| Vascular cognitive impairment is one of the cognitive impairment diseases,and it is also one of the diseases that can be intervened in advance to delay or even prevent the occurrence and development of the disease.It refers to a kind of clinical syndrome caused by cerebrovascular disease and its risk factors,involving at least one cognitive domain damage.This concept highlights the importance of vascular risk factors in the pathogenesis of vascular cognitive impairment,and prompts us to further explore and discover various risk factors leading to the disease,so as to prevent and alleviate cognitive symptoms in a timely manner.The pathogenesis of this disease is still unclear,and there is currently a lack of specific drugs for the treatment of this disease.However,early intervention on the controllable risk factors of vascular cognitive impairment can not only delay or even prevent the occurrence of cognitive impairment,but also has great significance in improving the quality of life of patients and reducing the burden on families.This article mainly analyzes the prevalence of the disease and related risk factors through epidemiological investigation,and provides a certain theoretical basis for the intervention of the disease.The full text is divided into two parts.Part I:Literature ReviewThe literature review is divided into two parts,including the understanding of vascular cognitive impairment in Traditional Chinese Medicine and Western medicine.The first part discusses the name,etiology,pathogenesis,syndrome differentiation and treatment of Traditional Chinese Medicine on vascular cognitive impairment,and the treatment of Traditional Chinese Medicine.The second part discusses the overview,classification,epidemiology,pathogenesis and related factors of vascular cognitive impairment in western medicine and the prevention and treatment of this disease.Part II:Clinical ResearchObjective:To analyze the epidemiological situation of vascular cognitive impairment in natural population in Beijing community through epidemiological investigation,and to understand the prevalence rate and related risk factors of the disease and its relationship with kidney-yang deficiency,so as to provide a certain theoretical basis and thinking methods for the prevention and treatment of this disease.Methods:The method of cluster sampling was used to select the natural population aged 40 and above in three communities,including Ganjiakou Community Health Service Center,Aviation Materials Institute Community Health Service Center,and Beitaipingzhuang Community Health Service Center,Haidian District,Beijing,as the survey objects.2150 questionnaires were collected,and 2078 people were finally included in the study.From September 2020 to October 2021,face-to-face questionnaires were conducted in designated places in various communities.The questionnaires included basic information of the respondents,past history,Hamilton Depression Scale(HAMD)assessment,and cognitive ability self-rating scale(AD8),Montreal Cognitive Assessment(Beijing Version)(MOCA),Self-rating Scale for Kidney-Yang Deficiency Syndrome,etc.SPSS 26.0 software was used for statistical analysis of the data,and the chi-square test was used to analyze the relationship between the prevalence of vascular cognitive impairment and different demographic data,lifestyle,family history,and past history.Univariate unconditional Logistic regression analysis and multivariate unconditional Logistic regression analysis were used to analyze the related factors of vascular cognitive impairment.Statistical significance was established with P<0.05.Results:(1)Among the 2078 subjects included in this study,822 were male,accounting for 39.6%;1256 were female,accounting for 60.4%.Among them,the youngest is 40 years old,the oldest is 90 years old,and the average age is 67 years old.The number of patients with vascular cognitive impairment in this study was 173,with a prevalence rate of 8.3%.Among them,the male prevalence rate was 8.4%,and the female prevalence rate was 8.3%,and the difference was not statistically significant(χ2=0.008,P>0.05).Taking 10 years as an age group,the age of the respondents was divided into 5 groups.The prevalence rates of VCI in each group from 40 years old to 90 years old were:2.9%,3.4%,6.9%,11.3%,and 16.6%,respectively.With the increase of age,the prevalence gradually increased,and the difference was statistically significant(χ2=44.937,P<0.05).