Inzelberg Rivka, Massarwa Magda, Schechtman Edna, Strugatsky Rosa, Farrer Lindsay A, Friedland Robert P
Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Israel The Sagol Neuroscience Center, Department of Neurology, Sheba Medical Center, Israel.
Department of Neurology, Hillel Yaffe Medical Center, Hadera, Israel.
J Alzheimers Dis. 2015;45(3):865-71. doi: 10.3233/JAD-142871.
Vascular risk factors and lack of formal education may increase the risk of Alzheimer's disease (AD).
To determine the contribution of vascular risk factors and education to the risk of mild cognitive impairment (MCI) and AD and to estimate the risk for conversion from MCI to AD.
This door-to-door survey was performed by an Arab-speaking team in Wadi Ara villages in Israel. All consenting residents aged ≥ 65 years were interviewed for medical history and underwent neurological and cognitive examinations. Individuals were cognitively classified as normal (CN), MCI, AD, vascular dementia, or unclassifiable. MCI patients were re-examined at least one year later to determine conversion to AD. The contributions of age, gender, school years, and vascular risk factors to the probability of conversion were estimated using logistic regression models.
Of the 906 participants, 297 (33%) had MCI and 95 (10%) had AD. Older age (p = 0.0008), female gender (p = 0.023), low schooling (p < 0.0001), and hypertension (p = 0.0002) significantly accounted for risk of MCI versus CN, and diabetes was borderline (p = 0.051). The risk of AD versus CN was significantly associated with age (p < 0.0001), female gender (p < 0.0001), low schooling (p = 0.004) and hypertension (p = 0.049). Of the 231 subjects with MCI that were re-examined, 65 converted to AD.
In this population, age, female gender, lack of formal education, and hypertension are risk factors for both AD and MCI. Conversion risk from MCI to AD could be estimated as a function of age, time interval between examinations, and hypertension.
血管危险因素和缺乏正规教育可能会增加患阿尔茨海默病（AD）的风险。
确定血管危险因素和教育程度对轻度认知障碍（MCI）和AD风险的影响，并估计MCI转化为AD的风险。
由一个讲阿拉伯语的团队在以色列瓦迪阿拉村进行了这项挨家挨户的调查。所有年龄≥65岁且同意参与的居民均接受了病史访谈，并接受了神经学和认知检查。个体在认知上被分类为正常（CN）、MCI、AD、血管性痴呆或无法分类。MCI患者至少在一年后重新接受检查以确定是否转化为AD。使用逻辑回归模型估计年龄、性别、受教育年限和血管危险因素对转化概率的影响。
在906名参与者中，297人（33%）患有MCI，95人（10%）患有AD。年龄较大（p = 0.0008）、女性（p = 0.023）、受教育程度低（p < 0.0001）和高血压（p = 0.0002）显著增加了MCI相对于CN的风险，糖尿病处于临界值（p = 0.051）。AD相对于CN的风险与年龄（p < 0.0001）、女性（p < 0.0001）、受教育程度低（p = 0.004）和高血压（p = 0.049）显著相关。在重新接受检查的231名MCI受试者中，65人转化为AD。
在该人群中，年龄、女性、缺乏正规教育和高血压是AD和MCI的危险因素。MCI转化为AD的风险可以根据年龄、检查间隔时间和高血压来估计。
