Leiden University Medical Center, Department of Psychiatry, NL-2300 RC Leiden, The Netherlands.
Dement Geriatr Cogn Disord. 2009;28(5):433-41. doi: 10.1159/000255600. Epub 2009 Nov 10.
BACKGROUND/AIMS: Because poor lung function may be a risk factor for cognitive decline, we aimed to test the association of respiratory function with cognitive function and dementia later in life, as well as potential effect modification by APOE epsilon4 carrier status.
In a prospective population-based cohort study, forced vital capacity and forced expiratory flow were measured around 1965 in 857 men aged 45-64 years (394 from Finland, 208 from The Netherlands, and 255 from Italy). The Mini-Mental State Examination scores around 1990, 1995 and 2000 were analyzed using multilevel regression models and the Clinical Dementia Rating score around 1990 using multinomial logistic regression analyses.
Midlife lung function was positively associated with cognitive function in old age in APOE epsilon4 non-carriers, but not in carriers (p < 0.05 for interaction). In Finland and Italy, 18.6% had questionable to mild dementia and 2.8% moderate to severe dementia after 25 years of follow-up. Dementia was inversely related to midlife lung function in APOE epsilon4 non-carriers, but not in carriers (p < 0.05 for interaction).
Small lung volumes were prospectively associated with an increased risk for poor cognitive function and dementia in non-carriers of the APOE epsilon4 gene.
背景/目的：由于肺功能不佳可能是认知能力下降的一个风险因素，我们旨在检验呼吸功能与认知功能和晚年痴呆的相关性，以及 APOE ε4 载脂蛋白状态的潜在修饰作用。
在一项前瞻性的基于人群的队列研究中，于 1965 年左右对 857 名年龄在 45-64 岁的男性（394 名来自芬兰，208 名来自荷兰，255 名来自意大利）进行了用力肺活量和用力呼气流量的测量。使用多层次回归模型分析了 1990 年、1995 年和 2000 年左右的 Mini-Mental State 考试成绩，使用多项逻辑回归分析了 1990 年左右的临床痴呆评定分数。
在 APOE ε4 非携带者中，中年时的肺功能与老年时的认知功能呈正相关，但在携带者中则无此相关性（交互作用 p<0.05）。在芬兰和意大利，25 年随访后，18.6%的人有可疑至轻度痴呆，2.8%的人有中度至重度痴呆。在 APOE ε4 非携带者中，痴呆与中年时的肺功能呈负相关，但在携带者中则无此相关性（交互作用 p<0.05）。
小的肺容量与 APOE ε4 基因非携带者认知功能和痴呆的风险增加有前瞻性关联。
