于年龄、性别、文化程度匹配的对照组(P均<0.005),说明病例组的言语记忆(学习记忆)和非言语记忆(视空记忆)能力均存在不同程度的损害。本研究发现,不同年龄组(55岁以下组、55岁及以上组),不同性别的T2DM患者的多项认
Objective: To explore the relationship of type 2 diabetes to cognitive impairment. Methods: A hospital-based frequency matched case-control study was conducted. 118 type 2 diabetes mellitus (T2DM) patients were compared with 100 age, gender and level of education matched non-diabetic controls. Cognitive function of the subjects was assessed by the following cognitive tests: (1) Mini-Mental State Examination (MMSE);(2) Four cognitive tests from Wechsler Adult Intelligence Scale-Revised in China (WATS-RC), namely, Picture Completion Test, Digit Span Test, Digit Symbol Substitution Test and the Similarities Test;(3) Clinical Memory Scale (CMS). The anxiety and depression symptoms of the subjects were assessed using Hospital Anxiety and Depression Scale (HAD). The statistical differences of cognitive scores between case and control groups were examined with t-test. Chi-square test was used to examine the differences for variable's proportions.Results: The MMSE scores of case and control groups were 27.0±3.2 and 27.8±2.0 respectively, which had no statistical difference between two groups (t=1.668, P=0.098) . The scores of four WATS-RC tests were all significantly lower in the cases than those in the controls. The results indicate that the cases were likely to be cognitively impaired in several cognitive domains including logical and abstractive reasoning, memory, attention, processing and psychomotor speed. The mean memory quotient (MQ) of the case group was significantly lower than that of the control group(90.0±15.6 vsl00.3±12.8, t=5.354, P<0.001). Similarly, the mean MQ of the case group was also significantly lower than the mean of Norm, while no significant difference of MQ was found between control group and the Norm (t=0.251, P=0.803) . The scores of 5 memory tests from
CMS in the cases were all significantly lower than those in the controls, which suggested that the case group had impaired verbal memory and visuospatial memory. Both age groups ( below 5 5-years old group and 5 5-years or older group) and gender groups of the cases had poorer performance in a number of cognitive tests copmpared with the controls, which indicate that the cases in different age and gender groups have impaired cognitive function. The results of HAD showed that the scores of depression in the case group were higher than those in the control group.Conclusion: Results from the present study suggest that type 2 diabetes are associated with cognitive impairment in a number of cognitive domains including logical and abstractive reasoning, memory, attention, processing and psychomotor speed, verbal memory and visuospatial memory. Further studies on delineating the mechanisms of the observed associations are warranted.
引文
1. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care 1998;21 (9): 1414-31.
2. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27(5): 1047-53.
3. Thomas VS, Darvesh S, MacKnight C, Rockwood K. Estimating the prevalence of dementia in elderly people: a comparison of the Canadian Study of Health and Aging and National Population Health Survey approaches. Int Psychogeriatr 2001;13 Supp 1:169-75.
4. Geldmacher DS, Whitehouse PJ. Evaluation of dementia. N Engl J Med 1996;335(5):330-6.
5. Panza F, D'Introno A, Colacicco AM, et al. Current epidemiology of mild cognitive impairment and other predementia syndromes. Am J Geriatr Psychiatry 2005;13(8):633-44.
6. Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST. PRACTICE PARAMETER: EARLY DETECTION OF DEMENTIA: MILD COGNITIVE IMPAIRMENT (AN EVIDENCE-BASED REVIEW), Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001;56: 1133-42.
7.王德全,姜晓丹.老年痴呆患病率及危险因素调查.中国公共卫生 2002;18(12):1498-9.
8.杨健霞,张桂青,仇银全,胡浴恒.新疆石河子地区65岁以上1 230人老年痴呆流行病学调查.中国临床康复2003;7(28):3848-50.
9.费伟民,程鎏,王玉梅,胡喜荣,孙才坚,高之旭.上海市卢湾区一个社区老年期痴呆患病率分析.四川精神卫生2001;14(1):31-2.
10. Kouta Y, Sakurai T, Yokono K. [Cognitive dysfunction and dementia associated with elderly diabetes]. Nippon Rinsho 2006;64(1):119-23.
