心脏病与痴呆症和阿尔茨海默病的长期风险：一项基于人群的CAIDE研究
Heart diseases and long-term risk of dementia and Alzheimer's disease: a population-based CAIDE study.
作者信息
Rusanen Minna, Kivipelto Miia, Levälahti Esko, Laatikainen Tiina, Tuomilehto Jaakko, Soininen Hilkka, Ngandu Tiia
机构信息
Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland Aging Research Center, Karolinska Institutet, Stockholm, Sweden Karolinska Institutet Alzheimer's Disease Research Center, Stockholm, Sweden.
出版信息
J Alzheimers Dis. 2014;42(1):183-91. doi: 10.3233/JAD-132363.
BACKGROUND
Many cardiovascular risk factors are shown to increase the risk of dementia and Alzheimer's disease (AD), but the impact of heart disease on later development of dementia is still unclear.
OBJECTIVE
The aim of the study was to investigate the long-term risk of dementia and Alzheimer's disease (AD) related to midlife and late-life atrial fibrillation (AF), heart failure (HF), and coronary artery disease (CAD) in a population-based study with a follow-up of over 25 years.
METHODS
Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study includes 2000 participants who were randomly selected from four separate, population-based samples originally studied in midlife (1972, 1977, 1982, or 1987). Re-examinations were carried out in 1998 and 2005-2008. Altogether 1,510 (75.5%) persons participated in at least one re-examination, and 127 (8.4%) persons were diagnosed with dementia (of which 102 had AD).
RESULTS
AF in late-life was an independent risk factor for dementia (HR 2.61, 95% CI 1.05-6.47; p = 0.039) and AD (HR 2.54, 95% CI 1.04-6.16; p = 0.040) in the fully adjusted analyses. The association was even stronger among the apolipoprotein E (APOE) ε4 non-carriers. Late-life HF, but not CAD, tended to increase the risks as well. Heart diseases diagnosed at midlife did not increase the risk of later dementia and AD.
CONCLUSION
Late-life heart diseases increase the subsequent risk of dementia and AD. Prevention and effective treatment of heart diseases may be important also from the perspective of brain health and cognitive functioning.
背景
许多心血管危险因素被证明会增加患痴呆症和阿尔茨海默病（AD）的风险，但心脏病对痴呆症后期发展的影响仍不明确。
目的
本研究的目的是在一项随访超过25年的基于人群的研究中，调查与中年和老年心房颤动（AF）、心力衰竭（HF）和冠状动脉疾病（CAD）相关的痴呆症和阿尔茨海默病（AD）的长期风险。
方法
心血管危险因素、衰老与痴呆（CAIDE）研究包括2000名参与者，他们是从最初在中年（1972年、1977年、1982年或1987年）进行研究的四个独立的基于人群的样本中随机选取的。1998年以及2005 - 2008年进行了重新检查。共有1510人（75.5%）至少参加了一次重新检查，127人（8.4%）被诊断患有痴呆症（其中102人患有AD）。
结果
在完全调整分析中，老年AF是痴呆症（风险比[HR] 2.61，95%置信区间[CI] 1.05 - 6.47；p = 0.039）和AD（HR 2.54，95% CI 1.04 - 6.16；p = 0.040）的独立危险因素。在载脂蛋白E（APOE）ε4非携带者中，这种关联甚至更强。老年HF，但不是CAD，也倾向于增加风险。中年诊断出的心脏病不会增加后期患痴呆症和AD的风险。
结论
老年心脏病会增加随后患痴呆症和AD的风险。从大脑健康和认知功能的角度来看，预防和有效治疗心脏病可能也很重要。
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