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在一个阿尔茨海默病中心队列中,自我报告的头部损伤与晚年功能障碍及阿尔茨海默病病理的风险

Self-reported head injury and risk of late-life impairment and AD pathology in an AD center cohort.

作者信息

Abner Erin L, Nelson Peter T, Schmitt Frederick A, Browning Steven R, Fardo David W, Wan Lijie, Jicha Gregory A, Cooper Gregory E, Smith Charles D, Caban-Holt Allison M, Van Eldik Linda J, Kryscio Richard J

机构信息

University of Kentucky Alzheimer's Disease Center, Sanders-Brown Center on Aging, University of Kentucky, Lexington, Ky., USA.

出版信息

Dement Geriatr Cogn Disord. 2014;37(5-6):294-306. doi: 10.1159/000355478. Epub 2013 Dec 31.

Abstract

AIMS

To evaluate the relationship between self-reported head injury and cognitive impairment, dementia, mortality, and Alzheimer's disease (AD)-type pathological changes.

METHODS

Clinical and neuropathological data from participants enrolled in a longitudinal study of aging and cognition (n = 649) were analyzed to assess the chronic effects of self-reported head injury.

RESULTS

The effect of self-reported head injury on the clinical state depended on the age at assessment: for a 1-year increase in age, the OR for the transition to clinical mild cognitive impairment (MCI) at the next visit for participants with a history of head injury was 1.21 and 1.34 for the transition from MCI to dementia. Without respect to age, head injury increased the odds of mortality (OR = 1.54). Moreover, it increased the odds of a pathological diagnosis of AD for men (OR = 1.47) but not women (OR = 1.18). Men with a head injury had higher mean amyloid plaque counts in the neocortex and entorhinal cortex than men without.

CONCLUSIONS

Self-reported head injury is associated with earlier onset, increased risk of cognitive impairment and dementia, increased risk of mortality, and AD-type pathological changes.

摘要

目的

评估自我报告的头部损伤与认知障碍、痴呆、死亡率以及阿尔茨海默病(AD)型病理变化之间的关系。

方法

对参加衰老与认知纵向研究的参与者(n = 649)的临床和神经病理学数据进行分析,以评估自我报告的头部损伤的长期影响。

结果

自我报告的头部损伤对临床状态的影响取决于评估时的年龄:年龄每增加1岁,有头部损伤史的参与者在下一次就诊时转变为临床轻度认知障碍(MCI)的比值比为1.21,从MCI转变为痴呆的比值比为1.34。不考虑年龄因素,头部损伤会增加死亡几率(比值比 = 1.54)。此外,头部损伤会增加男性AD病理诊断的几率(比值比 = 1.47),但不会增加女性的几率(比值比 = 1.18)。有头部损伤的男性在新皮质和内嗅皮质中的平均淀粉样斑块计数高于没有头部损伤的男性。

结论

自我报告的头部损伤与发病较早、认知障碍和痴呆风险增加、死亡风险增加以及AD型病理变化有关。

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