11. Cassel CK. GERIATRIC MEDICINE: AN EVIDENCE BASED APPROACH-4th Ed: Springer-Verlag New York, Inc., 2003.
12. Sasaki N, Toki S, Chowei H, Saito T, Nakano N, Hayashi Y, Takeuchi M, Makita Z. Immunohistochemical distribution of the receptor for advanced glycation end products in neurons and astrocytes in Alzheimer's disease. Brain Res 2001;888(2):256-62.
13. Qiu WQ, Folstein MF. Insulin, insulin-degrading enzyme and amyloid-beta peptide in Alzheimer's disease: review and hypothesis. Neurobiol Aging 2006;27(2): 190-8.
14. Janson J, Laedtke T, Parisi JE, O'Brien P, Petersen RC, Butler PC. Increased risk of type 2 diabetes in Alzheimer disease. Diabetes 2004;53(2):474-81.
15. Allen KV, Frier BM, Strachan MW. The relationship between type 2 diabetes and cognitive dysfunction: longitudinal studies and their methodological limitations. Eur J Pharmacol 2004;.490(1-3): 169-75.
16. Stewart R, Liolitsa D. Type 2 diabetes mellitus, cognitive impairment and dementia. Diabet Med 1999;16(2):93-112.
17. Strachan MW, Deary IJ, Ewing FM, Frier BM. Is type II diabetes associated with an increased risk of cognitive dysfunction? A critical review of published studies. Diabetes Care 1997;20(3):438-45.
18. Bozoki A, Giordani B, Heidebrink JL, Berent S, Foster NL. Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss. Arch Neurol 2001;58(3):411.-6.
19. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56(3):303-8.
20. Hanninen T, Soininen H. [Mild cognitive impairment as an early sign of dementia]. Duodecim 1999;I 15(4):381-8.
21. Friedrich MJ. Mild cognitive impairment raises Alzheimer disease risk. Jama 1999;282(7):621-2.
22. Albert SM, Michaels K, Padilla M, Pelton G, Bell K, Marder K, Stem Y, Devanand DP. Functional significance of mild cognitive impairment in elderly patients without a dementia diagnosis. Am J Geriatr Psychiatry 1999;7(3):213-20.
23. Katzman R, Fox. P. The world-wide impact of dementia: projections of prevalence and costs. In: Mayeux R, Christen Y, eds. Epidemiology of Alzheimer's disease:from gene to prevention. Heidelberg: Springer-Verlag, 1999:1-17.
24. Brookmeyer R, Gray S, Kawas C. Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. Am J Public Health 1998;88(9):1337-42.
25. WHO. Definition, dagnosis, and classification of diabetes mellitus and its complications. Report of a WHO consultation Part I : Diagnosis and classification of diabetes mellitus. Geneva, 1999.
26.庞星火,焦淑芳,黄磊,段佳丽,任振勇,刘泽军.北京市居民营养与健康状况调查结果.中华预防医学杂志2005;39(4):269-72.
27.青岛市糖尿病流行病学调查组.青岛地区20～74岁人群糖尿病患病率调查.中华糖尿病杂志2004;12(5):344-7.
28.杨娃,周利锋,郭立燕,高尔生.社区中老年人糖尿病患病及相关知识调查.中国公共卫生2005;21(2):131-3.
29. William D. Dupont WDP. PS: Power and Sample Size Calculation 2004.
30. 张明园。精神定量表手册:湖南科学技术出版社,2003.
31. Katzman R, Zhang MY, Ouang Ya Q, et al. A Chinese version of the Mini-Mental State Examination;impact of illiteracy in a Shanghai dementia survey. J Clin Epidemiol 1988;41 (10):971-8.
32.龚耀先.修订韦氏成人智力量表手册:湖南医学院.1981.
33.临床记忆量表编制协作组.临床记忆量表手册.中国科学院心理研究所,1996.
34. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67(6):361-70.
35. 冀瑞俊,贾建平.糖尿病患者总体认知功能和认知功能域的研究.中国临床康复2004;8(21):4133-5.
36. 赵燕,刘福源.糖尿病所致的认知功能障碍及相关研究.中国心理卫生杂志1999;13(5):314-6.
37. Molloy DW, Standish TI. A guide to the standardized Mini-Mental State Examination. Int Psychogeriatr 1997;9 Suppl 1:87-94;discussion 143-50.
38. Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 1992;40(9):922-35.
