BackgroundProgressive cognitive impairment in vascular dementia (VaD) is increasingly linked to brain network disruption, or “disconnection syndrome.” Although Compound Congrong Yizhi Capsule (CCYC), a marketed Chinese patent medicine approved in China for vascular cognitive disorders, has been studied in terms of therapeutic efficacy and molecular targets, these approaches do not directly explain how this multi-target intervention modulates brain functional organization. Resting-state functional magnetic resonance imaging (rs-fMRI) enables in vivo characterization of BOLD-based brain network functional phenotypes. Here, we used rs-fMRI to investigate the effects of CCYC in a rat model of VaD.MethodsVaD was induced by permanent bilateral common carotid artery occlusion (BCCAO) in rats. CCYC was administered by gavage for 6 weeks. Spatial navigation and memory retention were assessed using the Morris water maze (MWM). Resting-state fMRI was acquired on a 9.4 T scanner and analyzed using regional activity metrics, behavioral correlations, functional connectivity, and graph theoretical analyses.ResultsVaD rats showed abnormal regional activity in the frontal cortex, retrosplenial cortex, and hippocampal system, which were associated with impaired MWM performance. They also exhibited disrupted connectivity within the fronto-retrosplenial-hippocampal memory circuit, particularly between prefrontal/cingulate and retrosplenial-hippocampal regions. CCYC treatment was associated with partial normalization of these regional and circuit-level abnormalities. Graph theoretical analyses further showed partial improvement in whole-brain topological organization and nodal properties after CCYC treatment. These findings do not establish anatomical restoration of the underlying white matter tracts.ConclusionCCYC may ameliorate VaD by modulating a systems-level neuroimaging phenotype centered on the fronto-retrosplenial-hippocampal memory circuit.

BackgroundTremor is prevalent among older adults and is suggested to be associated with the subsequent development of Parkinson's disease (PD). However, prospective evidence for the association is scarce.ObjectiveThis population-based prospective study aimed to estimate PD risk and to explore predictive factors for PD conversion in community-dwelling older people with tremor.MethodsThe study was based on the Beijing Longitudinal Study on Aging (BLSA) II. Tremor was assessed using a validated self-administered method. Participants without parkinsonism and with any tremor were followed for an average of 7.7 years. The standardized incidence ratio (SIR) was used to estimate the risk of developing PD in older people with tremor, with age- and sex-specific incidence rates of PD in the general Chinese population as a reference. Risk factors, prodromal symptoms, and tremor features were assessed to identify predictors for incident PD.ResultsSeventeen (8.4%) of 202 participants with tremor developed parkinsonism, including 9 (4.4%) diagnosed with PD. The presence of any tremor was associated with an increased risk of developing PD (SIR: 3.12, 95% confidence interval [CI]: 1.52-5.73). Sensitivity analyses yielded similar results. Probable REM sleep behavior disorder (RBD), identified using the RBD Questionnaire-Hong Kong, and self-report of new-onset rest tremor predicted PD conversion.ConclusionsTremor is associated with an elevated risk of PD in the general older population. Screening for RBD and monitoring the evolution of tremor characteristics using simple questionnaires may help identify individuals at high risk for PD among community-dwelling older adults with tremor.

Background and purposeFrailty delineates a state of poor health characterized by the accumulation of age-related health deficits, and was associated with cognitive decline in patients with subjective cognitive complaints (SCC). However, whether cognitive recovery is related to frailty in elderly patients with post-stroke SCC remained unknown. This study investigated cognitive outcomes in patients with SCC within 1 year after stroke, identified the relationship between frailty and cognitive recovery, and determined factors associated with cognitive recovery.MethodsPatients over the age of 60 with a clinical diagnosis of post-stroke SCC were included in this study, who had evidence of cognitive deficits, including Clinical Dementia Rating Scale (CDR) = 0.5, Montreal Cognitive Assessment (MoCA) score < 26, and Mini–Mental State Examination score > 17 (illiterate) or > 20 (primary school) or > 24 (junior school or above). A 32-item frailty index (FI) was operationalized using various data at baseline to measure frailty. Neuropsychological assessments were conducted at two time points: at baseline, which occurred within 2 weeks to 6 months of the stroke onset, and at the six-month follow-up. Cognitive recovery was operationalized as unimpaired cognition (MoCA score≥26 and CDR = 0) after 6 months. Factors associated with recovery were defined through logistic regression analysis.ResultsAfter 6 months, 414 patients completed the follow-up with 53 (12.80%) presenting cognitive recovery. Contrary to expectations, frailty at baseline was not associated with cognitive recovery in patients with post-stroke SCC. A smaller proportion of women, higher baseline MoCA scores, and thalamus lesions were independently associated with high chance of cognitive recovery.ConclusionThis study found no association between baseline frailty and cognitive recovery at 6 months in post-stroke SCC patients. However, sex, higher baseline MoCA scores, and thalamic lesions independently predict cognitive function recovery in patients with SCC after stroke, which may influence the effectiveness of intervention measures.

