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Objective To investigate the relationship between vascular cognitive dysfunction and elderly patients with comobidities of hypertension. Methods 92 patients with essential hypertension who were hospitalized in the Gereology Department of Affiliated Hospital of Guizhou Medical University from October 2015 to December 2016 were selected. After admission,the patients were assessed with the mini mental state examination scale (MMSE ) for cognitive function, and the apolipoprotein E (ApoE) gene polymorphism test (using gene chip technology) and related laboratory tests were conducted respectively. Chronic disease comorbidities was observed in patients with cognitive impairment and normal cognitive function (grouped according to MMSE score), and the polymorphism of ApoE gene was analyzed. Results (1) High incidence of chronic disease dis ease comorbidities in elderly patients with hypertension. (2) The MMSE score of patients with 5 or more disease comorbidities [ ( 21. 65 ± 4.25) points] was lower than that of patients with 0 - 1 disease comorbidities [ ( 26.23 ± 1.48) points ] and patients with 2 - 4 disease comorbidities [ ( 26.11 ± 1.82) points], with statistically significant differences ( P < 0.01). (3) The incidence of cognitive impairment in elderly patients with hypertension with 0 - 1 comorbidities, 2 - 4 comorbidities and 5 or more comorbidities was 5.1 %, 25.6% and 69.2%, respectively. With the increase of comorbidities of chronic diseases, the incidence of cognitive impairment in elderly patients with hypertension increased,and the differences were statistically significant ( P < 0.01). (4) The MMSE score of patients with ApoE4 form [(21.35 ± 3.86) points] was lower than that of patients with ApoE3 form [ (24.45±3.45) points], and the difference was statistically significant (P<0.05). The carrying rate of ApoE4 gene in the cognitive dysfunction group (30.8%) was higher than that in the normal cognitive function group (11.3%), and the difference was statistically significant ( P < 0.05). (5) The results of multivariate logistic regression analysis showed that compared with 5 or more chronic diseases, patients with 0-1 comorbidities [odds ratio (OR ) < l,P= 0.001, 95.% confidence interval (95% CI) 0.009 - 0.306] and 2- 4 comorbidities (OR< l,P< 0.001, 95% CJ 0. 026-0. 234 ) had a lower risk of cognitive impairment. Conclusion The incidence of cognitive dysfunction in elderly hypertensive patients is associated with A poEgene polymorphism, and the proportion of cognitive impairment caused by ApoE4 allele is significantly higher than that of other genes. With the increasing number of chronic diseases comorbidities, the incidence of cognitive dysfunction is also increasing. In particular, the risk of cognitive dysfunction is significantly increased in patients with 5 or more comorbidities. [ABSTRACT FROM AUTHOR]

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Osteocalcin ( OC) is a structural protein synthesized by osteoblasts，and it has been long regarded as a marker in regulating the bone metabolism． However，recent studies have discovered that OC is actually a hormone participating in the glucose and lipid metabolism as well as the synthesis of leptin and adiponectin，which may indirectly affect the cognitive function of the brain． The newest research has shown that OC plays a decisive role in brain development，neural structure，and behavioral patterns． Especially，animal experiments have shown that uncarboxylated osteocalcin ( uc OC) may cross the blood-brain barrier，act on the neurons in brain stem，midbrain and hippocampus，and finally improve the cognitive function． Studies on the relationship between OC and cognitive dysfunction can help to find a new way to explore the cognitive interventions [ABSTRACT FROM AUTHOR]

Objective: To investigate the association of apolipoprotein E (ApoE) genotype, sleep problem, olfaction problems, chronic constipation and their interactions on cognitive impairment in the elderly aged 60 and above. Methods: A stratified multi-stage cluster sampling was used in 6 provinces (autonomous administrative regions and municipalities) to select the sample. 1 300 cases with cognitive impairment and 2 600 controls without cognitive impairment were recruited and matched according to their age, gender and resident area in a 1∶2 case-control study. A total of 3 501 people were included after data cleaning. Chi-square test and conditional logistic regression model were used for univariate analysis, multivariate analysis and interaction analysis. Results: ApoE carrying ε4 genotypes, sleep problems, smell disorders, constipation is independent risk factors of cognitive impairment in the elderly ( OR =1.44, 1.65, 2.26, 2.13, P <0.001). The additive interaction between ApoE genotype and olfaction change was statistically significant [ AP =0.45(95% CI : 0.13- 0.77), S =2.37 (95% CI : 1.08-5.24)]. The interaction between other factors with cognitive impairment was not found to be statistically significant. The above results were adjusted for occupation, tea drinking, neighborhood interaction, social activities, physical exercise, reading books and newspapers, playing cards and mahjong, memory changes and hypertension, diabetes, stroke. Conclusions: ApoE genotype, sleep problems, olfaction problems, and chronic constipation are risk factors for cognitive impairment in people 60 and older. There is a synergistic interaction effect between ApoE genotype and olfaction problems on cognitive impairment in the elderly over 60 years old.

Objective: To explore the influencing factors affecting the cognitive impairment of the elderly population in China. Methods: A stratified multi-stage cluster sampling was used in 6 provinces (autonomous administrative regions and municipalities) to select the sample. A total 24 000 urban and rural residents aged 60 years and above received a set of standardized questionnaire interview, physical examinations, laboratory test of lipid and glucose levels of blood and apolipoprotein E (APOE) genotype. The primary screening of cognitive function was assessed by using the Chinese Version of Ascertain Dementia 8, and then suspicious cognitive impairment cases with more than two abnormal results would receive the further cognitive function assessment by using the Mini-Mental State Examination (MMSE). 1 300 cases with cognitive impairment and 2 600 controls without cognitive impairment were recruited and matched according to their age, gender and resident area in a 1∶2 case-control study. The conditional logistic regression model was used to analyze the association between relevant factors and cognitive impairment. Results: Factors negatively associated with cognitive impairment and their OR (95 %CI ) values were primary or middle school as 0.63 (0.51-0.77), high school and above as 0.59 (0.39-0.88), daily neighborhood communication as 0.61 (0.50-0.75), weekly participating in social activities 0.59 (0.44-0.79), daily tea drinking as 0.71 (0.58-0.88) and doing regular exercise as 0.71 (0.57-0.88), reading newspaper (occasional: 0.50 (0.37-0.67); frequent: 0.40 (0.28-0.57)), playing majiang or cards (occasional: 0.51 (0.34-0.74); frequent: 0.50 (0.36-0.68)) respectively. Factors positively associated with cognitive impairment and their OR (95 %CI ) values were APOE-ε4 heterozygote as 1.31 (1.08-1.58), homozygote as 2.74 (1.52-5.00), diabetes onset before 50 years of age and after as 9.03 (3.07-33.60) and 4.40 (3.18-6.17), stroke as 1.90 (1.35-2.69), asthma as 1.95 (1.11-3.42) respectively. Conclusion: APOE-ε4 alleles, lower educational level, stroke, asthma, diabetes are risk factors of cognitive impairment in the elderly. Keeping a healthy lifestyle and preventing chronic diseases in the whole life course could significantly reduce the incidence of cognitive impairment in the elderly.