Analysis Of The Correlation Between Cognition And Affective Disorder In Patients With Cerebral Small Vessel Disease And The Influence Factors

Objective Cerebral small vessel disease(CSVD)is a clinical common accompaniment of ageing.It has characteristics of insidious onset,slow development,complex clinical manifestations and difficult in early diagnosis.CSVD is an established contributor to cognitive impairment,and the most common vascular cause of dementia.The relevant cognitive deficits of CSVD mainly involve execution capability,attention,orientation,and processing speed,with episodic memory and naming relatively spared.Neuropsychiatric symptoms such as depression,apathy are also more common in the patients with CSVD,resulting in poorer quality of life and a heavy economic and psychological burden to the society,families and individuals.Previous studies have aslo shown associations between CSVD and cognitive as well as affective disorder.However,it is not clear what risk factors are associated with cognitve disorder and affective disorder in CSVD patients,and it is not clear whether cognitive disorder is related to affective disorder in CSVD patients.In this paper,we aim to analyze the possible influencing factors of cognitive and affective disorders,and the correlation between cognitive and affective disorders in CSVD patients,hoping to identify new avenues for prevention and treatment.Methods 130 patients fulfilled the diagnostic criteria of CSVD were prospectively collected at the Department of Neurology,Leling People's Hospital,Shandong Province from June 2017 to June 2019.The demographic information,laboratory data and MRI image were collected for patients with CSVD.Montreal Cognitive Assessment(MoCA),Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)were used to evaluate the cognitive and affective condition.According to the MoCA score,patients with CSVD were divided into cognitive disorder group and non-cognitive disorder group.According to the scores of HAMA and HAMD,patients with CSVD were divided into the affective disorder group and the non-affective disorder group.All data were entered into the SPSS software 21.0 for storage and analysis.Statistical significance was considered at p=0.05 and was 2-sided.The possible independent risk factors for cognitive and affective disorders in patients with CSVD were analyzed by multivariate Logistic regression analysis.According to the scores of HAMA and HAMD,patients with cognitive disorder were divided into the affective disorder group and the non-affective disorder group.Pearson correlation analysis was conducted to analyze the relationship between cognitive disorder and affective disorder in patients with CSVD.Results(1)Multivariate Logistic regression analyses showed that history of hypertension,hyperhomocysteine(Hcy),hyperuricemia,high-sensitivity C reactive protein(hs-CRP),LI and degree of WML were independent risk factors for cognitive disorder in patients with CSVD,while high education level was a protective factor(P<0.05).(2)Multivariate Logistic regression analyses showed that high urinary microalbumin(MA),CMB and degree of WML were independent risk factors for affective disorder in patients with CSVD(P<0.05),while education level was a protective factor(P<0.05).(3)The incidence of affective disorder in the cognitive disorder group with CSVD was higher than that in the non-cognitive disorder group(P<0.05).Pearson correlation analysis showed that MoCA scores of patients with cognitive disorder and emotional disorder were negatively correlated with HAMA scores and HAMD scores(r=-0.363?-0.435,P<0.05).(4)There were statistically significant differences in educational level,history of hypertension,MA,incidence of LI and CMB,degree of WML between patients with affective disorder and those without in the cognitive disorder group(P<0.05).Conclusions(1)Educational level,history of hypertension,Hcy,blood uric acid,hs-CRP,LI and degree of WML are the influence factors of cognitive disorder in patients with CSVD.Educational level,MA,CMB and degree of WML are closely related to the occurrence of affective disorders in patients with CSVD.(2)Cognitive disorder in patients of CSVD is easily complicated with affective disorder,and the degree of cognitive disorder is positively correlated with the degree of affective disorder.Besides,educational level,history of hypertension,MA,CMB,LI,degree of WML may be influence factors that cause cognitive and affective disorders.