ObjectiveTo determine whether the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism is associated with cognitive impairment (CI) in community-dwelling Chinese older adults, and to investigate whether this relationship is modified by the Apolipoprotein E (APOE) ɛ4 allele.MethodsThe study is a secondary analysis of 703 participants aged ≥60 years randomly enrolled from the Beijing Longitudinal Study of Aging II prospective cohort. The education-adjusted Mini-Mental State Examination and the Clinical Dementia Rating Scale were used to measure the cognitive performance of the subjects. The main effects and interactions (additive and multiplicative) of the BDNF Met and the APOE ε4 alleles on CI were estimated by logistic regression models.ResultsIn total, 84 out of 703 older adults aged ≥60 years old had CI. No significant difference was observed in the risk of CI between participants with the BDNF Met allele and that of subjects without the BDNF Met allele (p = 0.213; p = 0.164). Individuals carrying both the BDNF Met and APOE ε4 alleles had an almost 1.5-fold increased odds of CI compared with carriers of the BDNF Met allele but without the APOE ε4 allele. The additive association indicated a positive interaction of both BDNF Met and APOE ε4 alleles with wide CIs (p = 0.021; p = 0.018).ConclusionThe results suggest that the APOE ε4 allele may be a potential modifier for the association of the BDNF Val66Met polymorphism with CI in community-dwelling older adults.

The prevalence of postural tremor increases with age and the tremor has been found to be associated with aging‐related physiological decline. However, whether postural tremor in older adults is associated with adverse outcomes such as disability is unclear. This study investigated the association between postural tremor and the risk of disability in activities of daily living (ADL) among community‐dwelling older people.

Background and purpose The objective cognitive trajectory in patients with post-stroke subjective cognitive complaints (SCC) over time remained unknown. We investigated cognitive outcomes in patients with SCC within 1 year after stroke, and determined factors associated with cognitive recovery. Methods This study included 599 patients with a clinical diagnosis of post-stroke SCC and evidence of cognitive deficits including Clinical Dementia Rating Scale (CDR) = 0.5, Montreal Cognitive Assessment (MoCA) score <26, and Mini–Mental State Examination score >17 (illiterate) or >20 (primary school) or >24 (junior school or above). Neuropsychological assessment was performed at baseline (2 weeks to 6 months after stroke) and 6-month follow-up visit. Cognitive recovery was operationalized as unimpaired cognition (MoCA score ≥26 and CDR = 0) after 6 months. Factors associated with recovery were defined through logistic regression analysis. Results After 6 months, 583 patients completed the follow-up with 80 (13.72%) presenting cognitive recovery, among which, 22 (9.48%) cases reported SCC within 2 weeks after stroke, six (10%) at 15–30 days, 13 (15.12%) at 31–60 days, 10 (16.13%) at 61–90 days, five (10.42%) at 91–120 days, nine (23.08%) at 121–150 days, and 15 (26.79%) at 151–180 days. Compared to those reported cognitive complaints at 151–180 days after stroke, patients with early post-stroke SCC had poorer cognitive recovery, which was only significant in individuals with high level of education. Male sex, higher baseline MoCA scores, coffee intake and thalamus lesions were independently associated with high chance of cognitive recovery. Conclusions Although post-stroke SCC contributes to persisting objective cognitive deficits, some patients presented cognitive recovery within 1 year after stroke. Patients with a high education level reporting SCC at earlier stage after stroke had poorer cognitive recovery. Male, higher baseline MoCA scores, coffee intake and thalamus lesions appear to independently predict cognitive recovery.

