Yaşlı Bireylerde Hafif Kognitif Bozuklukta Albümin ve Globulin Etkisi

Yıl 2024, Cilt: 46 Sayı: 6, 852 - 860, 07.11.2024

Sultan Keskin Demircan , Zeynep Ece Aytar

https://doi.org/10.20515/otd.1521221

Öz

Hafif kognitif bozukluğun başladığı dönemdeki değiştirilebilir faktörlerin bilinmesi ve erken fark edilmesi, tedavisi kısıtlı olan demansın önlenebilmesi için önemlidir. İnflamasyon ve demans arasındaki ilişki bilindiğinden, çalışmamızda albümin (A) ve globulin (G) düzeylerinin hafif kognitif bozukluğa etkisini göstermeyi amaçladık. Çalışmaya geriatri polikliniğine unutkanlık şikâyeti ile başvuran 60 yaş ve üstü hastalardan demans tanısı almayan hastalar alındı. Malignite, romatolojik hastalıklar ve aktif enfeksiyonu olan hastalar çalışma dışı bırakıldı. Mini Mental Durum Değerlendirmesinden (MMSE) 24-27 arası almış ve klinik demans skoru (CDR) skoru 0.5 olan hastalar hafif kognitif bozukluk, 28-30 arası alan ve CDR skoru 0 olanlar kontrol grubunu oluşturdu. Yesavage geriatrik depresyon skalası ile depresyon varlığına, geriatrik nütrisyon indeksi ile malnütrisyon riskine karar verildi. Hastaların yaş ortalaması 69.15±5.59 ve % 63.6 si kadın hastaydı. Hastaların 59.9 % unda hafif kognitif bozukluk, %77.9 u eğitimsiz ve % 55.9’u obezdi. Hafif kognitif bozukluk olan grupta anlamlı olarak kadın prevalansı, obezite ve eğitimsizlik daha fazlaydı (p=0.004, p=0.016, p <0.001). Hafif kognitif bozukluk olan grup ile sağlam grup arasında albümin, globulin, A/G, ürik asit, vitamin B12, vitamin 25(OH)D3 vitamini düzeyleri arsındaki fark anlamsızdı (p=0.687, p=0.517, p=0.542, p=0.472, p=0.914, p=0.703). Çok yönlü analizlerde de albümin, globulin, A/G ile hafif kognitif bozukluk arasında ilişkili bulunamadı. Tek yönlü analizlerde kadın olmak, obez olmak, eğitimsiz olmak ve GFR, hafif kognitif bozukluk riskini artırmaktaydı (OR:1.78, OR:1.77, OR: 4.62, OR:1.02; p=0.040, p= <0.001, p=0.017, p=0.036, sırasıyla). Hafif kognitif bozukluk, inflamatuar süreç dışında obezite ve eğitimsiz olmak gibi sebeplerden de etkilenmektedir. Albümin, globulin ve A/G düzeylerini etkileyen başka patolojik durumlar da olduğundan hafif kognitif bozukluk için kullanımı uygun değildir.

Anahtar Kelimeler

bilişsel gerileme, albumin, globulin, albumin-globulin oranı, depresyon, obezite

Effect of Albumin and Globulin on Mild Cognitive Impairment in Older Adults

Öz

It is important to identify and detect modifiable factors at the onset of mild cognitive impairment to prevent dementia, which has limited treatment options. Given the known relationship between inflammation and dementia, our study aimed to demonstrate the effect of albumin (A) and globulin (G) levels on mild cognitive impairment. Patients aged 60 and above who presented to the geriatric outpatient clinic with complaints of forgetfulness but were not diagnosed with dementia were included in the study. Those who scored between 24-27 on the Mini-Mental State Examination (MMSE) and had a Clinical Dementia Rating (CDR) score of 0.5 were classified as having mild cognitive impairment, while those who scored between 28-30 on the MMSE and had a CDR score of 0 were classified as the control group. Depression was assessed using the Yesavage Geriatric Depression Scale, and the risk of malnutrition was determined using the Geriatric Nutritional Index. The average age of the patients was 69.15±5.59 years, and 63.6% were women. Mild cognitive impairment was found in 59.9% of the patients, 77.9% were uneducated, and 55.9% were obese. The prevalence of women, obesity, and lack of education was significantly higher in the mild cognitive impairment group (p=0.004, p=0.016, p <0.001). In multivariate analyses, no association was found between albumin, globulin, A/G ratio, and mild cognitive impairment. In univariate analyses, age, being female, obesity, lack of education, and GFR increased the risk of mild cognitive impairment (OR: 0.95, OR: 1.78, OR: 1.77, OR: 4.62, OR: 1.02, respectively). Mild cognitive impairment is affected by factors such as obesity and uneducated, aside from inflammatory processes. Due to other pathological conditions affecting albumin, globulin, and A/G levels, their use as markers for cognitive dysfunction is not appropriate.

Anahtar Kelimeler

cognitive decline, albumin, globulin, albumin-globulin ratio, depression, obesity

Kaynakça

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