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1936年洛锡安出生队列中脑小血管疾病的早期生活特征与晚年负担

Early life characteristics and late life burden of cerebral small vessel disease in the Lothian Birth Cohort 1936.

作者信息

Field Thalia S, Doubal Fergus N, Johnson Wendy, Backhouse Ellen, McHutchison Caroline, Cox Simon, Corley Janie, Pattie Alison, Gow Alan J, Shenkin Susan, Cvoro Vera, Morris Zoe, Staals Julie, Bastin Mark, Deary Ian J, Wardlaw Joanna M

机构信息

University of British Columbia, S169-2211 Wesbrook Mall, Vancouver BC, V6T 2B5, Canada.

Division of Clinical Neurosciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

出版信息

Aging (Albany NY). 2016 Sep 19;8(9):2039-2061. doi: 10.18632/aging.101043.

Abstract

It is unknown whether relations between early-life factors and overall health in later life apply to burden of cerebral small vessel disease (cSVD), a major cause of stroke and dementia. We explored relations between early-life factors and cSVD in the Lothian Birth Cohort, a healthy aging cohort. Participants were recruited at age 70 (N = 1091); most had completed a test of cognitive ability at age 11 as part of the Scottish Mental Survey of 1947. Of those, 700 participants had brain MRI that could be rated for cSVD conducted at age 73. Presence of lacunes, white matter hyperintensities, microbleeds, and perivascular spaces were summed in a score of 0-4 representing all MRI cSVD features. We tested associations with early-life factors using multivariate logistic regression. Greater SVD score was significantly associated with lower age-11 IQ (OR higher SVD score per SD age-11 IQ = .78, 95%CI 0.65-.95, p=.01). The associations between SVD score and own job class (OR higher job class, .64 95%CI .43-.95, p=.03), age-11 deprivation index (OR per point deprivation score, 1.08, 95%CI 1.00-1.17, p=.04), and education (OR some qualifying education, .60 95%CI .37-.98, p=.04) trended towards significance (p<.05 for all) but did not meet thresholds for multiple testing. No early-life factor was significantly associated with any one individual score component. Early-life factors may contribute to age-73 burden of cSVD. These relations, and the potential for early social interventions to improve brain health, deserve further study.

摘要

早年生活因素与晚年总体健康之间的关系是否适用于脑小血管疾病(cSVD,中风和痴呆的主要原因)尚不清楚。我们在洛锡安出生队列(一个健康老龄化队列)中探索了早年生活因素与cSVD之间的关系。参与者在70岁时招募(N = 1091);作为1947年苏格兰精神调查的一部分,大多数人在11岁时完成了认知能力测试。其中,700名参与者在73岁时进行了可用于评估cSVD的脑部MRI检查。腔隙、白质高信号、微出血和血管周围间隙的存在情况被汇总为一个0至4分的分数,代表所有MRI的cSVD特征。我们使用多变量逻辑回归测试了与早年生活因素的关联。更高的SVD分数与11岁时较低的智商显著相关(每标准差11岁智商对应的更高SVD分数的OR = 0.78,95%CI 0.65 - 0.95,p = 0.01)。SVD分数与自身职业类别(更高职业类别的OR,0.64,95%CI 0.43 - 0.95,p = 0.03)、11岁时的贫困指数(每点贫困分数的OR,1.08,95%CI 1.00 - 1.17,p = 0.04)和教育程度(有一些合格教育的OR,0.60,95%CI 0.37 - 0.98,p = 0.04)之间的关联有显著趋势(所有p < 0.05),但未达到多重检验的阈值。没有早年生活因素与任何一个单独的分数成分显著相关。早年生活因素可能导致73岁时的cSVD负担。这些关系以及早期社会干预改善脑健康的潜力值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63a6/5076451/2bf65307a14a/aging-08-2039-g001.jpg

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