Background Musculoskeletal pain is commonly experienced in patients with Parkinson's disease (PD). Few studies have investigated the clinical characteristics and risk factors associated with musculoskeletal pain. Objectives To investigate the distribution, clinical characteristics, and factors associated with musculoskeletal pain in a large sample of patients with PD. Methods We enrolled 452 patients from two clinics and used a standardized questionnaire to collect demographic and clinical information. Musculoskeletal pain was diagnosed based on the Ford Classification System, and pain severity was assessed with the numeric rating scale (NRS). Multivariate regression models explored the association between clinical features of PD and quality of life and pain. Results Two hundred and six patients (45.58%) reported musculoskeletal pain, typically in their lower limbs and backs. Levodopa resulted in a ≥30% reduction in pain intensity scores in 170 subjects. Female sex (odds ratio [OR], 1.57; 95% CI, 1.07–2.29) and Levodopa-equivalent daily doses (LEDDs; OR, 3.35; 95% CI, 1.63–6.59) were associated with an increased risk for musculoskeletal pain. Pain duration ( p = 0.017), motor symptoms ( p < 0.001), and depression ( p < 0.001) were significantly associated with quality of life. Conclusions The lower limbs and back are common sites of musculoskeletal pain in patients with PD, and up to 82.52% of patients were responsive to Levodopa. Female sex and LEDDs are associated with musculoskeletal pain, suggesting that dopamine deficiencies, and not the motor and non-motor impairment, might be the most critical baseline risk factor of musculoskeletal pain.

BACKGROUND:Apathy is a neuropsychiatric symptom frequently observed in patients with cognitive impairment. It has been found to be a predictor of conversion from mild cognitive impairment (MCI) to dementia of Alzheimer disease type. However, this association between apathy and dementia conversion has not yet been confirmed in vascular MCI, especially post-stroke MCI. The aim of this study was to evaluate whether apathy would increase the risk of dementia conversion in patients with post-stroke MCI after 6 months.METHOD:A prospective multi-centre cohort study was performed in 14 clinics in seven provinces and cities of China. A total of 989 subjects were included 2 weeks to 6 months after stroke, and met the diagnostic criteria of International Working Group for MCI. Symptoms of apathy were assessed using the apathy subscale of Geriatric Depression Scale. Subjects were divided into an apathy group (n = 128) and a non-apathy group (n = 861). The primary outcome was the dementia conversion after 6 months. To eliminate potential biases, subjects were chosen from 861 non-apathy patients with similarity in seven potential predictors of cognitive impairment to match with the apathy group (n = 128) at a 1:1 ratio, as a matched non-apathy group (n = 128). The dementia conversion rate was compared between the apathy group (n = 128) and its correspondingly matched non-apathy group (n = 128), and the relative risk (RR) was calculated.RESULTS:The prevalence of apathy in post-stroke MCI was 12.9%. After 6 months, 5.2% of patients with post-stroke MCI converted to dementia. The dementia conversion rate of the apathy group was significantly higher than that of the non-apathy group before case-matching (17.2% vs 3.4%, P < 0.001), and also after case-matching (17.2% vs 6.3%, P < 0.001). Symptoms of apathy increased the risk of conversion from MCI to dementia (RR 2.75, 95% CI 1.272-5.947, P < 0.001).CONCLUSIONS:For patients with post-stroke MCI, apathy symptoms increase the risk of conversion from MCI to dementia.

Dementia affects millions of elderly worldwide causing remarkable costs to society, but effective treatment is still lacking. Acupuncture is one of the complementary therapies that has been applied to cognitive deficits such as Alzheimer's disease (AD) and vascular cognitive impairment (VCI), while the underlying mechanisms of its therapeutic efficiency remain elusive. Neuroplasticity is defined as the ability of the nervous system to adapt to internal and external environmental changes, which may support some data to clarify mechanisms how acupuncture improves cognitive impairments. This review summarizes the up-to-date and comprehensive information on the effectiveness of acupuncture treatment on neurogenesis and gliogenesis, synaptic plasticity, related regulatory factors, and signaling pathways, as well as brain network connectivity, to lay ground for fully elucidating the potential mechanism of acupuncture on the regulation of neuroplasticity and promoting its clinical application as a complementary therapy for AD and VCI.

