Wilson Robert S, Boyle Patricia A, Levine Steven R, Yu Lei, Hoganson George M, Buchman Aron S, Schneider Julie A, Bennett David A
Rush Alzheimer's Disease Center.
Department of Neurology, SUNY Downstate Medical Center.
Neuropsychology. 2014 Mar;28(2):305-11. doi: 10.1037/neu0000022. Epub 2013 Dec 23.
Harm avoidance, a trait indicative of behavioral inhibition, is associated with disability and dementia in old age, but the basis of these associations is uncertain. We test the hypothesis that higher level of harm avoidance is associated with increased likelihood of cerebral infarction.
Older persons without dementia completed a standard measure of harm avoidance. During a mean of 3.5 years of follow-up, 257 (of 1,082) individuals died of whom 206 (80%) underwent brain autopsy. The number of chronic cerebral infarcts (microscopic plus gross; expressed as 0, 1, or >1) was assessed on neuropathologic examination, completed in 192 individuals at the time of analyses.
On postmortem examination, chronic cerebral infarcts were found in 89 (42 with 1, 47 with >1). Higher harm avoidance was associated with higher likelihood of infarcts (odds ratio = 1.083, 95% confidence interval = 1.040-1.128). A moderately high level of the trait (score = 17, 75th percentile) was associated with a 2.4-fold increase in the likelihood of infarction compared with a moderately low level of the trait (score = 6, 25th percentile). These associations persisted in models that controlled for other cardiovascular risk factors.
Higher level of the harm avoidance trait may be a risk factor for cerebral infarction.
避免伤害是一种行为抑制特征，与老年时的残疾和痴呆有关，但这些关联的基础尚不确定。我们检验了以下假设：较高水平的避免伤害与脑梗死可能性增加有关。
无痴呆的老年人完成了一项避免伤害的标准测量。在平均3.5年的随访期间，1082名个体中有257人死亡，其中206人（80%）接受了脑部尸检。在分析时对192名个体进行了神经病理学检查，评估慢性脑梗死的数量（微观加宏观；表示为0、1或>1）。
尸检发现89例有慢性脑梗死（42例为1个，47例为>1个）。较高的避免伤害水平与梗死可能性较高相关（比值比=1.083，95%置信区间=1.040-1.128）。与该特征中等低水平（得分=6，第25百分位数）相比，该特征中等高水平（得分=17，第75百分位数）与梗死可能性增加2.4倍相关。在控制了其他心血管危险因素的模型中，这些关联仍然存在。
较高水平的避免伤害特征可能是脑梗死的一个危险因素。
