老年患者的β-受体阻滞剂:神经保护作用还是认知能力下降的风险?
- 作者: Bogdanova T.A.1, Turusheva A.V.1
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隶属关系:
- North-Western State Medical University named after I.I. Mechnikov
- 期: 卷 26, 编号 2 (2022)
- 页面: 23-30
- 栏目: Original study article
- URL: https://journal-vniispk.ru/RFD/article/view/108434
- DOI: https://doi.org/10.17816/RFD108434
- ID: 108434
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详细
BACKGROUND: Due to the fact that the number of elderly people with cognitive disorders is steadily increasing worldwide, there is an increased interest in studying the effects of drugs of different pharmacological groups on cognitive function.
For many years, beta-blockers have been one of the main groups in the therapy of cardiovascular diseases. The effect of beta-blockers on cognitive function has been studied for a long time, and there is different, sometimes contradictory data on this issue.
AIM: To evaluate the incidence of cognitive impairment in elderly and to determine the associations between cognitive impairment and the beta-blockers use.
MATERIALS AND METHODS: Cross-sectional study included all patients aged 60 years and older who attended the ambulance care from 24.10.2019 to 15.12.2019 at the polyclinic No. 78 in Saint Petersburg.
Measurements: the Montreal cognitive assessment (MoCA) test, the 15-item Geriatric Depression Scale. Data collection included a full medical history, a medication review and questionnaire.
RESULTS: The prevalence of cognitive impairment among the study participants was 71.1% (n = 138). Сognitive impairment was associated with high blood pressure and a history of stroke (p < 0.05). Beta-blockers use was associated with decreased in total MoCA score, fluency (p = 0.0115), thinking (p = 0.0012), and memory (p = 0.0040). The identified association remained statistically significant after adjusting for gender, age, high blood pressure, a history of stroke, level of education, and decreased emotional background with odds ratio 2.245 (95% confidence interval 1.156–4.358) for the fluency test and coefficient of regression −0.781 (95% confidence interval [−1,233]–[−0,328]) for delayed memory.
CONCLUSIONS: Memory impairment (coefficient of regression −0.781, 95% confidence interval −1.233 to −0.328) and decreased fluency (odds ratio 2.245; 95% confidence interval 1.156–4.358) were observed in the study in the outpatient elderly patient population taking beta-blockers. The beta-blockers may lead to memory impairment. When choosing hypotensive therapy, all possible effects of beta-blockers should be considered, including the effect on cognitive status.
作者简介
Tatyana Bogdanova
North-Western State Medical University named after I.I. Mechnikov
编辑信件的主要联系方式.
Email: bogdanova.t@szgmu.ru
ORCID iD: 0000-0002-8636-8003
SPIN 代码: 4126-6041
俄罗斯联邦, 191015,俄罗斯,圣彼得堡,Kirochnaya大街41号。
Anna Turusheva
North-Western State Medical University named after I.I. Mechnikov
Email: anna.turusheva@gmail.com
ORCID iD: 0000-0003-3347-0984
SPIN 代码: 9658-8074
Scopus 作者 ID: 57189466350
Researcher ID: U-3654-2017
MD, Cand. Sci. (Med.), Assistant Professor
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