It was reported that acupuncture could treat Alzheimer’s disease (AD) with the potential mechanisms remaining unclear. The aim of the study is to explore the effect of the combination stimulus of Hegu (LI4) and Taichong (LR3) on the resting-state brain networks in AD, beyond the default network (DMN). Twenty-eight subjects including 14 AD patients and 14 healthy controls (HCs) matched by age, gender, and educational level were recruited in this study. After the baseline resting-state MRI scans, the manual acupuncture stimulation was performed for 3 minutes, and then, another 10 minutes of resting-state fMRI scans was acquired. In addition to the DMN, five other resting-state networks were identified by independent component analysis (ICA), including left frontal parietal network (lFPN), right frontal parietal network (rFPN), visual network (VN), sensorimotor network (SMN), and auditory network (AN). And the impaired connectivity in the lFPN, rFPN, SMN, and VN was found in AD patients compared with those in HCs. After acupuncture, significantly decreased connectivity in the right middle frontal gyrus (MFG) of rFPN ( P = 0.007 ) was identified in AD patients. However, reduced connectivity in the right inferior frontal gyrus (IFG) ( P = 0.047 ) and left superior frontal gyrus (SFG) ( P = 0.041 ) of lFPN and some regions of the SMN (the left inferior parietal lobula ( P = 0.004 ), left postcentral gyrus (PoCG) ( P = 0.001 ), right PoCG ( P = 0.032 ), and right MFG ( P = 0.010 )) and the right MOG of VN ( P = 0.003 ) was indicated in HCs. In addition, after controlling for the effect of acupuncture on HCs, the functional connectivity of the right cerebellum crus I, left IFG, and left angular gyrus (AG) of lFPN showed to be decreased, while the left MFG of IFPN and the right lingual gyrus of VN increased in AD patients. These findings might have some reference values for the interpretation of the combination stimulus of Hegu (LI4) and Taichong (LR3) in AD patients, which could deepen our understanding of the potential mechanisms of acupuncture on AD.

目的:探讨社区健康促进联合健康教育对改善脑卒中轻度认知障碍患者认知功能和日常生活能力的效果.方法:将40例脑卒中后轻度认知功能障碍患者采用随机信封法分为观察组和对照组,每组20例.观察组采用社区医师指导下的健康促进联合健康教育的干预方案,对照组仅接受基本的健康教育.干预前、干预6个月后采用蒙特利尔认知评估量表(MoCA)北京版评价认知功能,采用日常生活能力量表(ADL)评价日常生活能力.结果:观察组患者的视空间与执行力、命名、注意的评分均显著高于干预前,且高于对照组,差异均具有统计学意义(P<0.05);观察组患者的ADL评分低于干预前,且低于对照组,差异均具有统计学意义(P<0.05).结论:健康促进联合健康教育可改善脑卒中后轻度认知障碍患者的认知功能和日常行为能力.

Background Heterozygous mutations in the glucocerebrosidase gene (GBA) have been shown to be an important genetic risk factor for Parkinson's disease (PD) worldwide. However, the penetrance of GBA heterozygote for L444P, the common mutation for Asian population, is not known in older Chinese people. Objectives To assess the conversion rate to PD in identified carriers of GBA L444P/R mutations in Chinese community-dwelling older adults. Methods The GBA gene was sequenced for mutations at position 444 in 8405 people older than 55 years who participated in the Beijing Longitudinal Study on Aging II cohort. Nine subjects were identified as heterozygous carriers of GBA L444P or L444R mutations at baseline and clinically followed up from 2009 to 2019 to investigate their PD conversion, motor and nonmotor symptoms, and change of vesicular monoamine transporter type 2 using tracer of [F-18]9-fluoropropyl-(+)-dihydrotetrabenazine (F-18-DTBZ, also known as F-18-AV-133). Results Eight heterozygous GBA L444P and 1 L444R mutation carriers were identified without PD at baseline, and none of them developed clinical parkinsonism after a 10-year follow-up. Conclusions Although GBA mutations may lead to an earlier onset PD, the majority of GBA L444P heterozygotes in older adults may not convert to PD. Further studies are warranted to identify factors that modify the risk of conversion. (c) 2020 International Parkinson and Movement Disorder Society

In this study, we investigated the cross-sectional association of Self-perceived health (SPH) with frailty phenotype. A total of 4632 participants of the Beijing Longitudinal Study of Aging II (mean age 75.4 +/- 6.8years) were categorized into having good, fair, and poor SPH. Individuals were compared according to their frailty status (i.e., frail and prefrail vs robust) with SPH rating. The association of SPH with respect to the five components of frailty phenotype was further investigated. Older adults who were frail had lower odds of having good SPH (OR=0.64). Whereas frail and prefrail individuals had higher odds of having poor SPH (OR=6.26, OR=2.09 respectively). Having low education, polypharmacy, ADL and IADL disability, cognitive impairment, and depression was associated with a higher likelihood of having poor SPH. All components of frailty except weight loss was associated with poor SPH. SPH may serve as a tool to identify frail or prefrail individuals in the community. (C) 2020 Elsevier Inc. All rights reserved.

