@article {Mielke10.1212 / WNL。0000000000207134,作者={米歇尔·m·弗兰克Mielke和Ryan D和卢克R克里和朱莉字段和沃尔特·A·罗卡,维斯纳D Garovic}, title ={妊娠高血压疾病协会与认知在晚年},elocation-id = {10.1212 / WNL。={2023}0000000000207134},年,doi = {10.1212 / WNL。出版商0000000000207134}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标研究妊娠高血压疾病(黄芪丹参滴丸),包括妊娠期或慢性高血压(GH /首页 CH)和子痫前期/子痫(PE / E),建议对幼年时期和中年认知但一直受制于自我报告或使用的诊断代码,排除未生育过的女性,并在晚年缺乏认知的测量。我们检查的影响任何黄芪丹参滴丸,GH / CH, PE / E,未产妇在晚年认知。方法参与者包括2239名妇女(平均年龄73)参加的梅奥诊所研究衰老与医疗记录怀孕抽象信息。认知电池九每15个月进行了测试。全球认知和特定领域的z得分(内存,执行/注意力、视觉空间的语言)的结果。线性混合效应模型评估怀孕之间的联系历史(血压正常的人,任何HPD, HPD亚型(GH / CH、PE / E),或未生育过的)和调整了年龄和教育的认知能力下降。额外的模型调整的APOE、吸烟、高血压、血脂异常、体重指数(BMI)、糖尿病、中风和心脏病。怀孕之间的交互历史和年龄或教育认知性能检查。Results Of the 2,239 women, 1,854 (82.8\%) had at least one pregnancy (1,607 all normotensive, 100 GH/CH, 147 PE/E); 385 (17.2\%) were nulliparous. Cognitive performance did not cross-sectionally differ for women with a history of any HDP, GH/CH, or PE/E versus women with a history of all normotensive pregnancies; women who were nulliparous had lower global and domain-specific cognition (all p\<0.05) in age- and education-adjusted models. There was an interaction (p=0.015) between nulliparity and education such that the lower cognitive performance was most pronounced among nulliparous women with <=12 years of education (beta = -0.42, p\<0.001) versus 12+ years (b = -0.11, p=0.049). Longitudinally, women with any HDP had greater declines in global cognition and attention/executive z-scores compared to women with all normotensive pregnancies. When stratified by HDP type, only women with PE/E had greater declines in global cognition (beta = -0.04, p\<0.001), language (beta = -0.03, p=0.001), and attention (beta = -0.04, p\<0.001) z-scores. Adjustment for vascular risk factors, BMI, smoking, and APOE did not attenuate results.Discussion Women with a history of HDP, especially PE/E, are at greater risk of cognitive decline in later life.}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/early/2023/03/01/WNL.0000000000207134}, eprint = {//www.ez-admanager.com/content/early/2023/03/01/WNL.0000000000207134.full.pdf}, journal = {Neurology} }
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