Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan.
J Alzheimers Dis. 2010;22(2):673-82. doi: 10.3233/JAD-2010-100318.
We aimed to investigate the natural history of Alzheimer's disease (AD) and the risk factors associated with survival. We performed a 5-year retrospective cohort study on 467 consecutive outpatients clinically diagnosed with AD and treated between January 1, 2003, and December 31, 2006, at Huashan Hospital, Shanghai, China. The primary endpoint in this study was survival. At baseline, we evaluated the patients' demographic characteristics and neuropsychological characteristics, comorbid conditions, neuroimaging findings, complications, and neurological signs. Among the 467 patients, 398 survived. Male gender, age, and disease severity were associated with mortality. Survival analysis using the proportional hazard model with adjustments for gender, age, and disease stage revealed that the cognition factors that predicted longer survival included high total score [hazard ratio (HR), 0.85; 95% confidence interval (CI), 0.76-0.96] and sub-scores in the verbal fluency test (animals, vegetables, and fruits). The presence of at least 1 complication was an independent factor predictive of a decreased lifespan (HR, 5.55; 95% CI, 1.91-16.13). In AD patients, presence of complications was an indicator of poor survival, while good performance in assessments of executive function, such as the verbal fluency test and Stroop test, at baseline was associated with longer survival.
我们旨在研究阿尔茨海默病（AD）的自然史和与生存相关的危险因素。我们对 2003 年 1 月 1 日至 2006 年 12 月 31 日期间在中国上海华山医院临床诊断为 AD 并接受治疗的 467 例连续门诊患者进行了为期 5 年的回顾性队列研究。本研究的主要终点是生存。在基线时，我们评估了患者的人口统计学特征和神经心理学特征、合并症、神经影像学发现、并发症和神经体征。在 467 例患者中，398 例存活。性别、年龄和疾病严重程度与死亡率相关。使用调整了性别、年龄和疾病阶段的比例风险模型进行生存分析显示，预测生存时间更长的认知因素包括总评分较高[风险比（HR），0.85；95%置信区间（CI），0.76-0.96]和言语流畅性测验（动物、蔬菜和水果）的子评分较高。至少存在 1 种并发症是降低预期寿命的独立预测因素（HR，5.55；95%CI，1.91-16.13）。在 AD 患者中，并发症的存在是生存不良的指标，而基线时执行功能评估（如言语流畅性测验和 Stroop 测验）表现良好与生存时间延长相关。
