Luck T, Luppa M, Matschinger H, Jessen F, Angermeyer M C, Riedel-Heller S G
Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
Acta Psychiatr Scand. 2015 Apr;131(4):290-6. doi: 10.1111/acps.12328. Epub 2014 Sep 9.
In this study, we aimed to analyze the association between new-incident-subjective memory complaints (SMC) and risk of subsequent dementia in a general population sample aged 75+ years.
Data were derived from follow-up (FUP) waves I-V of the population-based Leipzig Longitudinal Study of the Aged (LEILA75+). We used the Kaplan-Meier survival method to estimate dementia-free survival times of individuals with and without incident SMC and multivariable Cox proportional hazards regression to assess the association between incident SMC and risk of subsequent dementia, controlled for covariates.
Of 443 non-demented individuals, 58 (13.1%) developed dementia during a subsequent 5.4-year follow-up period. Participants with incident SMC showed a significantly higher progression to dementia (18.5% vs. 10.0%; P=0.010) and a significantly shorter mean dementia-free survival time than those without (6.2 vs. 6.8 years; P=0.008). The association between incident SMC and risk of subsequent dementia remained significant in the multivariable Cox analysis (adjusted hazard ratio=1.8; P=0.028).
Our findings suggest higher progression to dementia and shorter dementia-free survival in older individuals with incident SMC. These findings support the notion that such subjective complaints should be taken seriously in clinical practice as possible early indicators of incipient dementia.
在本研究中，我们旨在分析75岁及以上普通人群样本中新发主观记忆障碍（SMC）与后续患痴呆症风险之间的关联。
数据来源于基于人群的莱比锡老年纵向研究（LEILA75+）的随访（FUP）I-V波。我们使用Kaplan-Meier生存方法来估计有和没有新发SMC的个体的无痴呆生存时间，并使用多变量Cox比例风险回归来评估新发SMC与后续患痴呆症风险之间的关联，并对协变量进行了控制。
在443名非痴呆个体中，58名（13.1%）在随后5.4年的随访期内患上了痴呆症。有新发SMC的参与者患痴呆症的进展明显更高（18.5%对10.0%；P=0.010），且无痴呆平均生存时间明显短于无新发SMC的参与者（6.2年对6.8年；P=0.008）。在多变量Cox分析中，新发SMC与后续患痴呆症风险之间的关联仍然显著（调整后的风险比=1.8；P=0.028）。
我们的研究结果表明，有新发SMC的老年人患痴呆症的进展更高，无痴呆生存时间更短。这些结果支持了这样一种观点，即在临床实践中，此类主观症状应作为早期痴呆症的可能早期指标予以重视。
