Clinical study of mild cognitive impairment in elderly patients with nonvalvular atrial fibrillation
投稿时间:2021-03-12  修订日期:2021-08-22
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Key words:elderly  non-valvular atrial fibrillation  mild cognitive impairment
杨艺 华中科技大学同济医学院附属同济医院综合医疗科 
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      Objective To investigate the relationship between non-valvular atrial fibrillation and mild cognitive impairment (MCI) in the elderly. Methods A retrospective analysis was made of 104 elderly hospitalized patients who met the requirements and they were divided into atrial fibrillation group (52 cases) and non-atrial fibrillation group (also 52 cases). Cognitive function was assessed using Mini-Mental State Evaluation Scale (MMSE) and Montreal Cognition Assessment Scale (MoCA). Statistical methods were used to analyze the detection rate, clinical characteristics and risk factors of MCI between the groups. Results MMSE score was (27.56?1.82) and MoCA score was (24.14?3.41) in the atrial fibrillation group, which were significantly lower than those of the non-atrial fibrillation group. Moreover, the detection rate of MCI in the atrial fibrillation group was significantly higher against the non-atrial fibrillation group (MMSE: 38.46% vs 7.69%; MoCA: 61.54% vs 30.77%). Using the MoCA scale to evaluate 7 sub-cognitive domains, which showed that the orientation ability, visual space and executive function, language ability, and abstract summary ability of patients in the atrial fibrillation group were worse compared with non-atrial fibrillation group, the difference being statistically significant (P<0.05). Univariate analysis showed that atrial fibrillation, hypertension, hyperlipidemia, age, education level, alcohol consumption and diabetes had influence on MoCA’s assessment of MCI, while atrial fibrillation, hypertension, hyperlipidemia, age and education level had influence on MMSE’s assessment of MCI. A positive MoCA assessment was defined as MCI patients, and five risk factors (atrial fibrillation, hypertension, hyperlipidemia, age and education level) were selected as independent variables substituting Logistic regression analysis.The results showed that atrial fibrillation is an independent risk factor for MCI (OR 3.163, 95%CI 1.190-8.406). Conclusion MCI is much more common in elderly non-valvular atrial fibrillation patients and their cognitive dysfunction features mainly in orientation, visual space and executive function, speech function and abstract thinking. Age, education level, and hypertension have influence on MCI. Atrial fibrillation is an independent risk factor for MCI. Effective management of risk factors such as atrial fibrillation can play a positive role in the prevention of MCI.