39. Helkala EL, Kivipelto M, Hallikainen M, Alhainen K, Heinonen H, Tuomilehto J, Soininen H, Nissinen A. Usefulness of repeated presentation of Mini-Mental State Examination as a diagnostic procedure--a population-based study. Acta Neurol Scand 2002;106(6):341-6.
40. Kelman HR, Thomas C, Kennedy G J, Cheng J. Cognitive impairment and mortality in older community residents. Am J Public Health 1994;84(8): 1255-60.
41. Cukierman T, Gerstein HC, Williamson JD. Cognitive decline and dementia in diabetes--systematic overview of prospective observational studies. Diabetologia 2005;48(12):2460-9.
42. 郭庆科.心理测验的原理与应用.人民军医出版社,北京2002:158-75.
43. Elias PK EM, Robbins MA, Budge MM. Blood pressure-related cognitive decline: does age make a difference? Hypertension 2004;44(5):631-6.
44. Mogi N, Umegaki H, Hattori A, .et al. Cognitive function in Japanese elderly with type 2 diabetes mellitus. J Diabetes Complications 2004;18(1):42-6.
45. Ferguson SC, Deary IJ, Perros P, Evans JC, Ellard S, Hattersley AT, Frier BM. Apolipoprotein-e influences aspects of intellectual ability in type 1 diabetes. Diabetes 2003;52(1): 145-8.
46. Knopman D, Boland LL, Mosley T, Howard G, Liao D, Szklo M, McGovern P, Folsom AR. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology 2001;56(1):42-8.
47. Helkala EL, Niskanen L, Viinamaki H, Partanen J, Uusitupa M. Short-term and long-term memory in elderly patients with NIDDM. Diabetes Care 1995;18(5):681-5.
48. 赵燕,刘福源.Ⅱ型糖尿病患者认知功能的初步研究.中国心理卫生杂志2000;14(1):21-4。
49. 金星,任桂英,许淑莲,等.老年糖尿病患者某些认知功能的临床探讨.中国心理卫 生杂志1999;12(5):310-1.
50. 刘晓芹,安宝富,袁英欣.中年2型糖尿病患者认知功能探讨.临床心身疾病杂志2003;9(1):21-3.
51. 左玲俊,徐俊冕,季建林,等.并发微血管病变的2型糖尿病患者的认知功能研究中国临床心理学杂志2001;9(2):103-5.
52. Bourdel-Marchasson I, Dubroca B, Manciet G, Decamps A, Emeriau JP, Dartigues JF. Prevalence of diabetes and effect on quality of life in older French living in the community: the PAQUID Epidemiological Survey. J Am Geriatr Soc 1997;45(3):295-301.
53. Gregg EW, Yaffe K, Cauley JA, Rolka DB, Blackwell TL, Narayan KM, Cummings SR. Is diabetes associated with cognitive impairment and cognitive decline among older women? Study of Osteoporotic Fractures Research Group. Arch Intern Med 2000;160(2): 174-80.
54. MacKnight C, Rockwood K, Await E, McDowell Ⅰ Diabetes mellitus and the risk of dementia, Alzheimer's disease and vascular cognitive impairment in the Canadian Study of Health and Aging. Dement Geriatr Cogn Disord 2002;14(2):77-83.
55. Fontbonne A, Berr C, Ducimetiere P, Alperovitch A. Changes in cognitive abilities over a 4-year period are unfavorably affected in elderly diabetic subjects: results of the Epidemiology of Vascular Aging Study. Diabetes Care 2001;24(2):366-70.
56. Perlmuter LC, Hakami MK, Hodgson-Harrington C, Ginsberg J, Katz J, Singer DE, Nathan DM. Decreased cognitive function in aging non-insulin-dependent diabetic patients. Am J Med 1984;77(6): 1043-8.
57. Reaven GM, Thompson LW, Nahum D, Haskins E. Relationship between hyperglycemia and cognitive function in older NIDDM patients. Diabetes Care 1990;13(1): 16-21.
58. Perlmuter LC, Tun P, Sizer N, McGlinchey RE, Nathan DM. Age and diabetes related changes in verbal fluency. Exp Aging Res 1987;13(1-2):9-14.
59. Gradman TJ, Laws A, Thompson LW, Reaven GM. Verbal learning and/or memory improves with glycemic control in older subjects with non-insulin-dependent diabetes mellitus. J Am Geriatr Soc 1993;41(12):1305-12.
