School of Pharmacy, University of Eastern Finland, Kuopio, Finland; School of Pharmacy, Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland.
School of Pharmacy, University of Eastern Finland, Kuopio, Finland; School of Pharmacy, Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland; Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Alzheimers Dement. 2017 Dec;13(12):1371-1379. doi: 10.1016/j.jalz.2017.04.010. Epub 2017 Jun 7.
Many previous studies have been limited by self- or proxy-reported injury or short follow-up. We investigated whether head or brain injuries are associated with Alzheimer's disease (AD), possible modifying factors and dose-response relationship.
Nested register-based case-control study of all community dwellers who received clinically verified AD diagnosis in Finland in 2005 to 2011 (n = 70,719) and one to four matched controls for each case (n of controls = 282,862).
The magnitude of association between hospital-treated head and/or brain injuries was strongly dependent on the lag time between exposure and outcome. With a 5-year lag time, head injury (adjusted odds ratio; 95% confidence interval 1.19; 1.15-1.23) or brain injury (1.23; 1.18-1.29) was associated with higher risk of AD. Dose-response relationship with number and severity of injuries was observed. Associations were stronger in those with earlier onset of AD.
Stronger associations with shorter lag times indicate that head and/or brain injuries may also reflect the ongoing AD disease process.
许多先前的研究受到自我或代理报告的伤害或短期随访的限制。我们研究了头部或脑部受伤是否与阿尔茨海默病（AD）有关，以及可能的修饰因素和剂量反应关系。
基于注册的病例对照研究，纳入了 2005 年至 2011 年间在芬兰居住的所有社区居民，他们均接受了临床证实的 AD 诊断（n=70719），并为每个病例匹配了 1 至 4 名对照者（n 对照者=282862）。
暴露与结局之间的时间间隔对医院治疗的头部和/或脑部损伤之间的关联程度有很大影响。在 5 年的时间间隔内，头部损伤（调整后的优势比；95%置信区间 1.19；1.15-1.23）或脑部损伤（1.23；1.18-1.29）与 AD 的风险增加有关。观察到与受伤次数和严重程度的剂量反应关系。在 AD 发病较早的患者中，相关性更强。
与较短的时间间隔的更强关联表明，头部和/或脑部损伤也可能反映 AD 疾病的持续过程。
