A complex picture of factors influencing cognition is necessary to be drawn for a better understanding of the role of potentially modifiable factors in dementia. The aim was to assess the prevalence and determinants of cognitive impairment, including the role of cerebral small vessel disease (CSVD) in Polish middle-aged cohort. A comprehensive set of clinical (hypertension, coronary heart disease, diabetes mellitus, hyperlipidaemia, body mass index, smoking status, alcohol intake) and socio-demographic data was collected in the PURE study in years 2007–2016, which was the basis for detailed analysis of risk factors of cognitive impairments in years 2016–2018 in the PURE-MIND sub-study. Five hundred forty-seven subjects (age range 39–65, mean 56.2 ± 6.5) underwent neuropsychological assessment with Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT) and Digit Symbol Substitution Test (DSST) followed by brain MRI. Mean MoCA score was 26.29 and 33% participants met criteria for mild cognitive impairment (MCI) (MoCA< 26). Seventy-three percent showed findings related to CSVD. Higher WMH burden and lacunar infarcts were associated with lower MoCA and DSST scores. Severe CSVD was associated with twofold incidence of MCI, and obesity increased its probability by 53% and hypertension by 37%. The likelihood of MCI was reduced in nonsmokers. One factor analysis showed the important role of lower level of education, older age, rural area of residence and hypertension. MCI and CSVD are highly prevalent in the middle-aged population in Poland. A greater importance should be given to potentially modifiable risk factors of dementia which are already present in mid-life.

为了更好地理解潜在可改变因素在痴呆症中的作用，有必要绘制一张影响认知因素的复杂图景。目的是评估认知障碍的患病率和决定因素，包括脑小血管疾病 (CSVD) 在波兰中年队列中的作用。在 2007-2016 年的 PURE 研究中收集了一套全面的临床（高血压、冠心病、糖尿病、高脂血症、体重指数、吸烟状况、酒精摄入量）和社会人口学数据，这是详细研究的基础PURE-MIND 子研究 2016-2018 年认知障碍危险因素分析。547 名受试者（年龄范围 39-65，平均 56.2 ± 6.5）接受了蒙特利尔认知评估 (MoCA) 的神经心理学评估，跟踪测试 (TMT) 和数字符号替换测试 (DSST)，然后进行脑部 MRI。平均 MoCA 评分为 26.29，33% 的参与者符合轻度认知障碍 (MCI) 标准 (MoCA<26)。73% 的调查结果与 CSVD 有关。较高的 WMH 负担和腔隙性梗死与较低的 MoCA 和 DSST 评分相关。严重的 CSVD 与 MCI 的发病率增加了两倍，肥胖增加了 53% 的概率和 37% 的高血压。非吸烟者发生 MCI 的可能性降低。一因素分析显示受教育程度低、年龄大、居住地农村和高血压的重要作用。MCI 和 CSVD 在波兰的中年人群中非常普遍。应该更加重视已经存在于中年的痴呆的潜在可改变风险因素。