基于列线图模型评估血压变异性和血浆同型半胱氨酸水平对老年双相情感障碍患者认知损害的预测价值OA

Objective To construct a nomogram model for predicting cognitive impairment in older patients with bipolar disorder(BD)based on blood pressure variability(BPV)and plasma homocysteine(Hcy)level.Methods The clinical data of 126 older patients with BD diagnosed and treated in Mental Health Center of Wuhan City from July 2023 to December 2024 were retrospectively selected.Patients were divided into cognitive impairment group(n=61)and non-cognitive impairment group(n=65)based on the presence or absence of cognitive impairment.Logistic regression analysis was used to analyze the influencing factors of cognitive impairment in older patients with BD,and a nomogram model was established.Results The incidence of cognitive impairment in 126 older patients with BD was 48.41%.Frequency of episodes,disease classification,daytime systolic coefficient of variation(dSCV),nighttime systolic coefficient of variation(nSCV),nighttime diastolic coefficient of variation(nDCV),and plasma Hcy level were all influencing factors for cognitive impairment in older patients with BD(P＜0.05).A nomogram model was constructed and its C-index was 0.953.The calibration curves tended to approach the ideal curve.The area under the curve value of the model's receiver operator characteristic curve was 0.947.The net benefit value of the model was positive within a prediction range 0%-98%.Conclusion BPV indicators and plasma Hcy level have high value in predicting the risk of cognitive impairment.The prediction model constructed in this study can effectively predict the risk of cognitive impairment.