Department of Neurology, Mayo Clinic College of Medicine, Rochester MN, Scottsdale, AZ, USA.
Neurology. 2013 Aug 27;81(9):833-40. doi: 10.1212/WNL.0b013e3182a2cbd1. Epub 2013 Jul 26.
To determine the risk factors associated with dementia with Lewy bodies (DLB).
We identified 147 subjects with DLB and sampled 2 sex- and age-matched cognitively normal control subjects for each case. We also identified an unmatched comparison group of 236 subjects with Alzheimer disease (AD). We evaluated 19 candidate risk factors in the study cohort.
Compared with controls, subjects with DLB were more likely to have a history of anxiety (odds ratio; 95% confidence interval) (7.4; 3.5-16; p < 0.0001), depression (6.0; 3.7-9.5; p < 0.0001), stroke (2.8; 1.3-6.3; p = 0.01), a family history of Parkinson disease (PD) (4.6; 2.5-8.6; p < 0.0001), and carry APOE ε4 alleles (2.2; 1.5-3.3; p < 0.0001), but less likely to have had cancer (0.44; 0.27-0.70; p = 0.0006) or use caffeine (0.29; 0.14-0.57; p < 0.0001) with a similar trend for alcohol (0.65; 0.42-1.0; p = 0.0501). Compared with subjects with AD, subjects with DLB were younger (72.5 vs 74.9 years, p = 0.021) and more likely to be male (odds ratio; 95% confidence interval) (5.3; 3.3-8.5; p < 0.0001), have a history of depression (4.3; 2.4-7.5; p < 0.0001), be more educated (2.5; 1.1-5.6; p = 0.031), have a positive family history of PD (5.0; 2.4-10; p < 0.0001), have no APOE ε4 alleles (0.61; 0.40-0.93; p = 0.02), and to have had an oophorectomy before age 45 years (7.6; 1.5-39; p = 0.015).
DLB risk factors are an amalgam of those for AD and PD. Smoking and education, which have opposing risk effects on AD and PD, are not risk factors for DLB; however, depression and low caffeine intake, both risk factors for AD and PD, increase risk of DLB more strongly than in either.
确定与路易体痴呆（DLB）相关的风险因素。
我们确定了 147 例 DLB 患者，并为每例患者匹配了 2 名性别和年龄相匹配的认知正常对照者。我们还确定了 236 例阿尔茨海默病（AD）的未匹配对照组。我们在研究队列中评估了 19 个候选风险因素。
与对照组相比，DLB 患者更有可能有焦虑史（比值比；95%置信区间）（7.4；3.5-16；p<0.0001）、抑郁史（6.0；3.7-9.5；p<0.0001）、中风史（2.8；1.3-6.3；p=0.01）、帕金森病家族史（4.6；2.5-8.6；p<0.0001）和携带 APOE ε4 等位基因（2.2；1.5-3.3；p<0.0001），但癌症史（0.44；0.27-0.70；p=0.0006）和咖啡因摄入史（0.29；0.14-0.57；p<0.0001）较少，酒精摄入史（0.65；0.42-1.0；p=0.0501）也有类似趋势。与 AD 患者相比，DLB 患者年龄较小（72.5 岁 vs 74.9 岁，p=0.021），更有可能为男性（比值比；95%置信区间）（5.3；3.3-8.5；p<0.0001）、有抑郁史（4.3；2.4-7.5；p<0.0001）、受教育程度较高（2.5；1.1-5.6；p=0.031）、有阳性帕金森病家族史（5.0；2.4-10；p<0.0001）、没有 APOE ε4 等位基因（0.61；0.40-0.93；p=0.02），并且在 45 岁之前进行过卵巢切除术（7.6；1.5-39；p=0.015）。
DLB 的风险因素是 AD 和 PD 的风险因素的混合体。吸烟和教育对 AD 和 PD 有相反的风险作用，不是 DLB 的风险因素；然而，抑郁和低咖啡因摄入，这两个 AD 和 PD 的风险因素，比在任何一个疾病中都更强烈地增加了 DLB 的风险。
