老年认知功能障碍的影响因素及蓝莓花色苷干预研究

发布时间：2018-10-17 12:06

【摘要】：目的调查天津市老年人认知功能障碍(cognitive impairment, CI)患病率,并分析其影响因素；探究载脂蛋白E基因多态性和老年认知功能的相关性；观察蓝莓花色苷对轻度认知功能障碍(mild cognitive impairment, MCI)患者认知功能及炎性因子分泌的影响,为老年痴呆症早期营养干预措施的制订提供科学依据。方法 1.采用横断面研究,调查505名天津市老年人CI患病率,并分析其影响因素。 2.采用聚合酶链式反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism, PCR-RFLP)方法随机检测160名天津市老年人的ApoE基因型,采用简易精神状态量表(mini-mental state examination, MMSE)、基本认知能力(Basic cognitive aptitude test,BCAT)软件测试老年人的认知功能,并分析ApoEε4基因对老年人认知功能及CI患病率的影响。 3.以筛查出的MCI患者46人为研究对象,分为干预组和对照组,每组各23人,分别给予蓝莓花色苷冲剂和饮用水,连续干预12周。研究对象均知情同意。采用BCAT测试软件、视觉反应测试及数字记忆广度测试检测认知功能,采用酶联免疫法(ELISA)检测血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)浓度。结果 1.505名调查对象的CI患病率为25.90%,主要影响因素为年龄、锻炼时间和收入水平,其中年龄是CI患病的危险因素,锻炼时间、收入水平是CI患病的保护因素；天津市老年人认知功能的主要影响因素为文化程度、锻炼时间、饮水量、收入水平、年龄和日常生活活动能力,文化程度、锻炼时间、饮水量、收入水平与MMSE分数呈正相关,而年龄、ADL分数与MMSE分数呈负相关。 2.160名调查对象中携带ApoEε4基因者35人,主要影响老年人的整体认知功能、知觉速度和工作记忆；携带ApoEs4基因者MMSE分数、BCAT分测试知觉速度和工作记忆得分及BCAT测试总分显著低于非携带ApoEε4基因者,差异有统计学意义(p0.05),且CI患者的ApoEε4基因携带率明显高于非CI患者,差异有统计学意义(p0.05)。 3.与干预前比较,蓝莓花色苷干预组老人BCAT测试总分、知觉速度、心算效率、空间表象效率及工作记忆分测试得分均明显提高,差异有统计学意义(p0.05),同时数字记忆广度测试得分明显提高,差异有统计学意义(p0.05),血清IL-6、TNF-α浓度无明显变化；与对照组比较,干预组老人空间表象效率、工作记忆、记忆再认分测试得分及BCAT测试总分明显提高,差异有统计学意义(p0.05),视觉反应测试中随机奇偶反应时明显缩短,差异有统计学意义(p0.05),血清IL-6、TNF-α浓度无明显变化。结论文化程度、锻炼时间、饮水量、收入水平、年龄和日常生活活动能力以及ApoEs4基因是影响老年认知功能的主要因素；蓝莓花色苷干预可明显改善MCI患者的认知功能。
[Abstract]:Objective to investigate the prevalence of (cognitive impairment, CI) in the elderly with cognitive dysfunction in Tianjin and analyze its influencing factors, and to explore the correlation between apolipoprotein E gene polymorphism and cognitive function in the elderly. To observe the effect of blueberry anthocyanin on cognitive function and inflammatory factor secretion in patients with mild cognitive impairment (mild cognitive impairment, MCI) and to provide scientific basis for early nutritional intervention in Alzheimer's disease. Method 1. A cross-sectional study was conducted to investigate the prevalence of CI in 505 elderly people in Tianjin and to analyze its influencing factors. Polymerase chain reaction-restriction fragment length polymorphism (polymerase chain reaction-restriction fragment length polymorphism, PCR-RFLP) was used to detect ApoE genotypes in 160 elderly people in Tianjin. The simple mental state scale (mini-mental state examination, MMSE), basic cognitive ability (Basic cognitive aptitude test,BCAT) was used to test the cognitive function of the elderly, and the effect of ApoE 蔚 4 gene on the cognitive function and the prevalence of CI was analyzed. 3. Forty-six patients with MCI were divided into intervention group (n = 23) and control group (n = 23). They were treated with blueberry anthocyanin granules and drinking water for 12 weeks. All the subjects were informed and agreed. BCAT test software, visual response test and digital memory span test were used to detect cognitive function. Serum interleukin-6 (interleukin-6,IL-6), tumor necrosis factor- 伪 (TNF- 伪) and serum levels of interleukin-6 (interleukin-6,IL-6) and tumor necrosis factor- 伪 (TNF- 伪) were detected by enzyme linked immunosorbent assay (ELISA). Results the prevalence rate of CI in 1.505 subjects was 25.90. The main influencing factors were age, exercise time and income level, among which age was the risk factor of CI disease, exercise time and income level were the protective factors of CI. The main factors influencing the cognitive function of the elderly in Tianjin were education level, exercise time, drinking water, income level, age and ability of daily life activities, education level, exercise time, drinking water, income level and MMSE score. Age, ADL score and MMSE score were negatively correlated. 35 subjects with ApoE 蔚 4 gene carried ApoE 蔚 4 gene in 2.160 subjects, which mainly affected the overall cognitive function, perceptual speed and working memory of the elderly. The MMSE score, BCAT score and total BCAT score of patients with ApoEs4 gene were significantly lower than those without ApoE 蔚 4 gene (p0.05), and the ApoE 蔚 4 gene carrying rate of CI patients was significantly higher than that of non-CI patients. The difference was statistically significant (p0.05). Compared with those before intervention, the total score of BCAT, the rate of perception, the efficiency of mental arithmetic, the efficiency of spatial representation and the score of working memory of the elderly in the blueberry anthocyanin intervention group were significantly improved. The difference was statistically significant (p0. 05), and the scores of digital memory span test were significantly improved (p0. 05), the serum IL-6,TNF- 伪 concentration was not changed significantly, compared with the control group, the elderly in the intervention group had the spatial representation efficiency and working memory. The score of memory recognition test and the total score of BCAT test were significantly increased (p0.05), the time of random odd-even reaction was shortened significantly in visual response test (p0.05), the difference was statistically significant (p0.05), the concentration of serum IL-6,TNF- 伪 did not change significantly. Conclusion Education level, exercise time, drinking water, income level, age, ability of daily life and ApoEs4 gene are the main factors affecting cognitive function of the elderly. Blueberry anthocyanin intervention can significantly improve the cognitive function of MCI patients.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.2

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