60. Dey J, Misra A, Desai NG, Mahapatra AK, Padma MV. Cognitive function in younger type Ⅱ diabetes. Diabetes Care 1997;20(1):32-5.
61. 左玲俊,季建林,徐俊冕,等.2型糖尿病患者认知功能相关因素的初步分析中国行为医学科学2001;10(2):95-7.
62. 汪亚珉,韩布新,魏冬捷,李珑,韩瑞英.老年2型糖尿病人记忆损伤特点.中国老年医学杂志2004:24:289-91。
63. ACP, American College of Physicians. ACP's PIER: The Physicians' Information and Education Resource w/AHFS DI Essentials. American College of Physicians 2006:325-45.
64. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001;24(6): 1069-78.
65. de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med 2001;63(4):619-30.
66. Cosway R, Strachan MW, Dougall A, Frier BM, Deary IJ. Cognitive function and information processing in type 2 diabetes. Diabet Med 2001;18(10):803-10.
67. Gregg E, Brown A. Cognitive and Physical Disabilities and Aging-Related Complications of Diabetes. Clinical Diabetes 2003;21:113-8.
68. Nortvedt MW, Riise T, Sanne B. Are men more depressed than women in Norway? Validity of the Hospital Anxiety and Depression Scale. J Psychosom Res 2006;60(2):195-8.
69. Sakamaki H, Ikeda S, Ikegami N, Uchigata Y, Iwamoto Y, Origasa H, Otani T, Otani Y. Measurement of HRQL using EQ-5D in patients with type 2 diabetes mellitus in Japan. Value Health 2006;9(1):47-53.
70. Demiryoguran NS, Karcioglu O, Topacoglu H, Kiyan S, Ozbay D, Onur E, Korkmaz T, Demir OF. Anxiety disorder in patients with non-specific chest pain in the emergency setting. Emerg Med J 2006;23 (2):99-102.
71. Thombs BD, Bass EB, Ford DE, et al. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med 2006;21(1):30-8.
72. Wood RL, Rutterford NA. Psychosocial adjustment 17 years after severe brain injury. J Neurol Neurosurg Psychiatry 2006;77(1):71-3.
73. Tuthill A, Slawik H, O'Rahilly S, Finer N. Psychiatric co-morbidities in patients attending specialist obesity services in the UK. Qjm 2006;99(5):317-25.
74. Meuter F, Thomas W, Gruneklee D, Gries FA, Lohmarm R. Psychometric evaluation of performance in diabetes mellitus. Horm Metab Res Suppl 1980;9:9-17.
75. Robertson-Tchabo EA, Arenberg D, Tobin JD, Plotz JB. A longitudinal study of cognitive performance in noninsulin dependent (type Ⅱ) diabetic men. Exp Gerontol 1986;21(4-5):459-67.
76. Mooradian AD, Perryman K, Fitten J, Kavonian GD, Morley JE. Cortical function in elderly non-insulin dependent diabetic patients. Behavioral and electrophysiologic studies. Arch Intern Med 1988;148(11):2369-72.
77. Cerizza M, Minciotti G, Meregalli S, Garosi V, Crosti PF, Frattola L. Central nervous system involvement in elderly patients with non-insulin-dependent diabetes mellitus. Acta Diabetol Lat 1990;27(4):343-8.
78. Lowe LP, Tranel D, Wallace RB, Welty TK. Type II diabetes and cognitive function. A population-based study of Native Americans. Diabetes Care 1994;17(8):891-6.
79. Atiea JA, Moses JL, Sinclair AJ. Neuropsychological function in older subjects with non-insulin-dependent diabetes mellitus. Diabet Med 1995;12(8):679-85.
80. Gallacher JE, Pickering J, Elwood PC, Bayer AJ, Yarnell JW, Ben-Shlomo Y. Glucoregulation has greater impact on cognitive performance than macro-vascular disease in men with type 2 diabetes: data from the Caerphilly study. Eur J Epidemiol 2005;20(9):761-8.
81. 朱德发,闫晓河,刘红艳.2型糖尿病对认知功能的影响.临床中老年保健 2003;6(2):90-1.
82. 王磊,吴多斌,刘建伟,等.老年期糖尿病与认知功能障碍的关系中国临床康复2002;23(6):3531.
83. 冀瑞俊,贾建平.糖尿病认知障碍的相关因素分析.脑与神经疾病杂志2003;11(2):69-72.
