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      Neuropsychiatric Disease and Treatment (submit here)

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      The Association Between the Duration, Treatment, Control of Hypertension and Lifestyle Risk Factors in Middle-Aged and Elderly Patients with Mild Cognitive Impairment: A Case-Control Study

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          Abstract

          Background

          Epidemiological studies suggest that the incidence of hypertension in China is causally related to cognitive impairment. However, there is a dearth of information available regarding important factors for the association, including disease duration, therapeutic options, and risk factors associated with mild cognitive impairment (MCI) in patients with hypertension.

          Methods

          We selected a diverse cohort of 572 patients with hypertension and assessed cognitive function using MoCA. Potential risk factors were investigated by a structured questionnaire. Risk factors associated with the hypertension-induced MCI occurring conversion of were analyzed using multifactorial regression analysis.

          Results

          MCI was observed in 256 of 572 individuals, which increased with age (OR=1.15, 95% CI 1.10–1.20), but was decreased with high education status (OR=0.47, 95% CI 0.32–0.71). Risk factors independently associated with MCI were diabetes (OR=2.40, 95% CI 1.53–3.76), hyperlipidemia (OR=1.49, 95%=1.01–2.16), high salt diet (OR=2.27, 95% CI 1.34–3.84), and physical activity:>2h/week (OR=0.65, 95%0.44–0.94). However, controlling blood pressure to “normal” target values helped decrease the incidence of MCI (OR=0.44, 95% CI 0.30–0.65): this was not age dependent.

          Conclusion

          Our results suggest that it is necessary to promote the education of the middle-aged and elderly Chinese population to correctly and effectively use anti-hypertensives to control hypertension to a normal range to prevent cognitive.

          Most cited references46

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          The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.

          To develop a 10-minute cognitive screening tool (Montreal Cognitive Assessment, MoCA) to assist first-line physicians in detection of mild cognitive impairment (MCI), a clinical state that often progresses to dementia. Validation study. A community clinic and an academic center. Ninety-four patients meeting MCI clinical criteria supported by psychometric measures, 93 patients with mild Alzheimer's disease (AD) (Mini-Mental State Examination (MMSE) score > or =17), and 90 healthy elderly controls (NC). The MoCA and MMSE were administered to all participants, and sensitivity and specificity of both measures were assessed for detection of MCI and mild AD. Using a cutoff score 26, the MMSE had a sensitivity of 18% to detect MCI, whereas the MoCA detected 90% of MCI subjects. In the mild AD group, the MMSE had a sensitivity of 78%, whereas the MoCA detected 100%. Specificity was excellent for both MMSE and MoCA (100% and 87%, respectively). MCI as an entity is evolving and somewhat controversial. The MoCA is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE.
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            Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults.

            For prevention of obesity in Chinese population, it is necessary to define the optimal range of healthy weight and the appropriate cut-off points of BMI and waist circumference for Chinese adults. The Working Group on Obesity in China under the support of International Life Sciences Institute Focal point in China organized a meta-analysis on the relation between BMI, waist circumference and risk factors of related chronic diseases (e.g., high diabetes, diabetes mellitus, and lipoprotein disorders). 13 population studies in all met the criteria for enrollment, with data of 239,972 adults (20-70 year) surveyed in the 1990s. Data on waist circumference was available for 111,411 persons and data on serum lipids and glucose were available for more than 80,000. The study populations located in 21 provinces, municipalities and autonomous regions in mainland China as well as in Taiwan. Each enrolled study provided data according to a common protocol and uniform format. The Center for data management in Department of Epidemiology, Fu Wai Hospital was responsible for statistical analysis. The prevalence of hypertension, diabetes, dyslipidemia and clustering of risk factors all increased with increasing levels of BMI or waist circumference. BMI at 24 with best sensitivity and specificity for identification of the risk factors, was recommended as the cut-off point for overweight, BMI at 28 which may identify the risk factors with specificity around 90% was recommended as the cut-off point for obesity. Waist circumference beyond 85 cm for men and beyond 80 cm for women were recommended as the cut-off points for central obesity. Analysis of population attributable risk percent illustrated that reducing BMI to normal range ( or = 28) with drugs could prevent 15%-17% clustering of risk factors. The waist circumference controlled under 85 cm for men and under 80 cm for women, could prevent 47%-58% clustering of risk factors. According to these, a classification of overweight and obesity for Chinese adults is recommended.
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              Status of Hypertension in China

              Although the prevalence of hypertension (HTN) continues to increase in developing countries, including China, recent data are lacking. A nationwide survey was conducted from October 2012 to December 2015 to assess the prevalence of HTN in China.
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                Author and article information

                Journal
                Neuropsychiatr Dis Treat
                Neuropsychiatr Dis Treat
                ndt
                Neuropsychiatric Disease and Treatment
                Dove
                1176-6328
                1178-2021
                19 March 2022
                2022
                : 18
                : 585-595
                Affiliations
                [1 ]Nanjing University of Chinese Medicine , Nanjing, Jiangsu Province, People’s Republic of China
                [2 ]Key Laboratory of Cognitive Impairment Research, Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing, Jiangsu Province, People’s Republic of China
                [3 ]Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing, Jiangsu Province, People’s Republic of China
                Author notes
                Correspondence: Cheng Chang; Xiwu Yan, Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine , Nanjing, Jiangsu Province, 210000, People’s Republic of China, Tel +86 13851821996; +86 18013930106, Email yxwssg@126.com; chch1967@163.com
                Author information
                http://orcid.org/0000-0002-5266-0348
                Article
                353164
                10.2147/NDT.S353164
                8942123
                35342291
                edeb7663-2ca2-43d6-a444-c399fa59f292
                © 2022 Yan et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 08 December 2021
                : 09 March 2022
                Page count
                Figures: 2, Tables: 8, References: 47, Pages: 11
                Categories
                Original Research

                Neurology
                hypertension,mild cognitive impairment,control,risk factors
                Neurology
                hypertension, mild cognitive impairment, control, risk factors

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