Middleton Laura E, Kirkland Susan A, Maxwell Colleen J, Hogan David B, Rockwood Kenneth
Division of Geriatric Medicine, Dalhousie University, Halifax, Canada.
J Am Geriatr Soc. 2007 Jul;55(7):1095-8. doi: 10.1111/j.1532-5415.2007.01238.x.
To investigate whether exercise confounds the relationship between folate and cerebrovascular events, all-cause dementia, and Alzheimer's disease.
Prospective cohort study.
Multiple centers in Canada.
In the Canadian Study of Health and Aging, 466 people reported exercise levels, had folate measurements, and were not demented at baseline. After 5 years, 194 had adverse cerebrovascular events, and 65 had dementia (Alzheimer's disease in 47).
Associations between folate and cerebrovascular outcomes were examined using logistic regression in the presence and absence of exercise and other confounders.
Folate was associated with greater risk of Alzheimer's disease (odds ratio (OR)=2.12, 95% confidence interval (CI)=1.01-4.54) and cerebrovascular outcomes (OR=2.05, 95% CI=1.11-3.78) in adjusted analyses before the inclusion of exercise and neared significance with all-cause dementia (OR=1.80, 95% CI=0.94-3.45). After the inclusion of exercise, the association between folate and dementia and Alzheimer's disease was 29% and 25% lower, respectively, and neither association was any longer significant (Alzheimer's disease: OR=1.91, 95% CI=0.89-4.11; all-cause dementia: OR=1.62, 95% CI=0.84-3.15). Exercise was a significant confounder in the relationship between folate and Alzheimer's disease (P=.03) and dementia (P=.003) but not cerebrovascular outcomes (P=.64). Unlike folate, exercise was significantly associated with Alzheimer's disease (OR=0.43, 95% CI=0.19-0.98) and dementia (OR=0.35, 95% CI=0.17-0.72) in adjusted analyses.
Exercise seems to account for much of the relationship between folate and incident dementia and Alzheimer's disease.
研究运动是否会混淆叶酸与脑血管事件、全因性痴呆和阿尔茨海默病之间的关系。
前瞻性队列研究。
加拿大多个中心。
在加拿大健康与老龄化研究中，466人报告了运动水平，进行了叶酸测量，且在基线时未患痴呆症。5年后，194人发生了不良脑血管事件，65人患有痴呆症（47人患有阿尔茨海默病）。
在有或无运动及其他混杂因素的情况下，使用逻辑回归分析叶酸与脑血管结局之间的关联。
在纳入运动因素之前的调整分析中，叶酸与阿尔茨海默病风险增加相关（比值比（OR）=2.12，95%置信区间（CI）=1.01 - 4.54）以及脑血管结局相关（OR = 2.05，95% CI = 1.11 - 3.78），与全因性痴呆接近显著相关（OR = 1.80，95% CI = 0.94 - 3.45）。纳入运动因素后，叶酸与痴呆症和阿尔茨海默病之间的关联分别降低了29%和25%，且两者均不再显著（阿尔茨海默病：OR = 1.91，95% CI = 0.89 - 4.11；全因性痴呆：OR = 1.62，95% CI = 0.84 - 3.15）。运动是叶酸与阿尔茨海默病（P = 0.03）和痴呆症（P = 0.003）之间关系的显著混杂因素，但不是脑血管结局的显著混杂因素（P = 0.64）。与叶酸不同，在调整分析中，运动与阿尔茨海默病（OR = 0.43，95% CI = 0.19 - 0.98）和痴呆症（OR = 0.35，95% CI = 0.17 - 0.72）显著相关。
运动似乎在很大程度上解释了叶酸与新发痴呆症和阿尔茨海默病之间的关系。
Zotero 插件