Montreal Cognitive Assessment And Analysis Of Related Factors For Cognitive Impairment In Patients With Chronic Cerebral Circulation Insufficiency

Objective: To investigate the occurrence characteristics and related risk factors ofpatients with chronic cerebral circulation insufficiency(CCCI). To provide evidence forearly diagnosis and establishment of intervention measures.Methods: One hundred and two patients met for the criteria of CCCI were chosenwho have been treated in neurology clinic and hospital of the First Affiliated Hospital ofDalian Medical University from October2011to September2012. These patients wereassessed in their cognitive function with Montreal cognitive assessment(MoCA) andwere divided into two groups based on MoCA scores: cognitive dysfunction group andnormal cognitive function group. General data such as patients’ gender, age, level ofeducation, type of job, course of disease, clinical manifestation, vascular risk factors(history of hypertension, diabetes and hyperlipidmia), head CT and MRI were collected.The neuropsychological features of cognitive impairment in CCCI patients wereanalyzed with the use of SPSS18.0statistical software. General data of CCCI patientswere analyzed by univariate and multivariate analysis to find major risk factors ofcognitive impairment and to analyze the relationship between cognitive impairment andmajor risk factors of CCCI patients.Results:1. Neuropsychological characteristics of cognitive impairment in102patients:Screened by MoCA, the detection rate for those patients with cognitive impairment was78.4%. Among various cognitive domains in MoCA,“visual-spatial and executive”function presented the most significant difference, its standard deviation was1.51.Patients who failed to reach full score occupied91.2%The completion of “delayedmemory” was the worst, patients who failed to reach the full score occupied96.1%, itsstandard deviation was1.20;“nomenclature” presented the most concentrated difference, its standard deviation was0.41, it was performed best, there were78.4%patients whohad reached full score.2. Analysis of risk factors of cognitive impairment in102CCCI patients: Tenfactors such as age, gender, type of job, course of disease, clinical manifestation and LAwere analyzed by single factor analysis. The result showed that age, LA, history ofhypertension, history of hyperlipidemia and the number of vascular risk factors wererelated to cognitive impairment (P<0.05). The above5related factors were analyzed bymultivariate analysis. The result showed that only age≥65years old（OR=2.689）and LA（OR=4.531）were left in regression equations.3. Relationship between age and cognitive impairment: Pearson’s correlationcoefficients test was conducted to age and cognitive impairment. The results showed asignificant negative correlation between age and MoCA score(r=-0.592、p=0.000).4. Relationship between LA and cognitive impairment: Among102patients,85patients had various degrees of LA. According to the severity of LA, they were devidedinto4grades. One way anova analysis showed that the grades of LA had significantstatistical difference in “MoCA scores”,“visual-spatial and executive functions”,“attention and calculation”, and “delayed memory” in different degrees of LA (P<0.01).There were also statistical differences in “language” and “abstract thinking”(P<0.05).There were not statistical difference in various groups of “nomenclature” and“orientation”(P>0.05). Using paired comparisons, there were significant difference inmultiple comparisons among every grade in “MoCA scores”,“visual-spatial andexecutive functions”(P<0.05); there were also significant difference in multiplecomparisons among every grade in “attention and calculation” besides Grade I and III(P<0.05);“Delayed memory” had significant difference in multiple comparisons amongevery grade besides Grade II and III (P<0.05).Conclusions:1. Patients with CCCI have a higher incidence of cognitive impairment.Visual-spatial and executive function, delayed memory and impaired language functionwhich are the most significant ones may be the characteristic manifestations ofcognitive impairment for patients with CCCI.2. Age and LA have the most significant impact on cognitive impairment in CCCIpatients. The order the patients are, the more serious the cognitive impairment will be.The heavier the LA is, the more serious the cognitive impairment will be.