Wang C, Ji X, Wu X, Tang Z, Zhang X, Guan S, Liu H, Fang X
Prof Xianghua Fang, Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University. No 45 Changchun street, Xicheng district, Beijing, China. Tel: +861083199295; fax: +861063153439 E-mail address:
J Nutr Health Aging. 2017;21(6):648-654. doi: 10.1007/s12603-016-0798-7.
To explore the relationship of general health decline assessed by frailty and risk of dementia and Alzheimer's disease (AD).
A seven-year prospective cohort study.
Secondary analysis of data from the Beijing Longitudinal Study on Aging.
Urban and rural community-dwelling people aged 60 and older at baseline.
Frailty was quantified using the deficit accumulation-based frailty index (FI), constructed from 40 health deficits at baseline. Dementia was diagnosed by DSM-IIIR. AD and vascular dementia (VaD) were diagnosed by NINCDS-ADRDA and NINDS-AIREN. The relationships between frailty and the risk of dementia, AD and death were evaluated through multivariable models.
Of 2788 participants at baseline (1997), 171 (11.1%) reported a history of dementia. In seven years, 351 people developed dementia (13%: 223 AD and 128 other types of dementia) and 813 died (29%). After adjustment for age, sex, education, and baseline cognition, baseline frailty status significantly associated with Alzheimer's disease and dementia and death. For each deficit accumulated, the odds ratio of death increased by 5.7%, and the odds ratio of dementia increased by 2.9% (p < 0.001).
Frailty was associated with Alzheimer's disease and dementia over a seven years period. Frailty index might facilitate the identification of older adults at high risk of dementia for the application of the most effective, targeted prevention strategies.
探讨通过衰弱评估的总体健康状况下降与痴呆症及阿尔茨海默病（AD）风险之间的关系。
一项为期七年的前瞻性队列研究。
对北京老年纵向研究的数据进行二次分析。
基线时年龄在60岁及以上的城乡社区居民。
使用基于缺陷累积的衰弱指数（FI）对衰弱进行量化，该指数由基线时的40项健康缺陷构建而成。痴呆症根据《精神疾病诊断与统计手册》第三版修订本（DSM-IIIR）进行诊断。AD和血管性痴呆（VaD）分别根据美国国立神经疾病和中风研究所 - 阿尔茨海默病及相关疾病协会（NINCDS-ADRDA）和美国国立神经疾病和中风研究所 - 瑞士神经科学研究国际协会（NINDS-AIREN）的标准进行诊断。通过多变量模型评估衰弱与痴呆症、AD及死亡风险之间的关系。
在基线时（1997年）的2788名参与者中，171人（11.1%）报告有痴呆症病史。七年内，351人患上痴呆症（13%：223例AD和128例其他类型痴呆症），813人死亡（29%）。在对年龄、性别、教育程度和基线认知进行调整后，基线衰弱状态与阿尔茨海默病、痴呆症及死亡显著相关。每累积一项缺陷，死亡的比值比增加5.7%，痴呆症的比值比增加2.9%（p < 0.001）。
在七年期间，衰弱与阿尔茨海默病和痴呆症相关。衰弱指数可能有助于识别痴呆症高风险的老年人，以便应用最有效、有针对性的预防策略。