Objectives: To investigate the relationship between probable rapid eye movement (REM) sleep behavior disorder (pRBD) and cognitive/motor impairments in a community-dwelling population and explore the moderating effects of education. Methods: In this cross-sectional study of the Beijing Longitudinal Study of Aging II (BLSA II), 4,477 subjects (>= 55 years) fulfilled the inclusion criteria. pRBD was determined by the RBD Questionnaire-Hong Kong (RBDQ-HK). Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to test the global cognitive performance. Walking speed was used to measure motor function. Logistic regression was performed to assess the relationship between pRBD and cognitive/motor impairments and the moderating effects of education. Results: There were 147 participants (3.3%) with pRBD. Participants with pRBD showed increased risks for cognitive impairment [odds ratio (OR) = 1.88, 95% CI 1.24-2.85, p = 0.003], decreased gait speed (OR = 1.43, 95% CI 1.02-2.01, p = 0.03), but not for mild cognitive impairment (MCI) (measured by MoCA: OR = 1.01, 95% CI 0.68-1.50, p = 0.95; measured by MMSE: OR = 0.90, 95% CI 0.59-1.37, p = 0.62). Education modified the effect of pRBD on MCI (measured by MoCA: p < 0.001; measured by MMSE: p = 0.061) and gait speed (p = 0.008). Conclusions: Our findings suggest that pRBD increases the risk of cognitive/motor impairments for a community-dwelling older population, and education could alleviate the negative effects. These findings implicate that education may have beneficial effects on delaying the onset of cognitive/motor decline in pRBD subjects.

We sought to assess structural and functional patterns of cerebellum in multiple system atrophy (cerebellar type), and investigate the associations of structural and functional cerebellar gray matter abnormalities. We collected magnetic resonance imaging data of 18 patients with multiple system atrophy (cerebellar type) and 18 health control subjects. The gray matter loss across the motor and cognitive cerebellar territories in patients was assessed using voxel-based morphometry. And change in the connectivity between the cerebellum and large-scale cortical networks was assessed using resting-state functional MRI analysis. Furthermore, we assessed the relationship between the extent of cerebellar atrophy and reduced-activation in the cerebellar-cortical and subthalamo-cerebellar functional connectivities. We confirmed the gray matter loss across the motor and cognitive cerebellar territories in patients and found that the extent of cerebellar atrophy was correlated with decreased connectivity between the cerebellum and large-scale cortical networks, including the default, frontal parietal, and sensorimotor networks. The volume reduction in the motor cerebellum was closely associated with the clinical motor severity. A post hoc analysis showed reduced-activation in the subthalamo-cerebellar functional connectivity without the subthalamic nucleus atrophy. These results emphasized significant atrophy in the cerebellar subsystem and its association with the large-scale cortical networks in multiple system atrophy (cerebellar type), which may improve our understanding of the neural pathophysiology mechanisms of disease.

Objectives We sought to assess associations of postural tremor with gait and balance impairments among community-dwelling older people in both cross-sectional and longitudinal analyses. Design A prospective cohort study. Setting Communities in Beijing, China. Participants This study included 7075 individuals aged 55 years or older. Measurements Postural tremor was assessed using a two-step method (tremor screening followed by a confirmation examination of positive cases) at baseline. Gait and balance performances were measured with the Tinetti Mobility Test at baseline and 1 year later. Results At baseline, 45 (24.7%) of 182 tremor cases vs 663 (9.6%) of 6893 controls had gait and balance impairments. At 1-year follow-up, 19 (21.1%) of 90 tremor cases vs 416 (9.8%) of 4262 controls experienced a rapid decline in gait and balance performance. After controlling for potential confounders, postural tremor was associated with gait and balance impairments at baseline (odds ratio [OR] = 1.77; 95% confidence interval [CI] = 1.20-2.62; p = .004) and a rapid decline in gait and balance performance at 1-year follow-up (OR = 1.99; 95% CI = 1.17-3.39; p = .01). Conclusion In this population-based cohort study, we found postural tremor was associated with gait and balance impairments among community-dwelling older people in both cross-sectional and longitudinal analyses. Our findings suggest that motor function should be routinely evaluated and monitored in older people with postural tremor. J Am Geriatr Soc 67:799-803, 2019.

