Yarchoan Mark, James Bryan D, Shah Raj C, Arvanitakis Zoe, Wilson Robert S, Schneider Julie, Bennett David A, Arnold Steven E
The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA.
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
J Alzheimers Dis. 2017;56(2):699-706. doi: 10.3233/JAD-160977.
Cancer and Alzheimer's disease (AD) are common diseases of aging and share many risk factors. Surprisingly, however, epidemiologic data from several recent independent cohort studies suggest that there may be an inverse association between these diseases.
To determine the relationship between history of cancer and odds of dementia proximate to death and neuropathological indices of AD.
Using data from two separate clinical-pathologic cohort studies of aging and AD, the Religious Orders Study (ROS) and the Rush Memory and Aging Project (MAP), we compared odds of AD dementia proximate to death among participants with and without a history of cancer. We then examined the relation of history of cancer with measures of AD pathology at autopsy, i.e., paired helical filament tau (PHFtau) neurofibrillary tangles and amyloid-β load.
Participants reporting a history of cancer had significantly lower odds of AD (OR 0.70 [0.55-0.89], p = 0.0040) proximate to death as compared to participants reporting no prior history of cancer. The results remained significant after adjusting for multiple risk factors including age, sex, race, education, and presence of an APOEɛ4 allele. At autopsy, participants with a history of cancer had significantly fewer PHFtau tangles (p < 0.001) than participants without a history of cancer, but similar levels of amyloid-β.
Cancer survivors have reduced odds of developing AD and a lower burden of neurofibrillary tangle deposition.
癌症和阿尔茨海默病（AD）是常见的老年疾病，且有许多共同的风险因素。然而，令人惊讶的是，最近几项独立队列研究的流行病学数据表明，这两种疾病之间可能存在负相关。
确定癌症病史与临终时痴呆几率以及AD神经病理学指标之间的关系。
利用两项关于衰老和AD的独立临床病理队列研究（宗教团体研究（ROS）和拉什记忆与衰老项目（MAP））的数据，我们比较了有和没有癌症病史的参与者临终时患AD痴呆的几率。然后，我们研究了癌症病史与尸检时AD病理学指标的关系，即配对螺旋丝tau（PHFtau）神经原纤维缠结和淀粉样β蛋白负荷。
与没有癌症病史的参与者相比，有癌症病史的参与者临终时患AD的几率显著降低（比值比0.70[0.55 - 0.89]，p = 0.0040）。在对包括年龄、性别、种族、教育程度和APOEɛ4等位基因存在情况等多个风险因素进行调整后，结果仍然显著。尸检时，有癌症病史的参与者的PHFtau缠结明显少于没有癌症病史的参与者（p < 0.001），但淀粉样β蛋白水平相似。
癌症幸存者患AD的几率降低，神经原纤维缠结沉积负担也较低。