84. 赵晋华,赵佩琴,赵燕,等.2型糖尿病患者局部脑血流灌注与认知功能障碍的关系.中华核医学杂志2001;21(1):49-51.
85. Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology 1999;53(9): 1937-42.
86. Leibson CL, Rocca WA, Hanson VA, Cha R, Kokmen E, O'Brien PC, Palumbo PJ. Risk of dementia among persons with diabetes mellitus: a population-based cohort study. Am J Epidemiol 1997;145(4):301-8.
87. Peila R, Rodriguez BL, Launer LJ. Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies: The Honolulu-Asia Aging Study. Diabetes 2002;51 (4): 1256-62.
88. Luchsinger JA, "Fang MX, Stem Y, Shea S, Mayeux R. Diabetes mellitus and risk of Alzheimer's disease and dementia with stroke in a multiethnic cohort. Am J Epidemiol 2001;154(7):635-41.
89. Yoshitake T, Kiyohara Y, Kato I, et al. Incidence and risk factors of vascular dementia and Alzheimer's disease in a defmed elderly Japanese population: the Hisayama Study. Neurology 1995;45(6): 1161-8.
2. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27(5): 1047-53.
3. Thomas VS, Darvesh S, MacKnight C, Rockwood K. Estimating the prevalence of dementia in elderly people: a comparison of the Canadian Study of Health and Aging and National Population Health Survey approaches. Int Psychogeriatr 2001;13 Supp 1:169-75.
4. Geldmacher DS, Whitehouse PJ. Evaluation of dementia. N Engl J Med 1996;335(5):330-6.
5. Panza F, D'Introno A, Colacicco AM, et al. Current epidemiology of mild cognitive impairment and other predementia syndromes. Am J Geriatr Psychiatry 2005;13(8):633-44.
6. Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST. PRACTICE PARAMETER: EARLY DETECTION OF DEMENTIA: MILD COGNITIVE IMPAIRMENT (AN EVIDENCE-BASED REVIEW), Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001;56: 1133-42.
7.王德全,姜晓丹.老年痴呆患病率及危险因素调查.中国公共卫生 2002;18(12):1498-9.
8.杨健霞,张桂青,仇银全,胡浴恒.新疆石河子地区65岁以上1 230人老年痴呆流行病学调查.中国临床康复2003;7(28):3848-50.
9.费伟民,程鎏,王玉梅,胡喜荣,孙才坚,高之旭.上海市卢湾区一个社区老年期痴呆患病率分析.四川精神卫生2001;14(1):31-2.
10. Kouta Y, Sakurai T, Yokono K. [Cognitive dysfunction and dementia associated with elderly diabetes]. Nippon Rinsho 2006;64(1):119-23.
11. Cassel CK. GERIATRIC MEDICINE: AN EVIDENCE BASED APPROACH-4th Ed: Springer-Verlag New York, Inc., 2003.
12. Sasaki N, Toki S, Chowei H, Saito T, Nakano N, Hayashi Y, Takeuchi M, Makita Z. Immunohistochemical distribution of the receptor for advanced glycation end products in neurons and astrocytes in Alzheimer's disease. Brain Res 2001;888(2):256-62.
13. Qiu WQ, Folstein MF. Insulin, insulin-degrading enzyme and amyloid-beta peptide in Alzheimer's disease: review and hypothesis. Neurobiol Aging 2006;27(2): 190-8.
14. Janson J, Laedtke T, Parisi JE, O'Brien P, Petersen RC, Butler PC. Increased risk of type 2 diabetes in Alzheimer disease. Diabetes 2004;53(2):474-81.
15. Allen KV, Frier BM, Strachan MW. The relationship between type 2 diabetes and cognitive dysfunction: longitudinal studies and their methodological limitations. Eur J Pharmacol 2004;.490(1-3): 169-75.
16. Stewart R, Liolitsa D. Type 2 diabetes mellitus, cognitive impairment and dementia. Diabet Med 1999;16(2):93-112.
17. Strachan MW, Deary IJ, Ewing FM, Frier BM. Is type II diabetes associated with an increased risk of cognitive dysfunction? A critical review of published studies. Diabetes Care 1997;20(3):438-45.
18. Bozoki A, Giordani B, Heidebrink JL, Berent S, Foster NL. Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss. Arch Neurol 2001;58(3):411.-6.
19. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56(3):303-8.
20. Hanninen T, Soininen H. [Mild cognitive impairment as an early sign of dementia]. Duodecim 1999;I 15(4):381-8.
21. Friedrich MJ. Mild cognitive impairment raises Alzheimer disease risk. Jama 1999;282(7):621-2.
22. Albert SM, Michaels K, Padilla M, Pelton G, Bell K, Marder K, Stem Y, Devanand DP. Functional significance of mild cognitive impairment in elderly patients without a dementia diagnosis. Am J Geriatr Psychiatry 1999;7(3):213-20.
23. Katzman R, Fox. P. The world-wide impact of dementia: projections of prevalence and costs. In: Mayeux R, Christen Y, eds. Epidemiology of Alzheimer's disease:from gene to prevention. Heidelberg: Springer-Verlag, 1999:1-17.
24. Brookmeyer R, Gray S, Kawas C. Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. Am J Public Health 1998;88(9):1337-42.
25. WHO. Definition, dagnosis, and classification of diabetes mellitus and its complications. Report of a WHO consultation Part I : Diagnosis and classification of diabetes mellitus. Geneva, 1999.
26.庞星火,焦淑芳,黄磊,段佳丽,任振勇,刘泽军.北京市居民营养与健康状况调查结果.中华预防医学杂志2005;39(4):269-72.
27.青岛市糖尿病流行病学调查组.青岛地区20～74岁人群糖尿病患病率调查.中华糖尿病杂志2004;12(5):344-7.
28.杨娃,周利锋,郭立燕,高尔生.社区中老年人糖尿病患病及相关知识调查.中国公共卫生2005;21(2):131-3.
29. William D. Dupont WDP. PS: Power and Sample Size Calculation 2004.
30. 张明园。精神定量表手册:湖南科学技术出版社,2003.
31. Katzman R, Zhang MY, Ouang Ya Q, et al. A Chinese version of the Mini-Mental State Examination;impact of illiteracy in a Shanghai dementia survey. J Clin Epidemiol 1988;41 (10):971-8.
32.龚耀先.修订韦氏成人智力量表手册:湖南医学院.1981.
33.临床记忆量表编制协作组.临床记忆量表手册.中国科学院心理研究所,1996.
34. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67(6):361-70.
35. 冀瑞俊,贾建平.糖尿病患者总体认知功能和认知功能域的研究.中国临床康复2004;8(21):4133-5.
36. 赵燕,刘福源.糖尿病所致的认知功能障碍及相关研究.中国心理卫生杂志1999;13(5):314-6.
37. Molloy DW, Standish TI. A guide to the standardized Mini-Mental State Examination. Int Psychogeriatr 1997;9 Suppl 1:87-94;discussion 143-50.
38. Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 1992;40(9):922-35.
39. Helkala EL, Kivipelto M, Hallikainen M, Alhainen K, Heinonen H, Tuomilehto J, Soininen H, Nissinen A. Usefulness of repeated presentation of Mini-Mental State Examination as a diagnostic procedure--a population-based study. Acta Neurol Scand 2002;106(6):341-6.
40. Kelman HR, Thomas C, Kennedy G J, Cheng J. Cognitive impairment and mortality in older community residents. Am J Public Health 1994;84(8): 1255-60.
41. Cukierman T, Gerstein HC, Williamson JD. Cognitive decline and dementia in diabetes--systematic overview of prospective observational studies. Diabetologia 2005;48(12):2460-9.
42. 郭庆科.心理测验的原理与应用.人民军医出版社,北京2002:158-75.
43. Elias PK EM, Robbins MA, Budge MM. Blood pressure-related cognitive decline: does age make a difference? Hypertension 2004;44(5):631-6.
44. Mogi N, Umegaki H, Hattori A, .et al. Cognitive function in Japanese elderly with type 2 diabetes mellitus. J Diabetes Complications 2004;18(1):42-6.
45. Ferguson SC, Deary IJ, Perros P, Evans JC, Ellard S, Hattersley AT, Frier BM. Apolipoprotein-e influences aspects of intellectual ability in type 1 diabetes. Diabetes 2003;52(1): 145-8.
46. Knopman D, Boland LL, Mosley T, Howard G, Liao D, Szklo M, McGovern P, Folsom AR. Cardiovascular risk factors and cognitive decline in middle-aged adults. Neurology 2001;56(1):42-8.
