Abbreviation (ISO4): Chinese Journal of Alzheimer's Disease and Related Disorders
Editor in chief: Jun WANG
Chinese Journal of Alzheimer's Disease and Related Disorders >
Characteristics of autonomic dysfunction in Alzheimer’s disease
Received date: 2019-08-05
Revised date: 2019-08-13
Online published: 2019-12-25
Objective: To compare the characteristics of autonomic dysfunction in elderly population with Alzheimer’s disease (AD) and with normal cognitive function, and find out the prevalence and symptom characteristics of autonomic dysfunction in elderly population with AD. Methods: One hundred and eighty-eight elderly people over 65 years old who were diagnosed as probably AD and 860 elderly people over 65 years old with normal cognitive function from a community study were included finally. Basic information collection, neuropsychology scale assessment and autonomic dysfunction scale assessment were performed on all the included subjects to compare the prevalence and symptom characteristics of autonomic dysfunction. Results: The prevalence of autonomic dysfunction in the AD group was 21.3%, and the prevalence of autonomic dysfunction in the normal cognitive function group was 11.2%. There was significant difference between the two groups (P< 0.05). The symptoms that occurred mostly in both groups were constipation and urinary frequency, urinary urgency, urinary insufficiency. The prevalence of constipation in the AD group was higher than that in the normal cognitive function group, and the difference was statistically significant (P< 0.05). Multivariate analysis showed that the cardiovascular disease was the risk factor for autonomic dysfunction. Conclusion: The prevalence of autonomic dysfunction in the AD group is higher than that in the normal cognitive function group. The symptoms with significant difference is constipation.
Key words: Alzheimer’s disease; Dysautonomia; Prevalence; Dementia; Eelderly
DU Xiaoshan , LIU Shuai , HU Wenzheng , GAN Jinghuan , ZHU Han , SHI Zhihong , JI Yong . Characteristics of autonomic dysfunction in Alzheimer’s disease[J]. Chinese Journal of Alzheimer's Disease and Related Disorders, 2019 , 2(4) : 510 -516 . DOI: 10.3969/j.issn.2096-5516.2019.04.010
表1 自主神经功能障碍评估量表 |
自主神经功能障碍症状 | 有 | 无 | 时间/月 |
---|---|---|---|
直立性低血压 | 1 | 0 | |
多汗 | 1 | 0 | |
便秘 | 1 | 0 | |
尿频尿急尿不尽 | 1 | 0 | |
性功能障碍 | 1 | 0 |
表2 研究对象的人口学特征及比较 |
特征 | AD组 (n=188) | 认知正常组 (n=860) | χ2值 | P值 |
---|---|---|---|---|
n(%) | n(%) | |||
年龄 | 74.31±6.248 | 70.22±4.320 | <0.001 | |
性别 | 5.240 | 0.022 | ||
男 | 89(47.3) | 486(56.5) | ||
女 | 99(52.7) | 374(43.5) | ||
文化程度/年 | 9.78±4.242 | 6.520±3.060 | <0.001 | |
特征 | AD组 (n=188) | 认知正常组 (n=860) | χ2值 | P值 |
n(%) | n(%) | |||
吸烟史 | 10.101 | 0.001 | ||
有 | 45(23.9) | 310(36.0) | ||
无 | 143(76.1) | 550(64.0) | ||
饮酒史 | 175.119 | <0.001 | ||
有 | 20(10.6) | 548(63.7) | ||
无 | 168(89.4) | 312(36.3) | ||
CO中毒史 | 14.760 | <0.001 | ||
有 | 3(1.6) | 89(10.3) | ||
无 | 185(98.4) | 771(89.7) | ||
高血压病史 | 6.826 | 0.009 | ||
有 | 71(37.8) | 415(48.3) | ||
无 | 117(62.2) | 445(51.7) | ||
糖尿病病史 | 1.919 | 0.166 | ||
有 | 28(14.9) | 97(11.3) | ||
无 | 160(85.1) | 763(88.7) | ||
心血管疾病史 | 0.784 | 0.376 | ||
有 | 30(16.0) | 116(13.5) | ||
无 | 158(84.0) | 744(86.5) | ||
脑血管疾病史 | 0.611 | 0.434 | ||
有 | 25(13.3) | 97(11.3) | ||
无 | 163(86.7) | 763(88.7) | ||
脑外伤史 | 0.779 | 0.378 | ||
有 | 7(3.7) | 22(2.6) | ||
无 | 181(96.3) | 838(97.4) | ||
全麻手术史 | 12.789 | <0.001 | ||
有 | 7(3.7) | 110(12.8) | ||
无 | 181(96.3) | 750(87.2) | ||
MMSE | 14.01±7.184 | 26.74±1.423 | <0.001 | |
ADL | 33.66±14.229 | 20.00±0.000 | <0.001 |
表3 AD组与认知正常组的自主神经功能障碍症状发生率比较 |
自主神经功能障碍症状 | 总例数(n=1 048) | AD组(n=188) | 认知正常组(n=860) | χ2值 | P值 |
---|---|---|---|---|---|
n(%) | n(%) | n(%) | |||
直立性低血压 | 102(9.7) | 25(13.3) | 77(9.0) | 3.314 | 0.069 |
多汗 | 116(11.1) | 21(11.2) | 95(11.0) | 0.002 | 0.961 |
便秘 | 148(14.1) | 53(28.2) | 95(11.0) | 37.393 | <0.001 |
尿频尿急尿不尽 | 209(19.9) | 45(23.9) | 164(19.1) | 2.288 | 0.130 |
自主神经功能障碍 | 136(13.0) | 40(21.3) | 96(11.2) | 13.974 | <0.001 |
表4 自主神经功能障碍的多因素Logistic回归分析 |
影响因素 | B | SE | Wald χ2 | P值 | OR | 95%CI | |
---|---|---|---|---|---|---|---|
下限 | 上限 | ||||||
年龄 | 0.035 | 0.018 | 3.608 | 0.057 | 1.035 | 0.999 | 1.073 |
女性 | 0.240 | 0.246 | 0.954 | 0.329 | 1.272 | 0.785 | 2.059 |
文化程度 | 0.043 | 0.027 | 2.536 | 0.111 | 1.044 | 0.990 | 1.100 |
吸烟史 | -0.358 | 0.265 | 1.825 | 0.177 | 0.699 | 0.415 | 1.175 |
饮酒史 | 0.136 | 0.271 | 0.252 | 0.615 | 1.146 | 0.674 | 1.947 |
CO中毒史 | -0.132 | 0.354 | 0.139 | 0.710 | 0.876 | 0.438 | 1.755 |
高血压史 | -0.090 | 0.191 | 0.225 | 0.635 | 0.914 | 0.629 | 1.327 |
糖尿病史 | 0.468 | 0.256 | 3.340 | 0.068 | 1.596 | 0.967 | 2.635 |
心血管病史 | 0.587 | 0.242 | 5.886 | 0.015 | 1.798 | 1.119 | 2.888 |
脑血管病史 | 0.221 | 0.273 | 0.655 | 0.418 | 1.247 | 0.730 | 2.131 |
脑外伤史 | -0.319 | 0.633 | 0.254 | 0.614 | 0.727 | 0.210 | 2.511 |
全麻手术史 | -0.225 | 0.311 | 0.524 | 0.469 | 0.798 | 0.434 | 1.469 |
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