Mortimer J A, van Duijn C M, Chandra V, Fratiglioni L, Graves A B, Heyman A, Jorm A F, Kokmen E, Kondo K, Rocca W A
Geriatric Research, Education and Clinical Center, Veterans Affairs Medical Center, Minneapolis, Minnesota.
Int J Epidemiol. 1991;20 Suppl 2:S28-35. doi: 10.1093/ije/20.supplement_2.s28.
A re-analysis of the data from 11 case-control studies was performed to investigate the association between head trauma and Alzheimer's disease (AD). To increase comparability of studies, exposures were limited to head trauma with loss of consciousness (hereafter referred to as 'head trauma') and comparisons were restricted to community (versus hospital) controls. Test for heterogeneity across studies was negative; consequently, data were pooled in subsequent analyses. The pooled relative risk for head trauma was 1.82 (95% confidence interval: 1.26-2.67). Stratified analyses showed stronger associations in cases without a positive family history of dementia and in males (versus females). Adjustment of the pooled relative risk for family history of dementia, education and alcohol consumption did not alter significantly the association between head trauma and AD. There was no interaction effect between head trauma and family history of dementia, suggesting that these risk factors operate independently. Mean age of onset was not significantly different in cases with a history of head trauma compared to cases without such a history. The findings of the pooled analysis support an association between reported head trauma and AD.
对11项病例对照研究的数据进行了重新分析，以调查头部创伤与阿尔茨海默病（AD）之间的关联。为提高研究的可比性，暴露因素仅限于伴有意识丧失的头部创伤（以下简称“头部创伤”），对照则限于社区（而非医院）对照。各研究间异质性检验为阴性；因此，后续分析将数据进行了合并。头部创伤的合并相对风险为1.82（95%置信区间：1.26 - 2.67）。分层分析显示，在无痴呆症家族史阳性的病例以及男性（与女性相比）中关联更强。对痴呆症家族史、教育程度和饮酒情况进行合并相对风险调整后，头部创伤与AD之间的关联未发生显著改变。头部创伤与痴呆症家族史之间不存在交互作用，表明这些风险因素独立起作用。有头部创伤史的病例与无此病史的病例相比，平均发病年龄无显著差异。合并分析的结果支持所报告的头部创伤与AD之间存在关联。
