摘要
Abstract
Objective To investigate the correlation between hypertension and cognitive impairment among the older adults in Shanghai,and evaluate the potential mediating effects of estimated glomerular filtration rate(eGFR).Methods From July 2016 to December 2019,a cross-sectional survey was conducted among 1 380 older adults aged≥60 years from two sub-district communities of Xuhui District,Shanghai.Their general demographic data were collected.The Montreal cognitive assessment(MoCA)was used to evaluate the cognitive function.Independent sample t-tests were used to compare differences in MoCA scores across groups with different characteristics.Multivariate linear regression models were applied to analyze independent influencing factors of cognitive function.Furthermore,a mediation model was constructed,and the Bootstrap method was employed to test the mediating effect of eGFR on the correlation between hypertension and cognitive function.Results Univariate analysis showed that the MoCA scores of the hypertensive population were significantly lower than those of the non-hypertensive population(21.33±4.51 vs.22.26±4.18,P＜0.001),and people with a history of cardiovascular and cerebrovascular diseases had significantly lower MoCA scores than those without(20.81±4.71 vs.22.07±4.21,P＜0.001).After adjusting for confounding factors such as age,sex,education level,marital status,smoking history,and alcohol consumption history,multivariate linear regression analysis revealed that hypertension(β=-0.055,95%CI:-0.961--0.047,P=0.031)and cardiovascular and cerebrovascular diseases(β=-0.077,95%CI:-1.204--0.261,P=0.002)were independent risk factors for cognitive function,while eGFR(β=0.090,95%CI:0.013-0.058,P=0.002)were an independent protective factor.Mediation analysis indicated that eGFR exerted a significant partial mediating effect on the correlation between hypertension and cognitive function(indirect effect value=-0.062,95%CI:-0.126--0.016),accounting for 10.95%of the total effect.Conclusion Hypertension is a significant risk factor for cognitive impairment and may exert a negative effect on cognitive function by reducing glomerular filtration rate.Screening for hypertension and renal function should be strengthened to facilitate early diagnosis and intervention of cognitive decline in the older adults.关键词
高血压/肾小球滤过率/认知功能/社区老年人Key words
hypertension/glomerular filtration rate/cognitive function/community-dwelling older adults
