Atti Anna Rita, Palmer Katie, Volpato Stefano, Zuliani Giovanni, Winblad Bengt, Fratiglioni Laura
Aging Research Centre, Division of Geriatric Epidemiology, Department of Neurotec, Karolinska Institutet and Stockholm Gerontology Research Center, Stockholm, Sweden.
Neurobiol Aging. 2006 Feb;27(2):278-84. doi: 10.1016/j.neurobiolaging.2005.02.007.
Although cross-sectional studies found an association between anaemia and dementia, longitudinal studies provided contradictory results. We hypothesize that anaemia might increase the risk of developing dementia because of chronic brain hypo-oxygenation. Using baseline data from a community-based longitudinal study, the Kungsholmen Project, Stockholm, Sweden, we clinically followed 1435 non demented subjects aged 75-95 years for 3 years to detect incident dementia cases (DSM-III-R criteria). Subjects that fulfilled WHO criteria for anaemia, baseline haemoglobin concentration; 130 g/L (men) and 120 g/L (women), had a higher hazard ratios (HR) of developing dementia 3 years later (HR 1.6, 95% CI: 1.1-2.4). In persons with good baseline cognition (MMSE>or=26, n=1139), the association was stronger and still significant after adjustments for conditions potentially related to anaemia and dementia, such as chronic diseases, inflammatory markers, and indicators of nutritional status. The HR was increased even when different haemoglobin cut offs for anaemia definition were used. Thus, anaemia is suggested to be a new potential modifiable risk factor for dementia.
尽管横断面研究发现贫血与痴呆之间存在关联，但纵向研究结果却相互矛盾。我们推测，由于慢性脑缺氧，贫血可能会增加患痴呆症的风险。利用瑞典斯德哥尔摩 Kungsholmen 项目这一基于社区的纵向研究的基线数据，我们对 1435 名年龄在 75 - 95 岁之间的非痴呆受试者进行了为期 3 年的临床随访，以检测新发痴呆病例（采用 DSM - III - R 标准）。符合世界卫生组织贫血标准（基线血红蛋白浓度：男性 130 g/L，女性 120 g/L）的受试者，3 年后患痴呆症的风险比（HR）更高（HR 1.6，95%置信区间：1.1 - 2.4）。在基线认知良好（简易精神状态检查表得分≥26，n = 1139）的人群中，这种关联更强，在对可能与贫血和痴呆相关的状况（如慢性病、炎症标志物和营养状况指标）进行调整后，该关联仍然显著。即使采用不同的血红蛋白临界值来定义贫血，风险比仍会升高。因此，贫血被认为是痴呆症一个新的潜在可改变风险因素。