(2)The chi-square test results show that:among demographic characteristics,educational level(χ2=11.053,P<0.05),marital status(χ2=7.404,P<0.05),annual income(χ2=14.807,P<0.05),etc.were related to the prevalence of vascular cognitive impairment,and the difference was statistically significant.There was no significant difference in the prevalence of ethnicity,length of service,and type of work(P>0.05).In lifestyle,exercise(χ2=8.951,P<0.05),meat and vegetarian(χ2=15.752,P<0.05),frequency of eating vegetables(χ2=21.231,P<0.05)and frequency of eating fruit(χ2=23.860,P<0.05)were related to the prevalence of vascular cognitive impairment,and the difference was statistically significant.There was no significant difference in smoking,drinking,diet taste and other factors(P>0.05).In the family history,the family history of hypertension(χ2=6.554,P<0.05)and the family history of stroke(χ2=13.670,P<0.05)have a statistical difference in the prevalence of vascular cognitive impairment.However,there was no statistical significance in the prevalence of family history of senile dementia,family history of osteoporosis,family history of coronary heart disease,family history of tumor and family history of diabetes(P>0.05).In the past history,cerebrovascular disease(χ2=34.054,P<0.05),heart disease(χ2=11,107,P<0.05),hypertension(χ2=19.401,P<0.05),dyslipidemia(χ2=11.479,P<0.05),diabetes(χ2=8.702,P<0.05),folic acid and/or vitamin B12 deficiency(χ2=8.126,P<0.05)were all statistically significant in prevalence,decreased thyroid function(χ2=1.479,P>0.05)was not statistically significant.Among the Traditional Chinese Medicine syndrome types,the prevalence rates of vascular cognitive impairment belonging to three types:kidneyyang deficiency,tending kidney-yang deficiency,and non-kidney-yang deficiency were 13.6%,6.3%,and 2.6%,respectively,and the differences were statistically significant(χ2=62.105,P<0.05).(3)Univariate unconditional Logistic regression analysis showed that there were 14 factors related to the prevalence of vascular cognitive impairment(P<0.05):age,marital status,educational level,exercise status,meat and vegetarian status,Weekly frequency of eating fruit,family history of hypertension,family history of stroke,history of cerebrovascular disease,history of heart disease,hypertension,dyslipidemia,diabetes,folic acid and/or vitamin B12 deficiency,etc.The results of multivariate unconditional Logistic regression analysis showed that high educational level(OR=0.483,95%CI:0.256-0.912)may be a protective factor for vascular cognitive impairment,while advanced age,a partial vegetarian diet,a lack of fruit,and a Family history of stroke,cerebrovascular disease,and diabetes may be independent risk factors for vascular cognitive impairment.Among them,the risk of vascular cognitive impairment in the elderly(over 80 years old)is 4 times that of the middle-aged group(40-50 years old)(OR=4.270,95%CI:1.419-12.848);The risk of the disease was twice that of the meat-loving population(OR=2.266,95%CI:1.106-4.642);the risk of the disease in the population who ate fruit ≤2 days per week was about 2 times that of the population who ate fruit≥5 days per week(OR=1.687,95%CI:1.079-2.635);people with a family history of stroke are at higher risk than those without family history(OR=1.555,95%CI.1.077-2.246);people with cerebrovascular disease The risk of the disease was twice as high as that of people without a history of cerebrovascular disease(OR=2.276,95%CI:1.476-3.509);people with diabetes had a higher risk than those without diabetes(OR=1.449,95%CI:1.006-2.086).Conclusion:(1)The prevalence rate of vascular cognitive impairment in the natural population aged 40 years and above in three communities in Haidian District,Beijing was 8.3%.(2)Old age,poor marital status,lack of exercise,partial vegetarian diet,dislike of fruits,family history of hypertension,family history of stroke,history of cerebrovascular disease,history of heart disease,hypertension,dyslipidemia,diabetes,folic acid,and/or vitamins B12 deficiency may be the risks factor for vascular cognitive impairment,and high literacy levels may be its protective factor.The above risk factors should be paid special attention in the prevention and treatment of VCI.(3)Through simple syndrome differentiation,the prevalence of VCI is the highest among people with kidney-yang deficiency,suggesting that kidney-yang deficiency may play an important role in the occurrence and development of VCI.However,the scientific connotation of kidney-yang deficiency still needs further research to find its specific biological markers to lay a foundation for clarifying its role in the occurrence and development of VCI. |
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