Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.
Neuroepidemiology. 2012;38(1):56-63. doi: 10.1159/000334632. Epub 2012 Jan 6.
Generational differences in disease rates are the main subject of age-period-cohort (APC) analysis, which is mostly applied in cancer and suicide research. This study applied APC analysis to selected neurological diseases: amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD) and multiple sclerosis (MS).
The analyses were based on Swiss mortality data. Age-stratified data has been available for MS, PD and ALS since 1901, 1921, and 1942, respectively. APC analysis was performed within the framework of logit models. Main effect models were extended by implementing nested effects, i.e. age effects nested in subperiods, in order to account for the fact that age profiles may change for reasons other than generational influences.
In preliminary analyses, APC analysis yielded noteworthy birth cohort effects in all three diseases. After implementing nested effects, the birth cohort effects disappeared in ALS, and smoothed out in PD, where they were greater for the generations born before the 1920s. In MS, the birth cohort effects remained stable, and exhibited a peak in cohorts born in the 1910s and 1920s.
APC analysis yielded some evidence for birth cohort effects, i.e. predisposing risk factors that may change in historical terms, in MS and PD, but probably not in ALS.
代际疾病发病率差异是年龄-时期-队列（APC）分析的主要课题，该分析方法主要应用于癌症和自杀研究。本研究将 APC 分析应用于选择的神经退行性疾病：肌萎缩侧索硬化症（ALS）、帕金森病（PD）和多发性硬化症（MS）。
分析基于瑞士死亡率数据。自 1901 年、1921 年和 1942 年以来，MS、PD 和 ALS 分别有按年龄分层的数据。APC 分析是在逻辑模型框架内进行的。主要效应模型通过嵌套效应进行扩展，即将年龄效应嵌套在子时期中，以说明年龄分布可能因代际影响以外的原因而发生变化。
在初步分析中，APC 分析在所有三种疾病中均产生了显著的出生队列效应。实施嵌套效应后，ALS 中的出生队列效应消失，PD 中的出生队列效应趋于平稳，在 20 世纪 20 年代之前出生的代际中更为明显。在 MS 中，出生队列效应保持稳定，并在 20 世纪 10 年代和 20 年代出生的队列中出现峰值。
APC 分析为 MS 和 PD 中的出生队列效应提供了一些证据，即可能随历史变化的易感危险因素，但在 ALS 中可能没有。
