Alonso Alvaro, Jacobs David R, Menotti Alessandro, Nissinen Aulikki, Dontas Anastasios, Kafatos Anthony, Kromhout Daan
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
J Neurol Sci. 2009 May 15;280(1-2):79-83. doi: 10.1016/j.jns.2009.02.004. Epub 2009 Feb 28.
Previous research shows that cardiovascular risk factors in mid-adulthood could increase the risk of dementia later in life, but studies with very long follow-up are still scarce. We assessed whether cardiovascular risk factors measured in midlife were associated with dementia mortality during a 40-year follow-up. 10,211 men, aged 40-59 at baseline, from 13 cohorts of the Seven Countries Study were followed for 40 years. Information on cardiovascular risk factors was obtained at baseline from questionnaires and a physical examination. Dementia death was assigned if there was any mention of dementia on the death certificate. Associations between cardiovascular risk factors and death from dementia were estimated through Cox proportional hazards models. We identified 160 dementia deaths during the follow-up. Smoking, hypercholesterolemia, high blood pressure, low forced vital capacity and previous history of cardiovascular disease at baseline were associated with a higher risk of death from dementia in the follow-up. The hazard ratio (HR) of dementia death among heavy smokers was 1.58 (95% confidence interval (CI) 1.03, 2.43) compared to non-smokers. Similarly, the HR (95% CI) among those with systolic BP>or=160 or diastolic BP>or=95 mm Hg compared to normotensives (<140/90) was 1.55 (1.02, 2.35). Individuals with the largest forced vital capacity had a lower risk of dying of dementia (HR 0.54, 95% CI 0.30, 0.98). Finally, total serum cholesterol was directly associated with higher risk of dementia mortality (p for trend=0.03). In men, cardiovascular risk factors in midlife are associated with increased risk of dementia death later in life.
先前的研究表明，中年时期的心血管危险因素可能会增加晚年患痴呆症的风险，但随访时间很长的研究仍然很少。我们评估了中年时测量的心血管危险因素与40年随访期间的痴呆症死亡率是否相关。对来自七国研究13个队列的10211名男性进行了40年的随访，这些男性在基线时年龄为40 - 59岁。通过问卷调查和体格检查在基线时获取心血管危险因素的信息。如果死亡证明上提及任何痴呆症相关内容，则判定为痴呆症死亡。通过Cox比例风险模型估计心血管危险因素与痴呆症死亡之间的关联。我们在随访期间确定了160例痴呆症死亡病例。基线时吸烟、高胆固醇血症、高血压、低用力肺活量和心血管疾病既往史与随访期间更高的痴呆症死亡风险相关。与不吸烟者相比，重度吸烟者中痴呆症死亡的风险比（HR）为1.58（95%置信区间（CI）为1.03, 2.43）。同样，与血压正常者（<140/90）相比，收缩压≥160或舒张压≥95 mmHg者的HR（95%CI）为1.55（1.02, 2.35）。用力肺活量最大的个体死于痴呆症的风险较低（HR 0.54，95%CI 0.30, 0.98）。最后，血清总胆固醇与痴呆症死亡风险升高直接相关（趋势p = 0.03）。在男性中，中年时期的心血管危险因素与晚年痴呆症死亡风险增加相关。