47. Helkala EL, Niskanen L, Viinamaki H, Partanen J, Uusitupa M. Short-term and long-term memory in elderly patients with NIDDM. Diabetes Care 1995;18(5):681-5.
48. 赵燕,刘福源.Ⅱ型糖尿病患者认知功能的初步研究.中国心理卫生杂志2000;14(1):21-4。
49. 金星,任桂英,许淑莲,等.老年糖尿病患者某些认知功能的临床探讨.中国心理卫 生杂志1999;12(5):310-1.
50. 刘晓芹,安宝富,袁英欣.中年2型糖尿病患者认知功能探讨.临床心身疾病杂志2003;9(1):21-3.
51. 左玲俊,徐俊冕,季建林,等.并发微血管病变的2型糖尿病患者的认知功能研究中国临床心理学杂志2001;9(2):103-5.
52. Bourdel-Marchasson I, Dubroca B, Manciet G, Decamps A, Emeriau JP, Dartigues JF. Prevalence of diabetes and effect on quality of life in older French living in the community: the PAQUID Epidemiological Survey. J Am Geriatr Soc 1997;45(3):295-301.
53. Gregg EW, Yaffe K, Cauley JA, Rolka DB, Blackwell TL, Narayan KM, Cummings SR. Is diabetes associated with cognitive impairment and cognitive decline among older women? Study of Osteoporotic Fractures Research Group. Arch Intern Med 2000;160(2): 174-80.
54. MacKnight C, Rockwood K, Await E, McDowell Ⅰ Diabetes mellitus and the risk of dementia, Alzheimer's disease and vascular cognitive impairment in the Canadian Study of Health and Aging. Dement Geriatr Cogn Disord 2002;14(2):77-83.
55. Fontbonne A, Berr C, Ducimetiere P, Alperovitch A. Changes in cognitive abilities over a 4-year period are unfavorably affected in elderly diabetic subjects: results of the Epidemiology of Vascular Aging Study. Diabetes Care 2001;24(2):366-70.
56. Perlmuter LC, Hakami MK, Hodgson-Harrington C, Ginsberg J, Katz J, Singer DE, Nathan DM. Decreased cognitive function in aging non-insulin-dependent diabetic patients. Am J Med 1984;77(6): 1043-8.
57. Reaven GM, Thompson LW, Nahum D, Haskins E. Relationship between hyperglycemia and cognitive function in older NIDDM patients. Diabetes Care 1990;13(1): 16-21.
58. Perlmuter LC, Tun P, Sizer N, McGlinchey RE, Nathan DM. Age and diabetes related changes in verbal fluency. Exp Aging Res 1987;13(1-2):9-14.
59. Gradman TJ, Laws A, Thompson LW, Reaven GM. Verbal learning and/or memory improves with glycemic control in older subjects with non-insulin-dependent diabetes mellitus. J Am Geriatr Soc 1993;41(12):1305-12.
60. Dey J, Misra A, Desai NG, Mahapatra AK, Padma MV. Cognitive function in younger type Ⅱ diabetes. Diabetes Care 1997;20(1):32-5.
61. 左玲俊,季建林,徐俊冕,等.2型糖尿病患者认知功能相关因素的初步分析中国行为医学科学2001;10(2):95-7.
62. 汪亚珉,韩布新,魏冬捷,李珑,韩瑞英.老年2型糖尿病人记忆损伤特点.中国老年医学杂志2004:24:289-91。
63. ACP, American College of Physicians. ACP's PIER: The Physicians' Information and Education Resource w/AHFS DI Essentials. American College of Physicians 2006:325-45.
64. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001;24(6): 1069-78.
65. de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med 2001;63(4):619-30.
66. Cosway R, Strachan MW, Dougall A, Frier BM, Deary IJ. Cognitive function and information processing in type 2 diabetes. Diabet Med 2001;18(10):803-10.
67. Gregg E, Brown A. Cognitive and Physical Disabilities and Aging-Related Complications of Diabetes. Clinical Diabetes 2003;21:113-8.
68. Nortvedt MW, Riise T, Sanne B. Are men more depressed than women in Norway? Validity of the Hospital Anxiety and Depression Scale. J Psychosom Res 2006;60(2):195-8.
