Hippocampal metabolism and risk factors of cognitive impairment in elderly patients with ischemic cerebral small vessel disease
10.3969/j.issn.1009-0126.2025.04.006
- VernacularTitle:老年缺血性脑小血管病患者海马代谢水平及发生认知功能障碍的危险因素分析
- Author:
Meng ZHANG
1
;
Xiaolin YANG
Author Information
1. 710038 西安,空军军医大学第二附属医院神经外科
- Publication Type:Journal Article
- Keywords:
cerebral small vessel diseases;
cognitive dysfunction;
hippocampus;
metabolism
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(4):422-425
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the level of hippocampal metabolism in elderly patients with is-chemic cerebral small vessel disease(ICSVD),and explore the risk factors for the occurrence of cognitive impairment.Methods A total of 164 elderly patients with ICSVD admitted in our hospi-tal from May 2020 to December 2023 were enrolled,and divided into cognitively impaired group(52 cases)and cognitively normal group(112 cases)according to their cognitive function.The clinical data and the ratios of myo-inositol(MI)/creatine(Cr),MI/N-acetyl aspartate(NAA),choline/Cr,and NAA/Cr were compared between the two groups.Multivariate logistic regression analysis was applied to identify the risk factors of cognitive impairment in elderly ICSVD patients.Results The left and right hippocampal MI/Cr and MI/NAA ratios were significantly higher,while the right hippocampal NAA/Cr ratio was obviously lower in the cognitively impaired group than the cognitively normal group(P＜0.05).The former group had notably larger proportions of aged ≥65 years,hypertension and atherosclerosis,and higher levels of LDL-C,hs-CRP and Hcy than the latter group(P＜0.05,P＜0.01).Multivariate logistic regression analysis indicated that left and right hippocampal MI/Cr ratios,left and right hippocampal MI/NAA ratios,right hipp-ocampal NAA/Cr ratio,aged ≥65 years,hypertension,atherosclerosis,LDL-C were risk factors for cognitive impairment in elderly ICSVD patients(OR=2.795,95％CI:1.532-5.102,P=0.000;OR=2.782,95％CI:1.616-4.787,P=0.000;OR=2.177,95％CI:1.355-3.498,P=0.000;OR=3.364,95％CI:1.846-6.127,P=0.000;OR=0.450,95％CI:0.259-0.784,P=0.000;OR=2.740,95％CI:1.024-7.330,P=0.012;OR=3.074,95％CI:1.554-6.080,P=0.000;OR=2.942,95％CI:1.338-6.468,P=0.000;OR=2.418,95％CI:1.496-3.909,P=0.000).Conclusion The elderly ICSVD patients are at high risk of cognitive impairment,which may be closely associated with hippocampal metabolism level,age,comorbidity,LDL-C,hs-CRP,Hcy and other factors.It is necessary to focus on clinical screening of these indicators and take active prevention and control measures to reduce the risk of cognitive impairment.