The Cistanche species ("Rou Cong Rong" in Chinese) is an endangered wild species growing in arid or semi-arid areas. The dried fleshy stem of Cistanches has been used as a tonic in China for many years. Modern pharmacological studies have since demonstrated that Herba Cistanches possesses broad medicinal functions, especially for use in anti-senescence, anti-oxidation, neuroprotection, anti-inflammation, hepatoprotection, immunomodulation, anti-neoplastic, anti-osteoporosis and the promotion of bone formation. This review summarizes the up-to-date and comprehensive information on Herba Cistanches covering the aspects of the botany, traditional uses, phytochemistry and pharmacology, to lay ground for fully elucidating the potential mechanisms of Herba Cistanches' anti-aging effect and promote its clinical application as an anti-aging herbal medicine.

The Cistanche species (“Rou Cong Rong” in Chinese) is an endangered wild species growing in arid or semi-arid areas. The dried fleshy stem of Cistanches has been used as a tonic in China for many years. Modern pharmacological studies have since demonstrated that Herba Cistanches possesses broad medicinal functions, especially for use in anti-senescence, anti-oxidation, neuroprotection, anti-inflammation, hepatoprotection, immunomodulation, anti-neoplastic, anti-osteoporosis and the promotion of bone formation. This review summarizes the up-to-date and comprehensive information on Herba Cistanches covering the aspects of the botany, traditional uses, phytochemistry and pharmacology, to lay ground for fully elucidating the potential mechanisms of Herba Cistanches’ anti-aging effect and promote its clinical application as an anti-aging herbal medicine.

目的:综合评价中医综合干预方案对卒中后轻度认知功能障碍患者的临床疗效.方法:纳入卒中后轻度认知功能障碍患者,随机分为治疗组、对照组,治疗组给予中药(复方苁蓉益智胶囊)+中医特色疗法+非药物干预,对照组给予非药物干预,疗程180d.采用蒙特利尔认知评估量表(MoCA)、日常生活活动能力量表(ADL)及中医核心症状对干预方案进行综合评价.结果:干预180d后,治疗组较对照组MoCA总分显著提高明显(P＜0.01);两组ADL总分均较干预前下降(P＜0.01,P＜0.05);治疗组对“言谈不知首尾,时作时止” “转盼遗忘”“语后便忘,思量不能”“神思不聚”“言语懒”“兴趣索然”“烦躁易怒”等7条中医核心症状有显著改善作用(P＜0.01,P＜0.05).结论:中医综合干预方案能够改善卒中后轻度认知功能障碍患者认知功能,提高日常生活能力,改善中医核心症状,具有较好的临床疗效.

目的:分析NIHSS评分为0分的脑卒中患者认知功能损害特点、危险因素及中医证候要素特点,为脑卒中后认知障碍防治提供依据.方法:选择NIHSS评分为0分的脑卒中患者816例,观察其认知水平,采集基本资料、中医症状、舌象、脉象等信息,6个月后进行随访,观察认知功能变化,分析认知功能损害特点.根据认知功能下降与否分为认知功能下降组和非认知功能下降组,比较两组人群认知功能损害危险因素及中医症状、舌象、脉象及证候要素.结果:NIHSS评分为0分的脑卒中患者认知功能下降涉及视空间与执行能力、记忆力、计算力、语言等多方面,表现为大脑高级智能的全面下降.两组冠状动脉粥样硬化性心脏病史、脑卒中类型差异显著(P＜0.01),证候要素分布呈现显著差异(P＜0.01).结论:冠状动脉粥样硬化性心脏病史、腔隙性脑梗死与NIHSS评分为0分的脑卒中患者认知功能下降相关,患者证候要素复杂多样,特别是认知功能下降的患者多以复合证候要素为主,症状表现形式多样.