Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatrics, University of Ferrara, Via Savonarola 9, 44100 Ferrara, Italy.
J Gerontol A Biol Sci Med Sci. 2010 May;65(5):559-64. doi: 10.1093/gerona/glq026. Epub 2010 Mar 18.
To evaluate the association between plasma lipid fractions and the prevalence of dementia in a large sample of Italian older individuals.
A total of 1051 older community-dwelling individuals (age >/=65 years), enrolled in the InChianti study, were included. Diagnosis of dementia was established at baseline and at the 3-year follow-up using Diagnostic and Statistical Manual of Mental Disorder (Fourth Edition) criteria. Plasma lipids were measured by standardized methods at baseline and after 3 years.
At baseline, 61 individuals (5.8%) were affected by dementia. Demented individuals showed significantly lower total cholesterol (TC), nonhigh-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C) levels compared with controls; no differences were found in triglycerides (TG) and lipoprotein (a) levels. Of the 819 subjects reevaluated at the 3-year follow-up, 81 (9.9%) received a new diagnosis of dementia. Again, demented subjects were characterized by significantly lower TC, non-HDL-C, and HDL-C levels compared with controls, thus confirming the baseline findings. At multivariate logistic regression analysis, HDL-C levels (odds ratio: 0.96, 95% confidence interval: 0.93-0.99), but not TG and non-HDL-C, were associated with dementia independent of important confounders including age, gender, apo E phenotype, stroke, weight loss, interleukin 6 levels, and ankle-brachial index.
Among community-dwelling older people, individuals affected by dementia showed significantly lower TC, non-HDL-C, and HDL-C levels; however, at multivariate analysis, only HDL-C was associated with dementia. Our results suggest the existence of an independent relationship between dementia and low HDL-C levels.
评估血浆脂质成分与意大利老年人痴呆患病率之间的关联。
共有 1051 名年龄大于等于 65 岁的社区居住的老年人参加了 InChianti 研究。痴呆的诊断是基于基线和 3 年随访时的《精神障碍诊断与统计手册》（第四版）标准建立的。基线和 3 年后用标准化方法测量血浆脂质。
基线时，61 人（5.8%）患有痴呆。与对照组相比，痴呆患者的总胆固醇（TC）、非高密度脂蛋白胆固醇（non-HDL-C）和高密度脂蛋白胆固醇（HDL-C）水平明显较低；而甘油三酯（TG）和脂蛋白（a）水平没有差异。在 819 名重新评估的受试者中，81 人（9.9%）在 3 年随访时被新诊断为痴呆。同样，与对照组相比，痴呆患者的 TC、non-HDL-C 和 HDL-C 水平明显较低，这再次证实了基线研究的结果。在多元逻辑回归分析中，HDL-C 水平（比值比：0.96，95%置信区间：0.93-0.99），而不是 TG 和 non-HDL-C，与痴呆独立相关，重要的混杂因素包括年龄、性别、载脂蛋白 E 表型、中风、体重减轻、白细胞介素 6 水平和踝臂指数。
在社区居住的老年人中，患有痴呆的患者 TC、non-HDL-C 和 HDL-C 水平明显较低；然而，在多变量分析中，只有 HDL-C 与痴呆有关。我们的研究结果表明，痴呆与低 HDL-C 水平之间存在独立的关系。
