Tsutsumimoto Kota, Makizako Hyuma, Doi Takehiko, Hotta Ryo, Nakakubo Sho, Makino Keitaro, Shimada Hiroyuki, Suzuki Takao
Section for Health Promotion,Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
Section for Health Promotion,Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
Am J Geriatr Psychiatry. 2017 Jun;25(6):607-616. doi: 10.1016/j.jagp.2016.12.008. Epub 2017 Jan 4.
Although subjective memory complaints (SMCs) are considered a risk factor for incident dementia in older people, the effect might differ based on cognitive function. The aim of the present study was to investigate whether the effect of SMCs on the incidence of dementia in older people differed based on cognitive function.
A 24-month follow-up cohort study.
Japanese community.
Prospective, longitudinal data for incident dementia were collected for 3,672 participants (mean age: 71.7 years; 46.5% men) for up to 24 months.
Baseline measurements included covariates for incident dementia, SMCs, and cognitive function. Associations between SMCs, cognitive impairment, and incident dementia were examined using Cox proportional hazards models.
Incidences of dementia in the cognitively intact without SMC, cognitively intact with SMC, cognitive impairment without SMC, and cognitive impairment with SMC groups were 0.3%, 1.8%, 3.4%, and 4.8%, respectively. In the cognitively intact participants, SMCs were associated with a significantly higher risk of dementia (hazard ratio [HR]: 4.95, 95% confidence interval [CI]: 1.52-16.11, p = 0.008). Incident dementia with cognitive impairment was not significantly different based on SMC presence (p = 0.527). Participants with cognitive impairment in multiple domains had a significantly higher risk of incident dementia (HR: 2.07, 95% CI: 1.01-4.24, p = 0.046) CONCLUSION: SMCs were related with dementia in cognitively intact older people, but not in those with cognitive impairment.Multiple domains of cognitive impairment were associated with a higher risk of incident dementia.
尽管主观记忆抱怨（SMCs）被认为是老年人发生痴呆症的一个风险因素，但这种影响可能因认知功能而异。本研究的目的是调查老年人中SMCs对痴呆症发病率的影响是否因认知功能而异。
一项为期24个月的随访队列研究。
日本社区。
收集了3672名参与者（平均年龄：71.7岁；46.5%为男性）长达24个月的新发痴呆症的前瞻性纵向数据。
基线测量包括新发痴呆症的协变量、SMCs和认知功能。使用Cox比例风险模型检查SMCs、认知障碍和新发痴呆症之间的关联。
认知功能正常且无SMCs、认知功能正常且有SMCs、认知障碍且无SMCs以及认知障碍且有SMCs组的痴呆症发病率分别为0.3%、1.8%、3.4%和4.8%。在认知功能正常的参与者中，SMCs与痴呆症风险显著升高相关（风险比[HR]：4.95，95%置信区间[CI]：1.52 - 16.11，p = 0.008）。基于是否存在SMCs，伴有认知障碍的新发痴呆症没有显著差异（p = 0.527）。多个领域存在认知障碍的参与者发生新发痴呆症的风险显著更高（HR：2.07，95% CI：1.01 - 4.24，p = 0.046）。结论：SMCs与认知功能正常的老年人患痴呆症有关，但与认知障碍者无关。多个领域的认知障碍与新发痴呆症的较高风险相关。
