BACKGROUND & AIMS:
:The coexistence of cerebral infarcts and Alzheimer's disease (AD) is common, but the influence of symptomatic cerebral infarcts on cognition is uncertain in AD. We hypothesize that symptomatic cerebral infarcts may provide an additive cognitive factor contributing to dementia in the AD population. We studied 1,001 clinically probable or possible AD patients in the Alzheimer Disease Research Center (ADRC) database. Linear regression was used to evaluate for an association between symptomatic cerebral infarcts and memory, language, executive function, abstract reasoning, and visuospatial performance, separately. Models were adjusted for covariates including age, gender, education, ethnicity, hypertension, diabetes mellitus, heart disease, clinical dementia rating, the presence of silent cerebral infarcts, and multiplicity or location of infarcts. Clinical history of stroke was present in 107 patients, radiological infarcts in 308 patients, and 68 patients with both were considered to have symptomatic infarcts. Adjusting for all covariates, AD patients with symptomatic infarcts had more impairment of executive function (P < 0.05). The influence of cerebral infarcts is neither general nor diffuse, and the presence of clinical history may have a more important influence on executive performance in AD.
背景与目标:
: 脑梗死与阿尔茨海默病 (AD) 并存是常见的,但症状性脑梗死对认知的影响不确定。我们假设有症状的脑梗塞可能会提供导致AD人群痴呆的附加认知因素。我们在阿尔茨海默病研究中心 (ADRC) 数据库中研究了1,001名临床可能或可能的AD患者。线性回归用于评估症状性脑梗死与记忆,语言,执行功能,抽象推理和视觉空间表现之间的关联。对模型进行了协变量调整,包括年龄,性别,教育程度,种族,高血压,糖尿病,心脏病,临床痴呆等级,无症状性脑梗塞的存在以及梗塞的多重性或位置。107例患者有中风的临床病史,308例患者有放射性梗塞,68例患者均被认为有症状性梗塞。调整所有协变量后,有症状梗死的AD患者执行功能受损更多 (P <0.05)。脑梗死的影响既不是一般的,也不是弥漫性的,临床病史的存在可能对AD的执行绩效有更重要的影响。