69. Sakamaki H, Ikeda S, Ikegami N, Uchigata Y, Iwamoto Y, Origasa H, Otani T, Otani Y. Measurement of HRQL using EQ-5D in patients with type 2 diabetes mellitus in Japan. Value Health 2006;9(1):47-53.
70. Demiryoguran NS, Karcioglu O, Topacoglu H, Kiyan S, Ozbay D, Onur E, Korkmaz T, Demir OF. Anxiety disorder in patients with non-specific chest pain in the emergency setting. Emerg Med J 2006;23 (2):99-102.
71. Thombs BD, Bass EB, Ford DE, et al. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med 2006;21(1):30-8.
72. Wood RL, Rutterford NA. Psychosocial adjustment 17 years after severe brain injury. J Neurol Neurosurg Psychiatry 2006;77(1):71-3.
73. Tuthill A, Slawik H, O'Rahilly S, Finer N. Psychiatric co-morbidities in patients attending specialist obesity services in the UK. Qjm 2006;99(5):317-25.
74. Meuter F, Thomas W, Gruneklee D, Gries FA, Lohmarm R. Psychometric evaluation of performance in diabetes mellitus. Horm Metab Res Suppl 1980;9:9-17.
75. Robertson-Tchabo EA, Arenberg D, Tobin JD, Plotz JB. A longitudinal study of cognitive performance in noninsulin dependent (type Ⅱ) diabetic men. Exp Gerontol 1986;21(4-5):459-67.
76. Mooradian AD, Perryman K, Fitten J, Kavonian GD, Morley JE. Cortical function in elderly non-insulin dependent diabetic patients. Behavioral and electrophysiologic studies. Arch Intern Med 1988;148(11):2369-72.
77. Cerizza M, Minciotti G, Meregalli S, Garosi V, Crosti PF, Frattola L. Central nervous system involvement in elderly patients with non-insulin-dependent diabetes mellitus. Acta Diabetol Lat 1990;27(4):343-8.
78. Lowe LP, Tranel D, Wallace RB, Welty TK. Type II diabetes and cognitive function. A population-based study of Native Americans. Diabetes Care 1994;17(8):891-6.
79. Atiea JA, Moses JL, Sinclair AJ. Neuropsychological function in older subjects with non-insulin-dependent diabetes mellitus. Diabet Med 1995;12(8):679-85.
80. Gallacher JE, Pickering J, Elwood PC, Bayer AJ, Yarnell JW, Ben-Shlomo Y. Glucoregulation has greater impact on cognitive performance than macro-vascular disease in men with type 2 diabetes: data from the Caerphilly study. Eur J Epidemiol 2005;20(9):761-8.
81. 朱德发,闫晓河,刘红艳.2型糖尿病对认知功能的影响.临床中老年保健 2003;6(2):90-1.
82. 王磊,吴多斌,刘建伟,等.老年期糖尿病与认知功能障碍的关系中国临床康复2002;23(6):3531.
83. 冀瑞俊,贾建平.糖尿病认知障碍的相关因素分析.脑与神经疾病杂志2003;11(2):69-72.
84. 赵晋华,赵佩琴,赵燕,等.2型糖尿病患者局部脑血流灌注与认知功能障碍的关系.中华核医学杂志2001;21(1):49-51.
85. Ott A, Stolk RP, van Harskamp F, Pols HA, Hofman A, Breteler MM. Diabetes mellitus and the risk of dementia: The Rotterdam Study. Neurology 1999;53(9): 1937-42.
86. Leibson CL, Rocca WA, Hanson VA, Cha R, Kokmen E, O'Brien PC, Palumbo PJ. Risk of dementia among persons with diabetes mellitus: a population-based cohort study. Am J Epidemiol 1997;145(4):301-8.
87. Peila R, Rodriguez BL, Launer LJ. Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies: The Honolulu-Asia Aging Study. Diabetes 2002;51 (4): 1256-62.
88. Luchsinger JA, "Fang MX, Stem Y, Shea S, Mayeux R. Diabetes mellitus and risk of Alzheimer's disease and dementia with stroke in a multiethnic cohort. Am J Epidemiol 2001;154(7):635-41.
89. Yoshitake T, Kiyohara Y, Kato I, et al. Incidence and risk factors of vascular dementia and Alzheimer's disease in a defmed elderly Japanese population: the Hisayama Study. Neurology 1995;45(6): 1161-8.