Chandra V, Kokmen E, Schoenberg B S, Beard C M
Neuroepidemiology Branch NINDS, Bethesda, MD.
Neurology. 1989 Dec;39(12):1576-8. doi: 10.1212/wnl.39.12.1576.
We identified all incident cases of clinically diagnosed Alzheimer's disease among the population of Rochester, MN, with onset from 1965 through 1974. A control (selected from the same community) was matched to each case by age, race, sex, and length of stay in Rochester. We studied 274 case-control pairs. Using the records linkage system available for residents of this community, we abstracted information on the occurrence of head trauma with loss of consciousness (LOC) from the medical records of both cases and controls. There were 5 pairs in which the case suffered an episode of head trauma with LOC but the control did not, and 4 pairs in which the control suffered an episode of head trauma with LOC but the case did not. We failed to detect a statistically significant difference between the 2 groups. This study overcomes many problems encountered in previous case-control studies reporting this association. The sample size was large; severity of head injury was documented in high-quality medical records; data about head injury were recorded before the onset of dementia: equal quality of data were available for cases and controls; and, since the study was population-based, there was no selection bias for cases or controls.
我们确定了明尼苏达州罗切斯特市1965年至1974年发病的所有临床诊断为阿尔茨海默病的病例。从同一社区选取对照，使其在年龄、种族、性别以及在罗切斯特的居住时长上与每个病例匹配。我们研究了274对病例对照。利用该社区居民可用的记录链接系统，我们从病例和对照的医疗记录中提取了有关伴有意识丧失（LOC）的头部外伤发生情况的信息。有5对中病例发生了伴有LOC的头部外伤事件而对照没有，有4对中对照发生了伴有LOC的头部外伤事件而病例没有。我们未检测到两组之间存在统计学上的显著差异。本研究克服了先前报告这种关联的病例对照研究中遇到的许多问题。样本量很大；高质量医疗记录中记录了头部损伤的严重程度；有关头部损伤的数据在痴呆症发病之前就已记录；病例和对照可获得同等质量的数据；并且，由于该研究基于人群，病例或对照不存在选择偏倚。
