Study On The Detection Rate And Risk Factors Of Vascular Cognitive Impairment Not Dementia In Silent Brain Infarction Patients

ObjectiveWith the growing problem of aging population,dementia has become a major health issue faced by human.Dementia not only gives rise to serious mental and economic pressure to patients and their families,but also brings a burden to the society.Vascular Cognitive Impairment(VCI)is the most common senile dementia in the epidemiology besides Alzheimer’s Disease(AD),and Vascular Cognitive Impairment with not Dementia(VCIND)is considered to be the early event of VCI.Therefore,if the potential VCI patients can be detected and diagnosed at early stage,a corresponding early intervention can prevent them from progression to dementia to some extent.The wide utilization of the skull CT,such as MRI,has significantly increased the detection rate of silent brain infarction,especially for the olders.Because of the increase of the risk that SBI patients’ overall decline of their cognitive function,it becomes a urgent demand to clarify their overall cognitive level and identify the patients who have cognitive dysfunction at an early stage.These can help to identify the focus group who need cognitive intervention and to analyse the high risk factors which damage the cognition,and these findings provide scientific basis for formulating effective prevention of cognitive impairment and the measures of intervention of clinical treatment.Method:1.We selected 246 patients from 2019 to 2020 in our hospital who were diagnosed with SBI.Patients are investigated by questionnaire,including natural factors such as age,gender,body mass index and years of education,lifestyles such as smoking and drinking,and clinical histories they may have such as diabetes,hypertension,etc.Moreover,all of them need to carry out a blood biochemical test,which inspects blood lipid,serum uric acid,plasma homocysteine and so on.The cognitive function of patients was assessed by the screening evaluation results of Montreal Cognitive Assessment(Mo CA)Beijing version.2.Use SPSS 23.0 statistical software for data processing.The statistical methods are as follows: statistical description with relative number,variance analysis,t test for difference analysis,multi-factor linear regression and logistic regression for correlation analysis.Results:1.Current status of cognitive impairment in SBI.(1)Incidence of VCIND was 38.2%.(2)The cognitive level of all enrolled patients decreased.2.Analysis of risk factors in cognitive impairment.(1)Univariate analysis:⑴ The shorter the years of education,the higher the incidence of cognitive impairment.The incidence of cognitive impairment between men and women was the same.⑵Smoking declines the Mo CA score of the SBI patients.⑶Hypertension,high plasma homocysteine and high blood uric acid are all risk factors for SBI,and the incidence of SBI is significantly increased.Mo CA score significantly decreased..(2)multi-factor: BMI,hyperuricemia,TC,TG and LDL-C were the main factors affecting MOCA score,and were negatively correlated with MOCA score.Conclusion:1.The overall cognitive level of SBI declined.2.Smoking declines the Mo CA score of the SBI patients more easily if they have an older age or a lower level of education;3.Hyperlipidemia,high plasma homocysteine and hyperuricemia are all risk factors for VCIND in SBI.4.Multi-factor analysis in SBI patients found that years of education,hypertension,,high plasma homocysteine,hyperuricemia and age may be independent risk factors for VCIND in SBI.