Prevalence, Influence Factors and Cognitive Characteristics of Vascular Mild Cognitive Impairment and Vascular Dementia In Hypertension

2020 
Background: Hypertension is considered as an independent risk factor for vascular mild cognitive impairment (vMCI) and vascular dementia (VaD). This study was performed to investigate the prevalence, influencing factors, and cognitive characteristics of vMCI and VaD in elderly patients with hypertension in China. Methods: In the cross-sectional study, we performed a cluster random sampling of 3246 people age 60 years and older across the country. All participants were interviewed and screened for hypertension. Among the 1495 hypertensive patients, 57 were diagnosed with vMCI and 48 with VaD according to the criteria of Petersen and DSM-IV, respectively. Logistic regression analyses were performed to evaluate risk and protective factors for vMCI and VaD with Hypertension. And we also assessed their cognitive function by a series of neuropsychological tests. Results: We finally found that: 1) the prevalence of vMCI and VaD in hypertension was 3.8% and 3.2%, respectively, which was much higher than that of normal controls (p<0.05). 2)Multivariate logistic regression analyses showed that advanced age (p<0.001, OR=1.066, 95%CI: 1.030~1.104), sleep too little (p=0.011, OR=2.279, 95%CI: 1.210~4.291) and physical discomfort (p<0.001, OR=6.380, 95%CI: 2.956~13.774) were the risk factors for the development of vMCI in patients with hypertension; advanced age (p=0.002, OR=1.061, 95%CI: 1.021~1.011), physical discomfort (p=0.005, OR=3.922, 95%CI: 1.506~10.214) and depressive symptoms (p<0.001, OR=8.363, 95%CI: 3.023~23.138) were also the risk factor for VaD, while education (p=0.040, OR=0.941, 95%CI: 0.888~0.997), tea drinker (p=0.017, OR=0.483, 95%CI: 0.266~0.878) as well as take exercise (p=0.003, OR=0.416, 95%CI: 0.234~0.737) were protective factors of VaD;3) both overall and specific areas of cognitive function decrease in hypertension patients with vMCI and VaD, and show a gradual trend of aggravation. Conclusions: In summary, the prevalence of vMCI and VaD in patients with hypertension is much higher than that in the normal control group. Preventive strategies for vMCI and VD are needed to enhance lifestyle factors that promote brain health. Funding Statement: This work was supported by grants from Clinical research center project of Shanghai Mental Health Center (CRC2017ZD02), the Cultivation of Multidisciplinary Interdisciplinary Project in Shanghai Jiaotong University (YG2019QNA10), curriculum reform of Medical College of Shanghai Jiaotong University, the Feixiang Program of Shanghai Mental Health Center(2020-FX-03). Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: This study was conducted by the principles of Declaration of Helsinki. The Research Ethical Committee of the affiliated mental health center of Shanghai Jiaotong University School of Medicine approved this study and written informed consent was obtained from all participants before the study was initiated.
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