目的:老年痴呆症(AD)是一种缓慢发展的神经退行性疾病,以β-淀粉样蛋白沉积和神经原纤维缠结为特征。外周动脉粥样硬化可能通过内皮细胞功能障碍和微血管损伤而使这些过程恶化。西洛他唑是一种磷酸二酯酶3抑制剂,是外周动脉闭塞性疾病的标准治疗方法,也是维持AD患者认知功能的潜在治疗方法。我们旨在通过评估认知能力筛查仪(CASI)领域来确定西洛他唑是否对患有外周动脉闭塞性疾病的AD患者有益。
方法:我们对台湾62例AD患者进行了回顾性病例对照研究。31例患者患有外周动脉闭塞性疾病,正在接受西洛他唑加乙酰胆碱酯酶抑制剂(AchEI)或N-甲基d-天冬氨酸拮抗剂,而其他31人正在接受AchEI。使用神经心理学评估来测量治疗反应。在基线和12个月后给予CASI;使用单变量和多变量分析在组间分析不同的领域。
结果:年龄,性别,教育持续时间,ApoEε4基因状态,和初始简易精神状态检查分数两组之间没有差异。除了流利,无CASI结构域显示两组间有统计学差异.在类别流畅性方面观察到显着差异(P=0.010)。在逻辑回归分析中,在调整协变量效应后,类别流畅性在组间仍有显著差异(P=0.013)。
结论:在接受食品和药物管理局批准的药物治疗的患有外周动脉闭塞性疾病的AD患者中,西洛他唑,作为抗血小板,可能有助于保持一般的认知功能,具有显著的类别流畅性保留。GeriatrGerontolInt2023;23:194-199。
OBJECTIVE: Alzheimer\'s dementia (AD) is a slowly progressing neurodegenerative disease, characterized by beta-amyloid deposition and neurofibrillary tangles. Peripheral atherosclerosis may deteriorate these processes via endothelial cell dysfunction and microvascular impairment. Cilostazol - a phosphodiesterase 3 inhibitor - is a standard treatment for peripheral arterial occlusive disease and a potential treatment for preserving cognitive function in AD patients. We aimed to determine whether cilostazol is beneficial in AD patients with peripheral arterial occlusive disease by evaluating Cognitive Abilities Screening Instrument (CASI) domains.
METHODS: We conducted a retrospective
case-control study of 62 AD patients in Taiwan. Thirty-one patients had peripheral arterial occlusive disease and were receiving cilostazol plus acetylcholinesterase inhibitors (AchEIs) or N-methyl d-aspartate antagonists, whereas 31 others were receiving AchEIs. Therapeutic responses were measured using neuropsychological assessments. The CASI was administered at baseline and 12 months later; different domains were analyzed between the groups using univariate and multivariate analyses.
RESULTS: Age, sex, education duration, ApoE ε4 gene status, and initial Mini-Mental State Examination scores were not different between the two groups. Except for fluency, no CASI domains showed a statistical difference between the groups. A significant difference was observed in category fluency (P = 0.010). In the logistic regression analysis, after adjusting for covariate effects, category fluency still showed a significant difference between the groups (P = 0.013).
CONCLUSIONS: In AD patients with peripheral arterial occlusive disease who have received Food and Drug Administration-approved pharmacotherapy, cilostazol, as an antiplatelet, may help to preserve general cognitive function, with significant preservation in category fluency. Geriatr Gerontol Int 2023; 23: 194-199.